Neurological Hip Pathology

Fat embolism syndrome is the presence of a fatty embolus in the circulatory system that can manifest itself in multiple ways, ranging from asymptomatic presentation to respiratory failure, neurocognitive deficits, and death. It is a relatively common complication after procedures or conditions such as orthopaedic surgery, severe burns, liver injury, closed-chest cardiac massage, and liposuction. This pathology is relatively common in the field of orthopaedics, especially in long bone fractures and procedures such as total hip replacements...

BACKGROUND: The term limb girdle muscular dystrophy (LGMD) describes a group of genetic muscular disorders that require specialist input from neurologically trained clinicians. The plethora of potential symptoms of this heterogenous group can result in patients presenting initially to musculoskeletal (MSK) physiotherapists. CASE PRESENTATION: The following case report highlights the presentation of a 21 year old female attending with 2 years of spinal pain and an unusual pattern of weakness, namely when rising from a sitting position the hips were abducted and then internally rotated...

RATIONALE: Giant synovial osteochondromatosis of the thigh is a highly unusual disease without standard diagnosis and curative managements so far. Our focus is to report a very rare case of giant synovial osteochondromatosis successfully operated by surgical treatment. The management of these unique cases has certain educational significance in clinical practice. PATIENT CONCERNS: A 63-year-old previously healthy man presented to our institution with a 4-year history of continuous progressive hip pain and local numbness of right side in January 2018...

Background: Occasionally, hip pathologies may present alone or combined with lumbar spine pathology, especially lumbar stenosis. Although the history and clinical examination may help differentiate between the two, hip X-rays alone without accompanying magnetic resonance imaging (MRI) studies may prove unreliable. Case Descriptions: Case 1 - A 72-year-old male presented with the sudden onset of severe back and left posterior thigh pain. Straight leg raising test was positive at 70° (right) and 60° (left), and he had left lower extremity numbness and weakness...

Introduction: Metal toxicity secondary to corrosion and wear has been reviewed in the arthroplasty literature with evidence supporting dermatologic, neurologic, and cardiac involvement. This is the first report of a novel case with the occurrence of systemic pathology with only mildly elevated serum cobalt (Co) and chromium (Cr) levels due to trunnion wear in a metal-on-polyethylene articulation. Case Report: A 45-year-old female who had undergone a revision total hip arthroplasty developed concerning dermatologic, neurologic, and cardiac symptoms...

Post-menopausal osteoporosis women are at increased risk for skeletal fractures with higher mortality and lower quality of life. Some studies have reported fall risk reduction in the elderly after Tai chi practice. Tai chi is a weight bearing mind-body exercise that has been reported to positively influence bone mineral density and improve postural control in different pathologies. The aim of this observational randomized case control study is to evaluate the effect of Tai chi on balance and quality of life in postmenopausal women with osteoporosis...

Osteoid osteoma is a benign primary bone tumor of unknown etiology that occurs most commonly in males during adolescence and early adulthood. Osteoid osteoma affects the spine in 20% of cases, and may cause spinal deformity, stiffness, and pain that may sometimes be worst at night. We present a novel description of a partial laminectomy with cement augmentation after resection of an osteoid osteoma. A 22-year-old male with a past medical history of Hodgkin's lymphoma status post chemotherapy and radiation to the mediastinum, and right hip osteoblastoma treated with surgery and radiofrequency ablation presented with low back pain for five years with a recent onset of severe radicular symptoms...

This article describes the diagnostic value of musculoskeletal sonography in the management of tendon pathology and outlines a clinical example of its scope of utilization. Herein we describe the case of a 65-year-old man who sought rehabilitation services for left groin pain following a period of intense trekking and uphill walking. He presented with left hip flexor weakness and local tenderness over the left iliopsoas tendon with negative findings on neurological evaluation. Additionally, he presented with left hip capsule and hip flexor tightness with left gluteus maximus and gluteus medius weakness...

BACKGROUND: Postoperative delirium is a relatively uncommon condition in middle aged patients, but very widespread in patients with psychiatric and neurological diseases undergoing general anesthesia. Few studies are currently available in the literature on the perioperative anesthesiological management of patients suffering from spinocerebellar ataxia. CASE PRESENTATION: A 58-year-old Caucasian woman affected by spinocerebellar ataxia type 2 underwent total hip arthroplasty for advanced osteoarthritis...

Gait asymmetry is typically evaluated using spatio-temporal or joint kinematics parameters. Only a few studies addressed the problem of defining an asymmetry index directly based on muscle activity, extracting parameters from surface electromyography (sEMG) signals. Moreover, no studies used the extraction of the muscle principal activations (activations that are necessary for accomplishing a specific motor task) as the base to construct an asymmetry index, less affected by the variability of sEMG patterns...

