Gestational gigantomastia complicated by pseudo-angiomatous stromal hyperplasia - a multidisciplinary management approach.

Gestational gigantomastia is a rare condition typified by disproportionate bilateral breast enlargement in pregnant women, resulting in skin thinning, ulceration, and bleeding. Less than sixty cases have been documented worldwide, and only one other in South Africa. Pseudo-angiomatous stromal hyperplasia (PASH) is a rare benign proliferation of stromal tissue in a tumorous or diffuse pattern.

Acetabular fracture after cycling related falls: High index of suspicion is required to avoid missing the injury on plain radiographs.

Cycling participation as a medium of transport and as a competitive sport has steadily increased in recent decades. Traumatic injuries secondary to falls and collisions occur relatively frequently. Fractures of the hip and pelvis are uncommon with no studies to date reporting their exact incidence in this sport.

Spinal Curvatures, Deformities, and the Level of Disability in People with Bilateral Spastic Cerebral Palsy Living in South Africa; A 6-Year Follow-Up Study During Adulthood.

Objective: Determine if spinal curvatures, deformities, as well as level of disability (due to back pain) changes with aging in adults with bilateral spastic cerebral palsy after receiving orthopedic interval surgery approach treatment in childhood.

Design: Consecutive case-series SETTING: Urban South Africa PARTICIPANTS: Twenty-seven ambulatory adults with cerebral palsy MAIN OUTCOME MEASURES: Spinal curvatures (scoliosis, thoracic kyphosis and lumbar lordosis) and deformities (spondylolysis and spondylolisthesis) were determined with X-rays, while the level of disability was assessed with the Oswestry Disability Index.

Results: The prevalence of spinal abnormalities were: 30% scoliosis (mild: <30°), 0% thoracic hyperkyphosis, 15% lumbar hyperlordosis, 0%; spondylolysis, and 0% spondylolisthesis.

A long-term follow-up study of spinal abnormalities and pain in adults with cerebral palsy and spastic diplegia more than 25 years after selective dorsal rhizotomy.

Objective: The main purpose of selective dorsal rhizotomy (SDR) is to reduce spasticity in the lower extremities of children diagnosed with cerebral palsy (CP) and spastic diplegia. The potential for developing spinal abnormalities and pain is a concern, especially in the aging CP population. Therefore, the aim of this study was to evaluate spinal abnormalities, level of pain, and disability (due to back or leg pain) in adults with CP, and associations with participant characteristics, more than 25 years after SDR.

A "scattered" SCAT in a football goalkeeper: a case report.

Background: In an acute field-side setting, it is often challenging to differentiate benign sports-related concussion (SRC) from potential, more sinister, intracranial pathology. Moreover, recovery in the ensuing days and weeks is often complex as the resolution of classical signs and symptoms does not always follow a standard pattern.

Aim: To highlight the value of a structured and repeated thorough clinical assessment approach toward SRC, particularly as atypical and unexpected sequences in patient recovery patterns may require further specialist referral and intervention.

If the shoe fits… should you just wear it? A complete calcaneal stress fracture in a female recreational runner.

Shoe choice by runners may follow trends related to purported generalised benefits rather than following an individual risk-benefit analysis. The benefits and risks related to minimalist footwear for running has been a much debated topic. The authors report a case of a complete calcaneal stress fracture in an otherwise healthy female recreational runner in the first three weeks following her conversion from a traditional cushioned running shoe to a minimalist type of running shoe.

A tale of two sit-bones: The cyclist's ischial hygroma (Perineal nodular induration).

The ischial hygroma, also known as a perineal nodular induration, is a relatively rare and mostly cycling-specific injury that is often incorrectly diagnosed and managed. Here two cases with divergent managements are described to highlight the spectrum of treatment available to manage this condition. The presentation, assessment and management of two cases of perineal nodular induration are discussed.

Who operated on me? What patients understand about surgical trainees.

Aims: To evaluate whether information delivered to patients about the level of training of the person operating on them is understandable and meaningful. To establish whether post-operative patients can identify when a doctor, undergoing training in surgery, has performed their surgery. To identify terms that are clear to patients, which can be used to improve understanding.

Physcomitrella patens MAX2 characterization suggests an ancient role for this F-box protein in photomorphogenesis rather than strigolactone signalling.

