Hip pain in children and adolescents poses a diagnostic challenge due to various underlying causes, ranging from benign to severe conditions. Presented here is the case of an otherwise healthy 14-year-old boy who arrived at the emergency department with a two-day history of left hip pain, limping, fever, anorexia, and vomiting. Upon physical examination, tenderness was noted upon palpation of the left sacroiliac joint and with mobilization of the left lower limb. Elevated inflammatory markers raised suspicion of an osteoarticular infection. Despite initially normal imaging, subsequent MRI revealed an iliopsoas abscess, later confirmed by blood cultures positive for . A conservative management with antibiotics was selected due to the infeasibility of percutaneous or surgical drainage, leading to clinical improvement. This case highlights the efficacy of non-surgical approaches in selected situations and underscores the importance of a thorough evaluation, early suspicion of infection, appropriate imaging, and tailored antimicrobial therapy in managing hip pain in pediatric patients.
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http://dx.doi.org/10.7759/cureus.71761 | DOI Listing |
Multimodal analgesia and anesthesia have become the gold standard in total joint arthroplasty to reduce postoperative pain and opioid consumption and minimize complications associated with opioid use. There are several elements in an effective multimodal protocol, including oral medications, periarticular injection, regional nerve blocks, and spinal and general anesthesia. Many nonopioid medications are often used, such as acetaminophen and NSAIDs.
View Article and Find Full Text PDFCureus
December 2024
Department of Orthopaedics and Traumatology, All India Institute of Medical Sciences, Raipur, Raipur, IND.
Knee pain in patients often involves varus deformity and unicompartmental osteoarthritis (OA). High tibial valgus osteotomy (HTO) is increasingly recognized as an effective treatment, as it realigns the knee's mechanical axis towards the healthier lateral compartment, delaying degenerative changes in the medial compartment and reducing the need for joint replacement. This case report discusses two patients with bilateral knee arthritis and varus deformity who underwent medial opening-wedge high tibial osteotomy (MOWHTO) using Dr.
View Article and Find Full Text PDFMed Acupunct
October 2024
Department of Family Medicine, West Virginia University, Morgantown, West Virginia, USA.
Objective: Stiff person syndrome (SPS) is a rare neurological disorder. Treatments are limited, and non-pharmacologic therapies are recommended based on symptomatology. A G2P2002 post-menopausal 60-year-old female with hypertension, obesity, and type II diabetes, and SPS secondary to a paraneoplastic process cause by endometrioid ovarian adenocarcinoma who presented to acupuncture clinic seeking treatment for SPS and its sequela.
View Article and Find Full Text PDFTher Clin Risk Manag
December 2024
Department of Spine Surgery, Ganzhou People's Hospital, Ganzhou, People's Republic of China.
Purpose: The debate over the effectiveness of platelet-rich plasma (PRP) versus hyaluronic acid (HA) in treating hip osteoarthritis (HOA) continues. This cross-sectional analysis of overlapping systematic reviews aims to evaluate the efficacy of intra-articular PRP compared to HA for HOA treatment. The goal is to guide decision-makers in selecting the most reliable systematic reviews and to provide treatment recommendations based on the best available evidence.
View Article and Find Full Text PDFBone Joint J
January 2025
Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
Aims: Prolonged waits for hip and knee arthroplasty have raised questions about the equity of current approaches to waiting list prioritization for those awaiting surgery. We therefore set out to understand key stakeholder (patient and surgeon) preferences for the prioritization of patients awaiting such surgery, in order to guide future waiting list redesign.
Methods: A combined qualitative/quantitative approach was used.
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