We present a case report of a patient with severe valgus deformity of the right knee due to multiple hereditary exostoses (MHEs) treated with total knee arthroplasty (TKA). The surgical management of MHE affecting the knee encompasses exostoses resection, joint deformity rectification, and limb-length discrepancy alignment. On rare occasions, distraction osteogenesis and TKA have been used to correct valgus deformities of the knee. TKA in MHE patients with knee involvement has only been described in 6 cases. Several considerations, such as extensive knowledge of frequently occurring skeletal aberrations, are required to successfully correct the deformities associated with MHE via TKA. This report describes a case of severe valgus knee deformity with a rotational component in MHE managed with TKA, the surgical technique, and future recommendations.
Purpose Retinitis pigmentosa (RP) is a group of inherited dystrophies with great clinical genetic and evolutionary heterogeneity. We report a patient with retinitis pigmentosa who presented a bilateral intermediate uveitis with cystoid macular edema associated and no other systemic disease. Methods A 16 year old man with a history of Retinosis pigmentosa since birth presented blurred vision associated with a bilateral intermediate uveitis. The visual acuity was 0,4, Tyndall ++, and intense vitritis with snowballs in both eyes. All systemic examinations were normal (analytics, autoimmunity and serology tests). Results Patient was treated with orals corticosteroids maintained in decreasing doses. Response to treatment was favorable, but then macular edema appeared. Due to the inability to control uveitis symptoms with steroids, azathioprine was associated and response has been favorable with resolution of macular edema and decreasing inflammation. Conclusion RP includes a large group of degenerative and hereditary diseases that may be associated with a number of ocular complications. Intermediate uveitis is a rare complication described but can cause decreased vision and requiring monitoring and appropriate treatment for their control.
Case Report. A 47-year-old man presented with blurred vision in the right eye. Ophthalmoscopic examination showed several placoid, pigmented lesions in the posterior pole and midperiphery of the retina of both eyes. Results. Patient referred a cutaneous malignant melanoma on the back skin removed 6 years ago. A systemic workup revealed multiple metastases in liver and spleen. After an exhaustive study we concluded that it was a dissemination of a cutaneous malignant melanoma with bilateral choroidal metastases, liver and spleen metastases. The patient obtained clinical ocular improvement after palliative chemotherapy, although he died in the following months. Pathological examination of the lesions confirmed the diagnosis of choroidal metastases from a malignant cutaneous melanoma. Conclusions. Monitoring patients who have had cutaneous malignant melanoma is very important, since melanoma metastases may occur even many years after the diagnosis of the primary tumor. Choroidal metastases from cutaneous melanoma are uncommon but we should be aware because their appearance worsens prognosis.
Case Report. A 47-year-old man presented with blurred vision in the right eye. Ophthalmoscopic examination showed several placoid, pigmented lesions in the posterior pole and midperiphery of the retina of both eyes. Results. Patient referred a cutaneous malignant melanoma on the back skin removed 6 years ago. A systemic workup revealed multiple metastases in liver and spleen. After an exhaustive study we concluded that it was a dissemination of a cutaneous malignant melanoma with bilateral choroidal metastases, liver and spleen metastases. The patient obtained clinical ocular improvement after palliative chemotherapy, although he died in the following months. Pathological examination of the lesions confirmed the diagnosis of choroidal metastases from a malignant cutaneous melanoma. Conclusions. Monitoring patients who have had cutaneous malignant melanoma is very important, since melanoma metastases may occur even many years after the diagnosis of the primary tumor. Choroidal metastases from cutaneous melanoma are uncommon but we should be aware because their appearance worsens prognosis.
Purpose To present a case report of a patient with acute dacryoadenitis as an atypical clinical presentation of Sjögren Syndrome. Methods A 37‐year‐old female developed acute left dacryoadenitis with poor response to oral corticosteroids. She had no history of any other clinical symptoms. During the following weeks she developed cervical lymphadenopathies, arthralgia and mild asthenia. Complete blood analysis, imaging diagnostic techniques, C‐reactive protein (CRP) and autoimmunity tests showed normal results, but high levels of anti‐Ro antibodies were found, suggesting Sjögren Syndrome (SS) as the etiopathological cause. Results All symptoms and clinical findings improved after successive treatment with intravenous corticosteroids, hydroxychloroquine and azathioprine. At the present moment the patient remains stable using maintenance treatment with immunosuppressive drugs. Conclusion Chronic destruction of the lacrimal gland is the most common cause of dry eye and ocular symptoms in SS. Acute dacryoadinitis is considered an atypical manifestation of this syndrome. Classical systemic corticosteroids treatment for SS usually needs association of immunosuppressive drugs, including biological treatments as a recent new option to control the disease progression and inflammatory activity. Topic cyclosporine and pilocarpine have reported benefits for severe xerophthalmia in recent medical trials.
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.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.