Strigolactones (SLs) are key hormonal regulators of flowering plant development and are widely distributed amongst streptophytes. In Arabidopsis, SLs signal via the F-box protein MORE AXILLARY GROWTH2 (MAX2), affecting multiple aspects of development including shoot branching, root architecture and drought tolerance. Previous characterization of a Physcomitrella patens moss mutant with defective SL synthesis supports an ancient role for SLs in land plants, but the origin and evolution of signalling pathway components are unknown.

Multimodality imaging of foreign bodies of the musculoskeletal system.

Objective: The purpose of this article is to clarify the most relevant points in managing suspected foreign bodies of the musculoskeletal system on the basis of a literature review and published reports with cases to illustrate each type on different imaging modalities.

Conclusion: Foreign bodies of the musculoskeletal system are a common problem in emergency departments, with more than a third missed in the initial clinical evaluation. These retained objects may result in various complications and also offer fertile ground for litigation.

Thoracic injuries in professional rugby players: mechanisms of injury and imaging characteristics.

Professional rugby players are prone to traumatic thoracic injuries due to the use of minimal protective gear to cover the torso. In the 2007 Rugby World Cup, thoracic injuries occurred at a rate of 8.3 cases/1000 player-hours.

Traumatic injuries of thigh and calf muscles in athletes: role and clinical relevance of MR imaging and ultrasound.

Objectives: Magnetic resonance (MR) imaging and ultrasound have become valuable tools for evaluation of traumatic muscle injuries in athletes. Common athletic injuries include strain, contusion and avulsion, which are characterised by muscle fibre disruption, intramuscular haemorrhagic dissection, haematoma at the musculotendinous junction, and perifascial blood or haematoma.

Methods: MR imaging may allow clinicians to predict the time required before athletes can return to competition and the risk of injury recurrence.

Are splanchnic hemodynamics related to the development of gastrointestinal symptoms in Ironman triathletes? A prospective cohort study.

Objective: To determine if prerace to postrace changes in superior mesenteric artery (SMA) and coeliac artery hemodynamics were related to the development of gastrointestinal (GI) symptoms during a triathlon.

Design: Prospective cohort study.

Setting: Field study at an international Ironman Triathlon.

Recurrent anterior shoulder instability: accuracy of estimations of glenoid bone loss with computed tomography is insufficient for therapeutic decision-making.

Objective: To evaluate the reliability of glenoid bone loss estimations based on either axial computed tomography (CT) series or single sagittal ("en face" to glenoid) CT reconstructions, and to assess their accuracy by comparing with actual CT-based bone loss measurements, in patients with anterior glenohumeral instability.

Materials And Methods: In two separate series of patients diagnosed with recurrent anterior glenohumeral instability, glenoid bone loss was estimated on axial CT series and on the most lateral sagittal (en face) glenoid view by two blinded radiologists. Additionally, in the second series of patients, glenoid defects were measured on sagittal CT reconstructions by an independent observer.

Pin-site epidural hematoma in an adult case of chronic hydrocephalus with associated thinning of the cranium.

We report a case of a 22-year-old man presenting with a fourth ventricular tumour and associated chronic obstructive hydrocephalus likely leading to thinning of the cranium. Intraoperatively, he developed an epidural hematoma secondary to a fracture of the temporal bone by application of the three-point skull fixator. This is the second reported adult case of an iatrogenic epidural hematoma secondary to pin-site complications.

Differential forces within the proximal patellar tendon as an explanation for the characteristic lesion of patellar tendinopathy: an in vivo descriptive experimental study.

Background: Patellar tendinopathy is a common condition affecting the posterior region of the proximal patellar tendon, but the reason for this typical location remains unclear.

Hypothesis: The posterior region of the proximal patellar tendon is subjected to greater tendinous forces than is the corresponding anterior region.

Study Design: Descriptive laboratory study.

Specificity and sensitivity of chest radiographs in the diagnosis of paediatric pulmonary tuberculosis and the value of additional high-kilovolt radiographs.

Tuberculosis (TB) remains the most common notifiable infectious disease in South Africa. The diagnosis of pulmonary TB in children is often very difficult because of the non-specific radiological signs and inter-observer variation in the interpretation of radiographs. The frontal high-kilovolt (kV) radiograph has been used to assess the effect of TB adenopathy on the tracheobronchial tree and to detect endobronchial lesions.