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Fulltext Issues in management of acute appendicitis in pregnancy

Nalliah, Sivalingam, Wijesuriya, Lionel, Venugopal, Subramani

International e-Journal of Science, Medicine & Education, 2011;5(1):2-9.
MyJurnal

Acute appendicitis is an infrequent yet the commonest surgical emergency in pregnancy occurring in about 1:1500 pregnancies. The classical abdominal pain in the right lower quadrant of the abdomen is the only reliable clinical sign. Delay in diagnosis is attributed to presence of symptoms commonly seen in pregnancy like nausea and vomiting and difficulty in localizing abdominal pain due to displacement of the appendix with advancing gestation. Perforated appendix and generalized peritonitis impacts adversely on pregnancy contributing to increases in miscarriage, pre-term delivery, fetal loss and even maternal mortality. Imaging studies like abdominal ultrasonogram, helical computerized tomography and magnetic imaging have been utilized to complement clinical suspicion and decrease ‘negative appendectomies’ but robust data on their routine use is awaited. Although the laparoscopic approach is a useful diagnostic and therapeutic tool in early pregnancy, its use as the primary approach for appendicectomy in pregnancy requires further evaluation as increases in the incidence of fetal loss of 5.6% has been reported compared to 3.1% in open access surgery

Matched MeSH terms: Abdominal Pain
Fulltext Cement vertebroplasty in the elderly with osteoporotic vertebral fractures. a preliminary study on the change in activity of daily living after treatment

Looi, Collin Seng-Kim

International e-Journal of Science, Medicine & Education, 2009;3(2):-.
MyJurnal

Background: To assess the effect of cement vertebroplasty on the activity of daily living of elderly patients who have sustained a vertebral osteoporotic fracture.
Patients and Methods: Seven patients with clinically significant and radiologically proven osteoporotic vertebral compression fractures suitable to be treated with percutaneous cement vertebroplasty were recruited. Evaluation was based on pre- and postprocedure activity by clinical documentation (including interview) and by a self-developed questionnaire (including quality of life).
Results: Following the procedure, 54% of patients resumed their activities of daily living with minimal pain while 46% of patients were able to do so without any pain (p

Matched MeSH terms: Pain
Fulltext Hot towel massage relieved a 7 years orofacial pain – a case report

Ma MS

Ann Dent, 2012;19(2):66-69.
MyJurnal

Diagnosis and management of orofacial pain of non-odontogenic origin has always been a challenge to dentists. Inaccurate diagnosis would result in delay of treatment and in cases of orofacial pain, affects patient’s quality of life. Temporomandibular pain dysfunction syndrome is the most common temporomandibular disorder that presents to dental clinics. Trigeminal neuralgia, also known as ticdouloureux is a relatively rare condition that causes electric shock-like pain when the trigger zone is stimulated by triggering factor. Case report: A case of temporomandibular pain dysfunction syndrome in a 52 years old Indian lady that was managed as trigeminal neuralgia for 7 years is presented. Conclusion: The aim of this case report is to make dentists aware of the signs and symptoms of different orofacial pain, so that early and accurate diagnosis can be made and appropriate treatment instituted.

Matched MeSH terms: Facial Pain
Fulltext The efficacy of 3 irrigating solution in surgical removal of lower wisdom tooth: a pilot study

Keat, John Hon Chong, Ahmad Dzulfikar Samsudin, Mei, Siang Ma

Archives of Orofacial Sciences, 2016;11(1):1-6.
MyJurnal

Surgical removal of impacted lower wisdom tooth has become increasingly costly to patient while still remains as the most common dental surgical procedure that is performed on outpatient basis. In the present study, a total of 23 patients with impacted lower wisdom tooth were surgically removed under local anaesthesia by using different irrigating solution namely, normal saline, distilled water and chlorhexidine. The samples underwent standard operating procedures and medication. Post operative complications in terms of pain, swelling, infection and delayed wound healing were assessed and compared on Day 1 and Day 7 after surgery. The result of this study showed that there is no significant difference between the three irrigating solution used in surgical removal of impacted lower wisdom tooth in terms of postoperative complication. A bigger scale of research with more samples is recommended to evaluate the most efficacy irrigating solution during surgical removal of impacted lower wisdom tooth.
Study site: Oral surgery clinic, Universiti Sains Islam Malaysia (USIM), Kuala Lumpur, Malaysia