Mucopolysaccharidoses (MPS) are a group of diseases characterized by abnormal accumulation of glycosaminoglycans (GAGs). Although there are differences among the various disease types, the osteoarticular system is always involved. The aim of the present study was to establish a framework for MPS-related orthopaedic manifestations and for their treatment. The authors, affiliated to three different Italian Orthopaedic Centres, report data taken from the literature reviewed in light of their accumulated professional experience...

Salmonella vertebral discitis/osteomyelitis is a rare manifestation of Salmonella infection. Here, we report a case of a 54-year-old Caucasian male who presented with five weeks of progressively worsening bilateral low back, buttock, and lower extremity pain following an 8-foot fall onto concrete from a ladder. Initial workup following the fall included hip X-ray and MRI of the lumbar spine and revealed only mild lumbar facet arthropathy and moderate left neural foraminal stenosis at L3-L4 without any concomitant hip or spine fracture...

Aims: The aim of this study was to identify the association between asymmetrical skin creases of the thigh, buttock or inguinal region and pathological developmental dysplasia of the hip (DDH). Patients and Methods: Between 1 January 1996 and 31 December 2016, all patients referred to our unit from primary or secondary care with risk factors for DDH were assessed in a "one stop" clinic. All had clinical and sonographic assessment by the senior author (RWP) with the results being recorded prospectively...

CASE: A 68-year-old woman who had undergone a right total hip arthroplasty presented with a right posterior hip dislocation, and subsequently developed an ipsilateral sciatic nerve palsy after closed reduction. Magnetic resonance imaging (MRI) with metal suppression demonstrated sciatic nerve entanglement around the prosthetic femoral neck. A sciatic nerve release was performed, resulting in poor early neurologic recovery. CONCLUSION: Sciatic nerve entanglement following closed reduction of a dislocated total hip prosthesis is a rare injury...

In the mature adult skeleton, new bone formation is normally restricted to regeneration of osseous tissue at sites of fracture. However, heterotopic ossification, or the formation of bone outside the normal skeleton, can occur within muscle, adipose, or fibrous connective tissue. Periarticular non-hereditary heterotopic ossification (NHHO) may occur after musculoskeletal trauma, following CNS injury, with certain arthropathies, or following injury or surgery that is often sustained in the context of age-related pathology...

A forty-year-old man experienced worsening heart failure four years following bilateral complicated total hip replacement. His condition was extensively worked up but no underlying pathology was immediately evident. Given the cobalt-chromium alloy component present in the hip arthroplasties, the raised cobalt blood levels, and a fitting clinical picture coupled with radiological findings, the patient underwent right hip revision. Evidence of biotribocorrosion was present on direct visualisation intraoperatively...

In this paper, a novel gait assessment system based on measures of gait variability reflected through the variability of shapes of gait cycles trajectories is proposed. The presented gait assessment system is based on SVM (support vector machine) classifier and on gait variability-based features calculated from the hip and knee joint angle trajectories recorded using wearable IMUs during walking trials. A system classifier was trained to distinguish healthy gait patterns from the pathological ones. The features were extracted by calculating the distances between the joint trajectories of the individual gait cycles using 4 different distance functions...

BACKGROUND: The incidence of peripheral artery disease (PAD) and cardiovascular (CV) events in the female population has been on the increase. AIM: To analyse the risk factors of a CV event and PAD in women and to assess the usefulness of the ankle-brachial index (ABI). METHODS: Evaluation of selected parameters in a cohort of 365 women living in the same district. The following data were prospectively recorded: weight, height, waist size, hip circumference, smoking, the intima-media complex, ABI value, and laboratory results...

BACKGROUND: Mouse has been extensively used as a tool for investigating the onset and development of human neurological disorders. As a first step to construct a transgenic mouse model of human brain lesions, it is of fundamental importance to clarify the similarity and divergence of genetic background between non-diseased human and mouse brain tissues. METHODS: We systematically compared, based on large scale integrated microarray data, the transcriptomes of three anatomically distinct brain regions; prefrontal cortex (PFC), hippocampus (HIP) and striatum (STR), across human and mouse...

Lumbar stenosis is frequently observed and treated by spine surgeons. The extent of neurological decompression and the potential spinal fixation are the basic concerns when surgery is planned. But this segmented approach to the problem is sometimes insufficient due to the complex functional situations induced by a sagittal imbalance of the patient and the combination of pathologies known as hip-spine or knee-spine syndromes. A total of 373 consecutive patients included from our EOS and clinical data base. Patients were divided in two groups...