PubMed · 5729821
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C Bronzini. 1968-12-16. [Cranial deformities caused by rickets].. https://pubmed.ncbi.nlm.nih.gov/5729821/
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The idea of early treatment for posttraumatic dystrophy (PD), although often cited in the literature and supported by clinical experience, is not based on convincing clinical evidence. The concept of PD is ill-defined and its diagnosis is based on variable criteria. Furthermore, scanty information about the natural course of early-diagnosed PD indicates that PD is partly self-limiting. Most important, however, is the lack of randomised placebo-controlled trials on different types of intervention. In studies without a control group, the effect of early therapy of a self-limiting disease is distorted: in case of early intervention there are relatively many patients with a milder form, whilst the more serious form predominates in case of late intervention. As a result of this patient selection, the results of therapy seem better or poorer, respectively, than would have been the case with a control group. Recent studies indicate that specific types of treatment may reduce the signs and symptoms of PD.
Three infants, 1 girl aged 10 months and 2 boys aged 2 and 4 months, presented with a discharging umbilicus directly or shortly after birth. Echography and cystography showed three different causes: a cystic remnant of the omphalomesenteric duct, a persistent urachus and a persistent omphalomesenteric duct. All were successfully managed surgically. The most common cause of a discharging umbilicus is an umbilical granuloma. This is usually treated by application of silver nitrate. In some patients, however, the discharge may not disappear or may contain urine or faecal material. These cases should be referred and echography performed. In case of an anomaly of the urachus or the omphalomesenteric duct, surgical exploration is mandatory. The lesion should be excised en bloc, together with a part of the bladder or the bowel.
STUDY DESIGN: A case report is described. OBJECTIVE: To highlight an unusual cause of thoracic myelopathy. METHODS: Clinical evaluation of 63-year-old male revealed myelopathy. Thoracic cord compression from a solitary projection of a facetal joint osteophyte at the T9-T10 level was documented on magnetic resonance imaging scans and computed tomography scans. RESULTS: The osteophyte was successfully excised. CONCLUSIONS: Thoracic cord compression can be caused by various space-occupying lesions, and a high index of suspicion will lead to diagnosis before neurologic deficit is clinically expressed. Magnetic resonance imaging scans and computed tomography scans both demonstrate the osteophyte, and expedient surgery avoids the progression of the neurologic deficit.