Matched MeSH terms: Pain
Fulltext Classical trigeminal neuralgia, purely paroxsymal with vascular compression - a case report

B, Elamathi, R, Vijaya, V, Valliappan, A, Ramanathan

Ann Dent, 2014;21(1):33-37.
MyJurnal

According to the 3rd edition of the international
classification of headache disorders (ICHD3 2013),
Trigeminal Neuralgia (TN) is classified into two types:
1. Classical TN, purely paroxysmal 2. Classical TN
with concomitant persistent facial pain. In this article,
the authors describe a 47 year-old, male with unilateral,
severe, recurring, electric shock-like pain involving left
lower jaw, teeth and gingiva. Diagnosis of classical TN
of the left 3rd division of the trigeminal nerve was made.
The patient was treated with pharmacotherapeutic agents
but without relief. Magnetic resonance imaging (MRI)
of the brain showed medial vascular compression of left
trigeminal pontine root entry zone caused by superior
cerebellar artery. A microvascular decompression (MVD)
surgery was done at the left trigeminal pontine root entry
zone resulting in good relief of pain. This article highlights
the differential diagnoses to be considered with TN and
also emphasize the difference between the two types of
the TN according to ICDH3 (2013). It also highlights the
difference between classical TN purely paroxysmal with
and without vascular compression by imaging techniques
and their differing treatment modalities, which therefore
should be reflected in future ICDH classification.

Matched MeSH terms: Facial Pain
Fulltext Chronic heel pain: It could be tuberculosis

Muhamad Effendi F, Ibrahim MI, Rozali KN, Miswan MF

Malays Fam Physician, 2016;11(2-3):20-23.
PMID: 28461854 MyJurnal

INTRODUCTION: Heel pain is a common presentation at a primary care setting. The majority of these cases are benign and self limiting in nature. Common differential diagnoses include plantar fasciitis and peroneal muscle sprains. However, certain conditions-if undetected early-may cause significant morbidity to the patient. A high index of suspicion and early referral for further investigations are needed to prevent long-term morbidities.

METHODS: A clinical review of a patient with chronic left heel pain was performed. Blood parameters and imaging investigations indicated chronic infection of the calcaneum. Histopathological examination was highly suggestive of tuberculosis.

RESULT: The patient responded well to antituberculous therapy. She was pain free and showed no signs of recurrence at final follow-up.

CONCLUSION: Here, we report a case of chronic heel pain, which was later diagnosed as tuberculosis of the calcaneum and successfully treated with antituberculous therapy.

Matched MeSH terms: Pain
Fulltext Spinal fusion for chronic low back pain: A 'magic bullet' or wishful thinking?

