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[Pain around the first ray of the hand: differential diagnoses and treatment].

Orthopadie (Heidelb)

January 2025

Klinik für Handchirurgie und Orthopädie, Spital Langenthal, Spital Region Oberaargau SRO AG, Langenthal, Schweiz.

Pain around the first ray of the hand, particularly in the thumb area, is a frequent clinical problem that can have various causes. This article explores the most important differential diagnoses, including thumb carpometacarpal (CMC-I) osteoarthritis (rhizarthrosis), de Quervain's stenosing tenosynovitis, carpal tunnel syndrome and Wartenberg's syndrome. A detailed medical history, targeted clinical examination and if necessary the use of modern imaging techniques are crucial for making the diagnosis.

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Which Test is Best for Pain in the Chest?

R I Med J (2013)

February 2025

Professor of Medicine, Clinician Educator, Warren Alpert Medical School, Brown University; Associate Chief, Cardiology, Brown University Health Cardiovascular Institute, Providence, Rhode Island.

Chest pain is one of the most common chief complaints seen in both the emergency department (ED) and primary care settings.1,2 It is estimated that 20-40% of the general population will suffer from chest pain at some point throughout their lives.3 Interestingly although obstructive coronary artery disease (CAD) prevalence has declined, chest pain as a presenting symptom has become increasingly common over the last decade.

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Background: Stereotactic radiosurgery (SRS) is widely used for managing brain metastases (BMs), but an adverse effect, radionecrosis, complicates post-SRS management. Differentiating radionecrosis from tumor recurrence non-invasively remains a major clinical challenge, as conventional imaging techniques often necessitate surgical biopsy for accurate diagnosis. Machine learning and deep learning models have shown potential in distinguishing radionecrosis from tumor recurrence.

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Solitary plasmacytomas are localized single tumors of monoclonal plasma cells that occur in two variants: solitary plasmacytoma of bone and extraosseous plasmacytoma. Solitary plasmacytoma of bone accounts for only 1%-2% of plasma cell lesions, and extraosseous plasmacytoma is also approximately 1%. These are both very uncommon at the skull base.

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