Rejected

The pediatric chronic regional pain syndrome (CRPS) type I is a recognized syndrome that follows a preliminary event (e.g., trauma, fracture) with amplified spontaneous or stimuli-induced extremity pain that differs from its adult form with rather favorable outcomes. Conservative treatment is usually indicated for CRPS treatment. We present a unique case of an adolescent girl who revealed severe wrist joint sequelae following a blunt trauma, complicated by a challenging CRPS resistant to treatment. Diagnostic wrist arthroscopy eventually revealed a massive cartilage degeneration and scapholunate tear as underlying causes for the pain and CRPS. It was decided to proceed with radioscapholunate wrist fusion, which promptly led to pain relief and disappearance of the CRPS. The relevance of this report is therefore to emphasize the possibility, against earlier thoughts, that well-indicated surgeries in pediatric CRPS patients may lead to prompt symptom improvement and may not be uniformly predicted to fail. With the clinical probability of a presence of an uncontrolled, symptomatic causative factor such as cartilage degeneration and chondrolysis, further early diagnostic and therapeutic interventions may be indicated to control the disease.

Psoriasis and hidradenitis suppurativa (HS) are both chronic inflammatory skin diseases with significant comorbidity. This study aimed to examine how patients with psoriasis or HS cope with their conditions on a personal and psychosocial level, especially in times of clinical exacerbation and symptom deterioration.

The patient-reported outcomes measurement information system (PROMIS) offers standardized assessment measures of clinically relevant patient-reported outcomes. This study evaluated the reliability and validity of select PROMIS measures with U.S. military veterans following orthopedic surgery. Data for the current study were collected as part of a pilot randomized control trial assessing the efficacy of a 1-day Acceptance and Commitment Therapy workshop on persistent postsurgical pain in at-risk veterans undergoing orthopedic surgery. Sixty-seven participants completed surveys 3 months after surgery. Participants completed the following PROMIS instruments: PROMIS Anxiety Short Form 8a, PROMIS Depression Short Form 8b, and PROMIS Pain Interference Short Form 8a. PROMIS measures were compared to the Generalized Anxiety Disorder 7-Item Scale, the Patient Health Questionnaire 9-Item Scale, and the Brief Pain Inventory Pain Interference subscale, respectively. All three PROMIS measures demonstrated excellent internal consistency (Cronbach's αs ranged from .93 to .96) and each loaded onto a single factor. The PROMIS measures were moderately correlated with their respective comparison measures ( = .69 to .76). The PROMIS anxiety and PROMIS depression measures were highly correlated to one another ( = .91). Findings highlight the potential utility of these PROMIS measures in veterans following orthopedic surgery and the overlap between the PROMIS depression and anxiety measures in this sample.

Direct rigid laryngoscopy and general anaesthesia (GA) are associated with many problems. Regional anaesthesia/airway blocks can be considered as safer and easier alternative techniques especially among old and comorbid patients and conditions with difficult airways as well. The present study was conducted to compare efficacy of regional anaesthesia/airway blocks versus general anaesthesia for diagnostic direct (rigid) laryngoscopy.

Acute pericarditis is frequently encountered in clinical practice; however, pericarditis as the first presentation of Graves' disease is rare and mainly limited to case reports in the literature. We hereby report a case in which a young patient presented with pericarditis as the first manifestation of Graves' disease.

Distal radius fractures are among the most common pediatric fractures. In unstable fractures, treatment methods include closed or open reduction and percutaneous pinning with Kirschner wire (K-wire). This report presents a 13-year-old boy with an unstable distal radius and ulnar fractures, following an accident, who was treated with open reduction and K-wire fixation. He had pain and limited wrist range of motion for 6 months. Conventional radiography revealed a lytic lesion with evident sclerotic margin. Chronic osteomyelitis and Brodie's abscess were also indicated. A complete curettage and antibiotic therapy for 3 months was successful. Culturing results showed that and pathologic findings were in favor of chronic osteomyelitis. Subacute osteomyelitis and Brodie's abscess are rare retarded complications in percutaneous pinning of distal radius pediatric fractures. The curettage of the lesion and antibiotic therapy for at least 3 months would be successful and could result in good prognosis among children.

To describe a case of nontraumatic subperiosteal orbital hemorrhage (NTSOH) in a laboring patient with gestational immune thrombocytopenic purpura.

1) To investigate whether physical therapists (PTs) can correctly identify new-onset inflammatory arthritis; 2) To assess whether PTs are aware that new-onset inflammatory arthritis cases should be referred to a rheumatologist; 3) To explore the comfort level of PTs to refer to medical specialists; 4) To determine factors associated with correctly identifying inflammatory arthritis and referring to a rheumatologist.

This case summarizes the rehabilitation and return to play management of a 17-year-old elite male soccer player who required surgical stabilization of an Osteochondritis Dissecans (OCD) lesion of the trochlea groove. Trochlea groove lesions represent <1% of OCD cases, resulting in limited evidence to inform practice. The case was initially identified as antalgic running gait, and at this point the player revealed progressively worsening knee pain (over preceding 2 months) which presented as patellofemoral pain with a small knee effusion and quadriceps atrophy present on assessment. No improvement in symptoms after 2 weeks of unloading (no running) and traditional patellofemoral treatment prompted magnetic resonance imaging and computed tomography scans to inform surgical intervention. We present a summary of the four-stage rehabilitation process defined by objective assessments, resulting in a successful return-to-play 24 weeks post-surgery. This case advocates consideration of OCD in the assessment of persistent knee pain in young athletes.