Dhillon KS

Malays Orthop J, 2016 Mar;10(1):61-68.
PMID: 28435551

Chronic low back pain is a common, disabling and costly health problem. The treatment of chronic low back is difficult and is often ineffective. For treatment to be effective the cause of the pain has to be established but unfortunately in 80% to 95% of the patients the cause cannot be determined despite the existence of modern imaging techniques. A pathoanatomical diagnosis which fits into a classical disease model where successful treatment can be carried out, can only be made in 5% to 7% of the patients. The back pain in the rest of the patients where no pathoanatomical diagnosis can be made is often labelled, unscientifically, as chronic low back pain. Despite the existence of sophisticated imaging techniques and a plethora of diagnostic test the source of pain in patients with nonspecific back pain cannot be established. There exist no causal relationship between imaging findings of degenerated disc, lumbar facet arthritis, spondylosis, spondylolysis and spondylolisthesis, to the pain in these patients. Surgical treatment of non-specific back pain where no pathoanatomical diagnosis has been established is bound to fail. Therefore the outcome of spinal fusion in these patients can be no better than nonsurgical treatment. Spinal fusion is a major surgery which can be associated with significant morbidity and occasionally with mortality. Yet there is rapid rise in the rates of spinal fusion. There is a growing tension between ethics and conflicts of interest for surgeons. The spine, unfortunately, has been labelled as a profit centre and there are allegations of conflicts of interest in the relationship of doctors with the multi-billion dollar spinal devices industry. The devices industry has a significant influence on not only research publications in peer review journals but also on decisions made by doctors which can have a detrimental effect on the welfare of the patient.

Matched MeSH terms: Low Back Pain
Fulltext The prevalence of hand arm vibration syndrome among automobile assembly workers

Shamsul Bahri Mohd Tamrin, Nor MaizuraYusoff, Anita Abd Rahman, Dayana Hazwani, M.S.N., Mansour A. Balkhyour

Malaysian Journal of Public Health Medicine, 2016;16(20):128-136.
MyJurnal

The objectives of this study are to determine the prevalence of hand-arm vibration (HAVS) among the automobile
assembly workers and the associated risks. A cross sectional study was conducted to determine the prevalence of
HAVS and also ascertain the association between HAVS and reduction in VPT among workers using vibration hand held
tool in automobile industry. Aim of this study was to determine the prevalence Hand Arm Vibration Syndrome
(HAVS) among vibrating hand held tool exposed workers. A cross sectional study design using structured
questionnaire and invasive measurement of vibrotactile perception threshold (VPT) at the fingertips was conducted
in one of the automobile company in Klang Valley. All the respondents were hand arm vibration exposed workers. A
total 109 assembly line workers with at least one year job tenure participated in this study. The finding revealed
that 27.5% of workers reported HAVS through questionnaire. This study consisted of 109 respondents. All of them
were male. The mean age was 32.9 years. The mean daily vibration exposure for 8-hours was 1.41m/s2. There was
11% of the tools measured were above the Action Level recommended by European Union Directive 2002. The overall
prevalence of HAVS based on reported symptom through questionnaire was 27.5%. None of the respondent reported
any whiteness at their fingers due to exposure to vibration. However, 36.7% of the respondent reported tingling
sensation and 57.8 % reported the feeling of numbness in their hands. Only 10.1% claim that the pain was
persistence. Since this study was done among exposed workers without control group, the thresholds were measured
by comparing the observed VPT with the VPT of healthy population provided by ISO 13091-2. The result showed that
98.2% of the respondent in this study having positive threshold which indicate the percentage of respondent that
having deterioration in finger tactile perception. The positive threshold from comparison above showed that the
respondent of this study was affected with the vibration exposure. The value proven that the exposure has caused
the deterioration of tactile sensitivity in 98.2% of respondent in this study which showed by having positive threshold
compared to healthy population. The result also showed that there was a significant correlation between daily
vibration exposure A (8) and VPT at both frequency tested which was 31.5Hz (r = 0.417, p = 0.002) and 125Hz (r =
0.480, p = 0.001). Even though the mean daily vibration exposure for 8-hours was low and below the recommended
level, the workers still exposed to the effect of hand arm vibration.

