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At least 1,693 records · Page 94Linked to original sources
PubMed2004

Child abuse: radiographic findings at King Chulalongkorn Memorial Hospital.

OBJECTIVE: To describe radiographic findings in physically abused children. MATERIAL AND METHOD: The physically abused children diagnosed in King Chulalongkorn Memorial Hospital from 1998 to 2002 were retrospectively reviewed of medical records and radiographic imaging. RESULT: Eighteen of 30 physically abused children had positive radiographic findings and 15 of 18 were related to head injury. Subdural hematomas and skull fractures were the two most common findings found in 11 cases and 9 cases respectively. Seven of 11 cases of head injury had retinal hemorrhage. Fractures other than the skull were detected in 6 patients, located at the long bones, ribs and spines. The abused children with positive radiographic findings were more commonly found in younger infants and mucocutaneous lesions might be absent. CONCLUSION: Inflicted head injury was the most common radiographic findings in the present series. Shaking-impact mechanism was likely to play a significant role in this group of patients.

Child Abuse↗
PubMed1984

Osteoporosis associated with pregnancy and lactation: bone biopsy and skeletal features in three patients.

Case reports of three young patients who developed vertebral fractures and skeletal complications during pregnancy and/or lactation are presented. Radiologic features are described. All three had severe disease with three to nine vertebral fractures at presentation postpartum. In two patients, follow-up for 5-7.8 yr (including further pregnancy in each) revealed no further fractures. In general, serum and urine features were normal, the exceptions being a low serum 25-hydroxyvitamin D level (plus intermittent elevation of serum parathyroid hormone) in one, a tendency to low plasma alkaline phosphatase in another, and in the third (the most severely affected patient) a transient rise in urinary hydroxyproline and plasma alkaline phosphatase during a phase of bone loss following her second and third pregnancies. Bone biopsies performed 1 to 6-1/2 yr after parturition showed quantitative bone histologic features and bone formation rates that, as a group, were not significantly different from either normal or postmenopausal osteoporotic subjects. These patients did not have osteomalacia and did not show high turnover osteoporotic features. It is possible that this type of osteoporosis may be somewhat self-limiting, although this hypothesis is subject to great influence by any adaptive lifestyle changes introduced by the patient. The severe fracture history of these patients emphasizes the gravity of their bone disease and stresses the need for further study on the etiology and treatment of this form of osteoporosis.

Adolescent↗
PubMed2006

Upper extremity stress fractures.

Although less common than lower-extremity stress fractures, upper-extremity stress fractures are becoming recognized much more frequently. A majority of these fractures are caused by overuse and fatigue of the surrounding musculature and, as a result, may be prevented by appropriate training and conditioning. Diagnosis is made by history and physical examination with the aid of plain radiographs, bone scans, and MRI. Most of these fractures heal with a period of relative rest followed by a structured rehabilitation program. A small percentage of these fractures, however, may require surgical fixation. The present article reviews the different types of upper extremity and torso stress fractures seen in athletes, starting with the sternum and extending outward to the fingers. The presentation, diagnosis, mechanism of injury, treatment, prevention, and prognosis for each of these injuries will be discussed.

Adolescent↗
PubMed2001

Musculoskeletal causes of chest pain.

BACKGROUND: Chest pain is a common presenting problem to general practitioners and accident and emergency departments. Such a symptom generates anxiety in both patients and their medical attendants, for fear that this symptom represents a life threatening event. Numerous investigations often ensue, adding to the physical and financial burden on an already stressed health system. Musculoskeletal causes of chest pain are common but frequently overlooked. OBJECTIVE: This article aims to outline some of the more common musculoskeletal problems which may present as chest pain, and to present a practical approach to their diagnosis and management. DISCUSSION: It is estimated that somewhere in the vicinity of 20-25% of noncardiac chest pain has a musculoskeletal basis. Careful history taking to identify red flag conditions differentiates those who require further investigation. Historical features suggesting a musculoskeletal cause include pain on specific postures or physical activities. A musculoskeletal diagnosis can usually be confirmed by clinical examination alone, the key to which is reproducing the patient's pain by either a movement or more specifically palpation over the structure that is the source of the pain. Confirming the diagnosis, explanation and reassurance allay anxiety. Management strategies include manual therapy, the provision of analgesia and anti-inflammatory agents, either topically, orally or by injection. Focal injection of local anaesthetic alone may also be a useful diagnostic and therapeutic tool.

Adult↗
PubMed2004

[Successful indirect cardiac massage as a cause of thoracic wall instability and respiratory insufficiency].

The authors in their two cases describe unusual complication after successful indirect cardiac massage which was carried out in terrain. Both patients were then transferred to Dept. of gerontology and metabolic care. However the resuscitation was in both cases successful it caused in these two cachectic oseoporotic patients sternal and costal en block fractures. This iatrogenic trauma of thoracic wall showed up in further cause as a major problem. The patients could not have been disconnected from artificial support of ventilation and therefore their thoracic cage had to be surgically stabilized.

Aged↗
PubMed1979

[Peritoneal lavage for the early diagnosis of intraabdominal injuries in blunt traumas. Personal results].

Peritoneal lavage has been found to be a simple, uncomplicated method of examination providing much information in cases of blunt abdominal trauma. It permits decision to start surgical procedures in adequate trauma at short notice and is performed routinely at our clinic in patients suffering from craniocerebral trauma, even in the absence of clinical symptoms of intraabdominal lesions. The advantage of the method is little need of time, personnel and surgery as well as the fact that it can be applied also by relatively unskilled doctors and does not really require a specialist. The precision of the method is high. An important factor for successful application is the use of sufficient quantities of a lavage solution.

Abdominal Injuries↗