Rejected

Os vesalianum pedisis located proximal to the base of the fifth metatarsal. Rarely, this accessory ossicle can be the source of lateral foot pain. There are very few cases of symptomatic os vesalianum pedisdescribed in the literature, and most of them were surgically managed. We report a painful case of os vesalianum pedis managed conservatively. A 25-year-old professional soccer player presented with lateral left midfoot pain. There was no known acute sprain or trauma, and no history of injuries in the left lower limb. The athlete reported both mechanical and inflammatory pain findings and tenderness on the palpation of the fifth metatarsal base. We conducted a radiographic study of the left foot and found an image compatible with os vesalianum pedis​​​​​​​. A right foot X-ray was also performed, and similar findings were reported, although the athlete had no pain. The athlete was treated conservatively, and the return-to-play was seven days.  Due to the unspecific symptoms of our athlete, many diagnoses could be considered such as peroneus brevistendinopathy, lateral plantar fasciitis, ligamentum plantare longumsprain. However, the X-ray findings led us to other possible pathologies, mainly affecting the bone. Integrating clinical and radiological findings is mandatory to achieve a proper diagnosis and avoid mistakenly diagnosing a fracture such as a Jones fracture or pseudo-Jones fracture. Even though os vesalianum pedis​​​​​​​ is usually asymptomatic, this condition can lead to chronic pain. Well-designed conservative management should always be pursued to treat this condition as it might prevent the need for surgery.

Paraneoplastic neuropathy, including pruritis, remains a vexing problem as it often does not resolve even with successful treatment of cancer. Scrambler Therapy is a superficial form of neuromodulation that replaces the pain signal with "non-pain information" that is approved for chronic and neuropathic pain, with few side effects. We report here two cases of paraneoplastic neuropathy, one with additional pruritis, that both responded satisfactorily to Scrambler Therapy with no side effects.

Secondary headache is a symptom of an underlying disease. Infective endocarditis (IE) is a serious infection of the heart tissue. Herein, we present a rare case of IE, with a secondary headache. The patient presented with persistent headache, fever of 39°C, myalgia, and painful erythema of the plantar surface of the foot. The headache progressively worsened over a few weeks. She was diagnosed with secondary headache, and sepsis was suspected. Blood culture revealed the presence of leading to a diagnosis of IE. Postoperatively, the patient recuperated without any complications. Headaches can be secondary to other conditions. Therefore, comprehensive assessment and accurate diagnosis are essential. Dentists must be aware that headache is a concomitant symptom of IE.

Spontaneous intracranial hypotension (SIH) due to a spinal cerebrospinal fluid (CSF) leak is secondary cause of headache with potentially devastating consequences. Its diagnosis is complicated owing to the lack of a reasonable, minimally invasive screening test. This results in many patients remaining undiagnosed for years after the headache onset. Current testing approaches are either overly invasive, namely the CSF infusion protocol or both invasive and insensitive viz. lumbar puncture (LP) with an opening pressure (OP) or computed tomography myelogram (CTM). These diagnostic methods are frequently employed in a clinical setting since they require access to the thecal space; they unfortunately have a dearth of sensitivity. CTM will not document a leak if it is intermittent or very slow and in the setting of a spinal CSF leak, the OP on LP may be high, low, or normal. A potential remedy for this state is the T2-sampling perfection with application-optimized contrasts by using flip angle evolution (SPACE) protocol spinal magnetic resonance imaging (MRI). We present two cases that demonstrate its potential value as a screening tool. It is well known for its high sensitivity for identifying spinal pathology and is minimally invasive, making it a good choice for a screening modality when diagnosing possible SIH cases.

This study examined the effect of out-of-pocket (OOP) payment reduction on the potential utilization of low-value magnetic resonance imaging (MRI) across income groups.

Sylvian fissure (SF) arteriovenous malformations (AVMs) are among the most challenging vascular lesions amenable to neurosurgical treatment and account for 10% of all locations. As radiosurgery and endovascular techniques are increasingly involved in multimodal management protocols, the role of microsurgery needs to be reassessed as a stand-alone technique. The aim of this study was to show that total excision can be achieved with reasonable levels of morbidity and mortality in a real-world setting from a specialized high-volume center.

We are currently in the midst of a sleep crisis. Our current work and lifestyle environments are normalizing poor sleep with substantial negative impact on our health. Research on sleep has linked sleep deprivation to poorer mental health, obesity, cancer, diabetes, heart disease, and a myriad of other health conditions. Sleep deprivation is an even greater issues for people with musculoskeletal conditions and chronic pain. Between 67% and 88% of individuals with chronic pain experience sleep disruption and insomnia, and at least 50% of people with insomnia report chronic pain. The link between sleep and pain is well documented. Experimental, cohort, and longitudinal studies have all demonstrated that restricted sleep is linked to greater pain. Poor sleep therefore not only affects general health but has a direct impact on inflammation, pain response, and experience. Improving sleep in people living with musculoskeletal conditions and with chronic pain has the potential to deliver great benefit to many. This article describes the evidence base that can underpin such work, including research about the link between pain and sleep as well as theories and approaches to intervention that may help. © 2022 The Authors. published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.

Cerebral venous sinus thrombosis is an uncommon adverse event in immune thrombocytopenia (ITP) patients treated with thrombopoietin receptor agonists (TPO-RAs).

COVID-19 and seasonal influenza vaccines are essential in preventing respiratory infections and their potentially severe complications. Simultaneous administration of vaccines is efficient and may improve coverage with each vaccine. However, the safety of simultaneous administration of COVID-19 and influenza vaccines has not been well described.