Matched MeSH terms: Pain
Fulltext A Prospective Randomised Controlled Study Comparing Ultrasonic Dissector with Electrocautery for Axillary Dissection in Patients of Carcinoma Breast

Deori A, Gupta N, Gupta AK, Yelamanchi R, Agrawal H, Durga CK

Malays J Med Sci, 2021 Feb;28(1):97-104.
PMID: 33679225 DOI: 10.21315/mjms2021.28.1.12

Background: Axillary dissection is one of the important components of modified radical mastectomy (MRM). The present study was conducted to compare surgical outcomes by using monopolar electrocautery and ultrasonic dissector for axillary dissection in MRM.
Methods: A parallel randomised controlled single blinded study was conducted with a sample size of 70 patients who were randomised into two groups. One group underwent MRM using ultrasonic dissector (Group A) and the other one using electrocautery (Group B). Intra- and post-operative outcomes were compared.
Results: Group A had an average operating time of 30.86 min, which was statistically less than that of Group B. The mean mop count and the daily drain output in Group A were less as compared to Group B and the differences were statistically significant. Drain was removed early in Group A as compared to Group B. However, post-operative pain scores and seroma formation were not statistically significant among the two groups.
Conclusion: Ultrasonic dissector group had significantly lesser intra-operative bleeding, operating time and post-operative drain output when compared to electrocautery group. However, the two groups had no significant difference in post-operative pain scores and seroma formation.

Matched MeSH terms: Pain, Postoperative
Fulltext Post-colonoscopy diverticulitis: A systematic review

Ng ZQ, Tan JH, Tan HCL, Theophilus M

World J Gastrointest Endosc, 2021 Mar 16;13(3):82-89.
PMID: 33763188 DOI: 10.4253/wjge.v13.i3.82

BACKGROUND: Post-colonoscopy diverticulitis is increasingly recognized as a potential complication. However, the evidence is sparse in the literature.
AIM: To systematically review all available evidence to describe the incidence, clinical course with management and propose a definition.
METHODS: The databases PubMed, EMBASE and Cochrane databases were searched using with the keywords up to June 2020. Additional manual search was performed and cross-checked for additional references. Data collected included demographics, reason for colonoscopy, time to diagnosis, method of diagnosis (clinical vs imaging) and management outcomes.
RESULTS: A total of nine studies were included in the final systematic review with a total of 339 cases. The time to diagnosis post-colonoscopy ranged from 2 h to 30 d. Clinical presentation for these patients were non-specific including abdominal pain, nausea/vomiting, per rectal bleeding and chills/fever. Majority of the cases were diagnosed based on computed tomography scan. The management for these patients were similar to the usual patients presenting with diverticulitis where most resolve with non-operative intervention (i.e., antibiotics and bowel rest).
CONCLUSION: The entity of post-colonoscopy diverticulitis remains contentious where there is a wide duration post-procedure included. Regardless of whether this is a true complication post-colonoscopy or a de novo event, early diagnosis is vital to guide appropriate treatment. Further prospective studies especially registries should include this as a complication to try to capture the true incidence.

Matched MeSH terms: Abdominal Pain
Fulltext Improvement in Quality of Life after Myomectomy

Ehab Helmy Abdel Malek Fahmy, Constance Liew Sat Lin, Alvin Oliver Payus, Rhanye Mac Guad, May Zaw Soe, Satishratnam Nagaratnam, et al.

Borneo Journal of Medical Sciences, 2020;14(1):55-59.
MyJurnal

Dysmenorrhea is one of the leading causes of pelvic pain and menstrual disorder among women during childbearing age. The burden of dysmenorrhea is greater than any other gynaecological complaint. Some women have severe dysmenorrhea which renders them incapacitated for days each menstrual cycle requiring absence from study or duty, frequently requiring pain killer, restriction of daily performance, poor sleep, negative moods such as anxiety and depression. A 31-year-old female presented with severe dysmenorrhea and heavy menstrual bleeding (HMB) as a cause of multiple uterine fibroids, underwent surgeries to remove 100 fibroids from her uterus which has improved her quality of life, eliminating her dysmenorrhea and menstrual abnormalities

Matched MeSH terms: Pelvic Pain
Fulltext Good recovery of prostate carcinoma with spine metastases to t9 following laminectomy

