Multiple cranial nerve palsies in malignant external otitis: A rare presentation of a rare condition.

Malignant external otitis (MEO) is a rare inflammatory and infectious condition, typically caused by , that mainly affects diabetic or immunocompromised elderly patients and is associated with severe morbidity and mortality. It begins in the external auditory canal and rapidly progresses through the skull base, leading to osteomyelitis and may result in cranial neuropathy, especially of the facial nerve. Here we describe a rare neurological presentation of MEO in a 65-year old diabetic man, who presented with an 8-month progressing left otitis externa and evolved with ipsilateral proptosis, ophthalmoplegia, blindness, facial palsy, hearing loss and contralateral evolvement of the temporal bone with hearing impairment.

[The importance of ultrasonography in orthopedics].

After patient history and clinical evaluation, sonography is a first-line modality in the orthopedic diagnostic algorithm together with laboratory results and standard radiographic findings. As an inexpensive investigation without known adverse effects it is used (and also repeated in the course of the disease) for the dynamic control of joint movements, and especially for imaging soft tissues. Sufficient training in the use of ultrasound in the musculoskeletal system is required; individual investigations are relatively time-consuming.

[MR-based 3D-analysis of the pathomechanics of traumatic and atraumatic shoulder instability].

Aim: Until now it is unknown to what extent malpositioning of the scapula is a relevant factor in shoulder instability that should be considered in therapy. The objective was to analyse 3D-scapular kinematics and humeral head (de-)centering in patients with atraumatic and/or traumatic shoulder instability and to investigate the correlation between the two factors.

Method: The shoulders of 28 healthy volunteers and of 14 patients each with atraumatic or traumatic instability were examined in various arm positions - with and without muscle activity - using open MR imaging.

[Swan-neck and buttonhole deformities on rheumatic long fingers].

Patients suffering from rheumatoid arthritis in many cases develop typical swan-neck and buttonhole deformities. In the further course of the disease we observe several stages. In the beginning active and later passive correction are still possible, while ultimately a fixed contracture is present.