Multicentric disappearing bone disease, or Gorham disease, is a rare entity. A middle age woman, presented to us with left sided antalgic gait and severe bony deformity of her left knee. Radiograph revealed massive bone defect of the medial condyle of the left tibia with subluxation of the knee joint. She was scheduled for knee replacement in six months. However, she developed another lesion over the right hip that typically mimicked the disease progression of disappearing bone disease. The right femoral head vanished progressively within three months without significant history of infection or trauma. Subsequent bone biopsy of the right femoral head and left tibia condyle confirmed the diagnosis. Total knee replacement was carried out for her left knee. She remained pain free on her left knee. A year later, after confirming by sequential radiographs that the osteolysis had stopped, total right hip replacement was performed. Five years later, she remained pain free and both the arthroplasties were stable.
We report a case of a non-pulsatile groin swelling in a 38 years old male drug addict without the typical clinical signs of an aneurysm. Ultrasound revealed a left femoral artery pseudo-aneurysm. He was surgically treated and the vessels were ligated without revascularisation.
INTRODUCTION: The purpose of this study was to investigate the pattern of muscle injuries and the factors that predict the return-to-play duration among Malaysian athletes.
METHODS: This is a retrospective review of the case notes of athletes who attended the National Sports Institute Clinic in Malaysia. The medical records of athletes with muscle injury, diagnosed on clinical assessment and confirmed by diagnostic ultrasonography, were included for final analysis.
RESULTS: From June 2006 to December 2009, 397 cases of muscle injury were diagnosed among 360 athletes. The median age of the athletes with muscle injuries was 20.0 years. Muscle injuries were mostly diagnosed among national-level athletes and frequently involved the lower limb, specifically the hamstring muscle group. Nearly all of the athletes (99.2%) were treated conservatively. The median return-to-play duration was 7.4 weeks. Athletes who waited more than one week before seeking medical attention, those with recurrent muscle injuries and female athletes were significantly more likely (p < 0.05) to take more than six weeks before returning to the sport.
CONCLUSION: Grade 2 lower limb muscle injury was commonly diagnosed among national-level athletes in this study. The frequency of weekly physiotherapy sessions did not affect the return-to-play duration. Factors such as initial consultation at more than one week post injury, recurrent muscle injuries and female gender were significant predictors of return-to-play duration among Malaysian athletes. These predictive factors should be kept in mind during clinical assessment so as to aid in prognosticating recovery after muscle injury.