Muhammad Wafiuddin

Borneo Journal of Medical Sciences, 2020;14(1):61-66.
MyJurnal

Prostate carcinoma is a common health issue that can metastasise in the spine. A 65-year-old male was diagnosed with prostate carcinoma and two years later he developed a progressive neurological deficit over the bilateral lower limb. He experienced severe back pain, became paraplegic and the quality of life was severely impaired. Radiographic investigations were done and revealed osteoblastic bone metastasis at thoracic vertebrae with spinal cord compression. The patient underwent surgical decompression surgery at the T9 level mainly for pain control. Six months post-surgery not only the pain was well controlled but patient able to ambulate with walking aid. It is a rare post-operative result as the neurological recovery in a patient with complete paralysis is less than 3%. This type of recovery is possible when the cause of the neurological deficit is mainly mechanical compression from tumour rather than cord ischaemia from traumatic injury.

Matched MeSH terms: Back Pain
Fulltext Rapidly Growing Huge Lower Back Malignant Peripheral Nerve Sheath Tumour

Abuzarifa N, Al-Chalabi MMM, Wan Sulaiman WA

Cureus, 2021 Mar 05;13(3):e13712.
PMID: 33842103 DOI: 10.7759/cureus.13712

Malignant peripheral nerve sheath tumours (also called neurofibrosarcomas) are a rare, highly aggressive soft tissue sarcomas that arise from the peripheral nerves or cells associated with the nerve sheath, such as Schwann cells, peri-neural cells and fibroblasts. It is representing 10% of all soft tissue sarcomas in which it is considered as an extremely rare malignancy, especially in patients with neurofibromatosis type I. In the general population, it affects approximately 1 in 100,000 people. This article is reporting a 56-year-old Malay female patient who is a known case of neurofibromatosis type I for 20 years, presented with a lower back, pruritic, gradually increasing swelling during the last five months. Last month before the presentation, the lesion rapidly grows, reaching a size of (15×15 cm), accompanied by foul-smelling discharge and pain exacerbated with movement. Although no history of preceding trauma or accident, the mass bleeds within contact. In conclusion, only a few cases of giant malignant peripheral nerve sheath tumours reported in the literature describing its location and growth progression. We present a massive, extremely rapid growth of cutaneous exophytic malignant peripheral nerve sheath tumours over the lower back.

Matched MeSH terms: Pain
Fulltext Treatment satisfaction and its influencing factors among fixed orthodontic patients in UiTM

Shamsul,Fadzil,S,S,, Ahmad,Khalil,A,I,, Noviaranny,I,Y,, Abdullah,Al-Jaf,N,M,, Kazi,J,A,

Compendium of Oral Science, 2020;7(1):21-29.
MyJurnal

Abstract
Objectives: The aims of this study were to evaluate patient’s satisfaction regarding the orthodontic treatment
provided by the Faculty of Dentistry Universiti Teknologi MARA (UiTM) and to determine the factors that
affected their satisfaction level.
Methods: : A cross-sectional study was conducted among the patients treated with full fixed appliances in the
faculty’s orthodontic clinic using a validated questionnaire.
Results: : The final sample consisted of 105 subjects (response rate 76%) which comprises of 26 males and 79
females were chose with 97% of the respondents are Malay. Most subjects had orthodontic treatment duration
of more than 1.5 years (100%) and were still wearing fixed appliances (89%). Items included in the
questionnaire: reasons for seeking orthodontic treatment, questions relevant to satisfaction with orthodontic
treatment, doctor-patient relationship and pain experience during orthodontic treatment. Concerning the doctor
patient relationship, 91% of the respondents were contented with their orthodontist. Respondents answered
‘Yes’ to the treatment plan explained prior to the procedure (91.4%), questions answered promptly (94.3%),
gentleness of the orthodontist (91.4%) and dental assistant (88.6%), orthodontist honesty about treatment
duration (90.5%) and cost (97.1%), and recommendation to others (90.5%).
Conclusion: Generally, patients who had received orthodontic treatment from the orthodontic clinic in Faculty
of Dentistry UiTM were satisfied with the overall treatment outcomes. However, there were still some aspects of
the service that can be improved in the future in order to provide a better healthcare services specifically in
orthodontic treatment.

