Rupture of the proximal tendon enthesis of the hamstring muscle (ICM) accounts for approximately 10% of all injuries of the ICM. It occurs most commonly in athletes and active middle-aged individuals. The complete rupture of all three tendons in active patients is generally seen as an indication for surgical repair of the tendon enthesis; however, the correct diagnosis is often not reached in a timely manner. This can lead to prolonged symptoms with pain, weakness and neuralgia. Operative treatment consists of anchor repair of the tendons resulting in good clinical outcome in several case series. Good knowledge of the anatomy and operative approach are mandatory to avoid complications as well as compliance with a gradual rehabilitation scheme to allow tendon to bone healing. The main aim of this review is to highlight the typical history, clinical presentation and examination technique to reach an immediate clinical diagnosis which should be confirmed with a magnetic resonance imaging (MRI) scan.
A 72-year-old patient with an implanted cardiac pacemaker presented with a circumscribed erythematous area on his chest. It was only several months later, after he had developed positional, localized pain in this area, that the diagnosis of an impending pacemaker extrusion became evident. This case illustrates the diagnostic difficulties in patients with pacemaker-associated skin lesions. Regular follow-up examinations and close co-operation of dermatologists, cardiologists and cardiothoracic surgeons are of major importance in view of the potentially life-threatening complications.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.