Tuberculosis remains a public health problem in developing country particularly in Tunisia. Bone location of tuberculosis infection is increasing and is often misdiagnosed due to the weakness of clinical presentation in early stages. Sternoclavicular joint tuberculosis is rare and unusual location of this disease. However, antibiotherapy and surgical debridement is still the basis of treatment. We report a case of sternoclavicular joint tuberculosis with a follow up of four years. The patient was treated surgically and put under antibiotherapy during twelve months. The site was sterilized. We report this case to show that debridement and antibiotherapy still efficient in tuberculous bone affection no matters the location.
Introduction: Inferior dislocation of the shoulder is a rare injury. Some specific complications may occur immediately or during follow-up. We present a rare case of erecta dislocation with a neurological injury. Case presentation: We report a 23-year-old female admitted for erecta dislocation on her right shoulder after sport accident complicated with a fracture of the greater tuberosity and axillary nerve palsy. A closed reduction had been indicated with a reduction of both fracture and dislocation. Functional treatment had been adopted. The neurapraxia had resolved spontaneously. At last outcome, the patient is satisfactory with a full range of motion on her right shoulder. Discussion: Inferior shoulder dislocation leads, usually to tears on soft tissue of the shoulder especially capsular, labral and inferior glenohumeral ligament. Immediate complications are serious such as neurological palsy and vascular problems. Indications depend on reducibility and associated injuries. Conclusion: Neurological complication especially neurapraxia is a serious injury but did not require open reduction and surgical exploration explained by the traction at the point where the axillary nerve passes through the quadrangular space.
IntroductionCushing’s syndrome is a relatively rare condition that results from chronic hypercortisolism. This syndrome is characterized by the presence of various psychiatric manifestations that can accompany it at all its stages of evolution. They can either inaugurate the clinical picture, or appear during the course of the disease, as they can persist even after the resolution of the syndrome. of Cushing. Through a clinical vignette, we report a case of Cushing’s syndrome in a 52-year-old patient who presented with a picture of melancholic depression as part of a bipolar disorder and who had preceded the discovery of Cushing’s disease.Objectivesestablish the relationship between Cushing’s syndrome and bipolar disorder and identify the main pillars of care.MethodsIt was proposed to present the clinical case of a 52-year-old patient in whom psychiatric manifestations of the psychotic and thymic types preceded the discovery of Cushing’s disease, to recall the main psychiatric symptoms that can be encountered during such endocrine disorders and their possible entanglement with psychiatric pathologies.ResultsMrs. F. is 52 years old. married and mother of 3 children, without social security coverage for medullary carcinoma of the thyroid, having benefited from thyroidectomy with radiotherapy, admitted for treatment of paraneoplastic Cushing’s syndrome. The beginning of his troubles goes back to 6 months before his consultation with psychiatry. The initial symptoms were typical of a progressive weight gain noticed by the entourage. There was the installation of thymic symptoms such as an elation of mood, self-esteem, multiple projects. One month before admission to the internal medicine department, the patient presented with a depressed mood, anhedonia , a disgust for life, and dark thoughts. She had stopped all drug treatment.Cushing’s disease is the most common cause of endogenous hypercortisolism (>85%). Corticotropic micro-adenomas , are the most frequently observed, i.e., in 90% of cases, and are sometimes not visible on magnetic resonance imaging . Its first-line treatment is neurosurgical with trans-sphenoidal excision. In its second intention, it uses drugs whose targets are pituitary or adrenal, as well as radiotherapy.Conclusionswe present the case of a patient with a picture of bipolar mood disorder and Cushing’s disease. Thymic and psychotic psychiatric symptoms preceded the discovery of endocrine disease whose symptoms were not apparent at first. The hypotheses of comorbidity or rather of the inauguration of the endocrine disease by a psychiatric picture, in particular bipolar mood disorder, remain advanced and the limits betweenDisclosure of InterestNone Declared
SCIWORA (spinal cord injury without radiological abnormality) is rare and almost seen in children; we report the case of an Adult cervical SCIWORA showing the evolution of this injury of high morbidity even well taken in charge. Treatments outcomes of SCIWORA patients are not well defined but still have poor clinical results.
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