Matched MeSH terms: Pain
Fulltext Comparing Efficacy and Safety of Empirical vs. Guided Therapy for Non-cardiac Chest Pain: A Pragmatic Randomized Trial

Abdul Kadir NP, Ma ZF, Abdul Hafidz MI, Annamalai C, Jayaraman T, Hamid N, et al.

Front Med (Lausanne), 2021;8:605647.
PMID: 33659261 DOI: 10.3389/fmed.2021.605647

Background: Non-cardiac chest pain is common with two-thirds due to gastroesophageal reflux disease (GERD). Objective: To evaluate the effectiveness and safety of guided vs. empirical therapy in non-cardiac chest pain. Methods: Adults with normal angiogram or stress test were randomized into either a guided or empirical group. In the guided group, after the ambulatory pH-impedance test, if GERD then dexlansoprazole 30 mg/day for 8 weeks, but if functional or hypersensitive chest pain, then theophylline SR 250 mg/day for 4 weeks. In the empirical group, dexlansoprazole 60 mg/day was given for 2 weeks. The primary outcome was global chest pain visual analog score (VAS) and secondary outcomes were Quality of Life in Reflux and Dyspepsia (QOLRAD), GERD questionnaire (GERDQ), and pH parameters, all determined at baseline, 2nd and 8th weeks. Results: Of 200 screened patients, 132 were excluded, and of 68 randomized per-protocol, 33 were in the guided group and 35 in the empirical group. For between-group analysis, mean global pain scores were better with guided vs. empirical group at 8th week (P = 0.005) but not GERDQ or QOLRAD or any of pH measures (all P > 0.05). For within-group analysis, mean QOLRAD improved earliest at 8th week vs. baseline (P = 0.006) in the guided group and 2nd week vs. baseline (P = 0.011) in the empirical group but no differences were seen in other secondary outcomes (P > 0.05). No serious adverse events were reported. Conclusions: Guided approach may be preferred over short-term empirical therapy in symptom response, however QOLRAD, acid-related symptoms, or pH measures are not significantly different (trial registration ID no. NCT03319121).

Matched MeSH terms: Chest Pain
Fulltext Knee pain during Islamic prayer after anterior cruciate ligament reconstruction using hamstring and bone patellar tendon autograft

Ahmed N, Shihabudin M.T, Ab Rahman S

IIUM Medical Journal Malaysia, 2020;19(1):31-36.
MyJurnal

Introduction: Hamstring tendon (HT) and bone patellar tendon bone (BPTB) are the commonly used
autograft in an anterior cruciate ligament reconstruction surgery. The BPTB is said to have more incidence of
anterior knee pain compared to HT. The study aimed to compare the severity of knee pain during Islamic
prayer kneeling. Methods: A cross sectional cohort analysis of patients undergoing ACL reconstruction surgery
using BPTB with HT autografts was conducted to determine differences in postoperative pain while kneeling
and ability to pray in normal position. Kneeling during prayer and the ability to sit while performing prayer
were assessed at 3rd, 4th, 5th and 6th month. Results: There were no significant differences in mean pain score
while kneeling at 3rd, 4th, 5th and 6th month. The mean difference of patient’s ability to perform normal
prayers for BPTB (3.56+1.16) and HT (3.30+1.05) was found insignificant. The average number of patients in
both groups was able to pray between 3 to 4 months post operatively as full range of motion of knee is
allowed within this period. Total 49 patients (BPTB 23, HT 26) out of 60 were able to pray normally within 4
months post-operation. Mostly delayed due to anterior knee pain. Conclusion: There is no different in term of
knee pain during kneeling while performing Islamic prayer between those who had their ACL reconstructed
either using BPTB or HT autograft.

Matched MeSH terms: Pain, Postoperative
Fulltext Regenerative medicine as a potential and future intervention for ankle sprain

Quan Fu Gan, Pooi Pooi Leong, Soon Keng Cheong, Chai Nien Foo

Malaysian Journal of Medicine and Health Sciences, 2020;16(2):290-299.
MyJurnal

Ankle sprain is one of the most common injuries associated with physical activities. Complications including pain and ankle instability are associated with decreased physical activity, reduced sport performance, and increased risk of recurrent ankle injury leading to detrimental effect on activities of daily living. Current management of ankle sprain can be conservative or surgical for serious cases. However, long healing period is required for conservative management in addition to its side effects and the risk of post-operative complications for surgical management. Due to the current challenges and setbacks faced by existing intervention, this paper aims to generate ideas in incorporat- ing regenerative medicine as an intervention for ankle sprain. This review will provide a brief review on the existing management for ankle sprain along with some history, application and the potential of regenerative medicine in speeding up the healing process of ankle sprains.

Matched MeSH terms: Pain
Fulltext Subcapital Femoral Neck Tension Stress Fracture - A Rare Injury in A Child: A Case Report

Hayyun MF, Jamil K, Abd-Rashid AH, Ibrahim S

Malays Orthop J, 2021 Mar;15(1):132-134.
PMID: 33880161 DOI: 10.5704/MOJ.2103.021

Femoral neck stress fractures are rare in children. To the best of our knowledge, the tension type stress fracture has been reported only twice in the English language literature. We report on a five years follow-up of a 10-year-old boy with this injury which was initially missed. The fracture healed after screw fixation. We highlight the importance of considering stress fracture as a differential diagnosis in a child with chronic hip pain. A careful physical examination and the appropriate imaging will avoid missing the diagnosis.

Matched MeSH terms: Pain
Fulltext Ewing's Sarcoma of the Vertebral Body in an Adolescent: A Rare Case Report and Literature Review

Goh TC, Bajuri MY, Yusof MF, Mohd Apandi H, Sarifulnizam FA

Cureus, 2021 Mar 03;13(3):e13664.
PMID: 33824815 DOI: 10.7759/cureus.13664

We report the case of a 14-year-old girl who presented with a one-month history of back pain and bilateral lower limb weakness preceded by constitutional symptoms. She neither had a family history of malignancy nor a previous history of trauma. A series of imaging procedures revealed an aggressive lesion of the T12 vertebra with a large soft-tissue component and intraspinal extension leading to spinal cord compression causing cord edema. She underwent urgent posterior instrumentation and fixation of T9 to T12 vertebrae due to worsening neurological deficits. Adjuvant and neoadjuvant chemotherapy with palliative spinal stabilisation were also performed. Features of the lesion were highly consistent with ES on immunohistochemical study and fluorescence in situ hybridization (FISH) analysis for the EWSR1 gene. Postoperatively, both of her lower limbs improved in power and she benefited from regular physiotherapy.

Matched MeSH terms: Back Pain
Fulltext Acute Retropharyngeal Calcific Tendonitis as a Rare Cause of Odynophagia and Neck Pain

Singh PKM, Noor MIM, Jaafar R, Ahmad A, Mohamad I

Medeni Med J, 2021;36(1):75-79.
PMID: 33828894 DOI: 10.5222/MMJ.2021.37539

Retropharyngeal calcific tendonitis (RCT) is an aseptic inflammatory process of the superior oblique tendons of the longus colli muscle caused by the deposition of calcium hydroxyapatite crystals. We reported a 23-year-old woman who presented with a sudden onset of neck pain with odynophagia after waking up from sleep. Physical examination showed paracervical point tenderness with limited neck movement in all directions. Prior to surgery, further imaging was requested to aid in diagnosis, which in turn revealed RCT. It is important to be aware that RCT presentation may mimic other severe conditions such as retropharyngeal space abscess or meningitis.

Matched MeSH terms: Neck Pain

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