Teoman Toni Sevinç

Treatment of plantar fasciitis using four different local injection modalities: a randomized prospective clinical trial.

BACKGROUND To determine the effectiveness of four different local injection modalities in the treatment of plantar fasciitis. METHODS In a prospective randomized multicenter study of plantar fasciitis, 100 patients were divided into four equal groups and were treated using four different methods of local injection: group A was treated with 2 mL of autologous blood alone; group B, an anesthetic (2 mL of lidocaine) combined with peppering; group C, a corticosteroid (2 mL of triamcinolone) alone; and group D, a corticosteroid (2 mL of triamcinolone) combined with peppering. The outcome was defined by using a 10-cm visual analog scale and modified criteria of the Roles and Maudsley score 3 weeks and 6 months after the injection and compared with the pretreatment condition. RESULTS The successful results in all of the groups after injections were higher than those in the pretreatment condition (P = .000). In groups C and D, in which local corticosteroid injections were used, excellent results were obtained, with superior effect in the group in which peppering was used (P < .05). CONCLUSIONS In the treatment of plantar fasciitis, combined corticosteroid injections and peppering is effective and produces better clinical results.

Intraneural hemangioma of the median nerve: A case report

Hemangiomas of the median nerve are very rare and, so far, only ten cases of intraneural hemangioma of this nerve have been reported in the literature. We present a case of 14-year-old girl who had a soft tissue mass in the region of the left wrist with signs and symptoms of carpal tunnel syndrome. Total removal of the mass was achieved using microsurgical epineural and interfasicular dissection. The symptoms were relieved completely, after this procedure, without any neurologic deficit. On follow-up two years later, no recurrence was observed. Whenever a child or young adult patient presents with CTS the possibility of a hemangioma involving the median nerve should be kept in mind in the differential diagnosis.

Lipoma arborescens of the peroneus longus and peroneus brevis tendon sheath: case report.

Lipoma arborescens is an uncommon pseudotumoral synovial lesion usually located in the suprapatellar pouch of the knee. Lipoma arborescens involving the synovial sheaths of the tendons is exceedingly rare. This diagnosis should be considered, particularly in patients with chronic joint effusion. We report a case with lipoma arborescens affecting the synovial sheaths of the peroneal tendons without involvement of the adjacent ankle joint. To our knowledge, this is the second reported case of lipoma arborescens involving tenosynovial sheaths of tendons around the ankle joint without ankle joint involvment.

Femoral nerve compression secondary to a ganglion cyst arising from a hip joint: a case report and review of the literature

IntroductionFemoral nerve compression due to a cystic lesion around the hip joint is rare and only a few cases have been described in the literature. Among these, true ganglion cysts are even more rare.Case presentationWe report the case of a 57-year-old woman with femoral nerve compression caused by a true ganglion cyst of the hip joint.ConclusionA high index of suspicion is required to predict a non-palpable cystic lesion around the hip joint as it may mimic different disorders and should be kept in mind in the differential diagnosis of unusual groin pain, radicular pain and peripheral vascular disorders.

Insufficiency fractures of both femoral necks in a young adult caused by osteoporosis: a case report

Insufficiency fractures of femoral necks due to osteoporosis of unknown aetiology occurring coincidentally on both sides in young adults, have not been described in English literature so far. A 18-year-old young girl presented with a 3-month history of gradual onset of bilateral thigh pain and progressive inability to walk. At the first look, plain radiographs of both hips showed no gross abnormal findings other than some tips on reduced bone mineral density of the femoral necks. MRI was ordered upon a high suspicion of fracture and T1-weighed MRI showed a linear low signal on both femoral necks. Dual-energy X-ray absorptiometry of the lumbar spine and femoral neck showed low mineral density. She was treated surgically with in-situ internal fixation using cannulated screws. The bilateral thigh pain was resolved and walking started immediately after the treatment. Insufficiency fracture of the femoral neck due to osteoporosis should be kept in mind even in young adults complaining of atypical pain without evidence of unusual activities. We used both the terms of stress fracture and insufficiency (osteoporotic) fracture interchangeably as the mechanism of fractures resemble each other.

Bilateral superficial peroneal nerve entrapment secondary to anorexia nervosa: a case report

We report a case of severe weight loss secondary to anorexia nervosa causing bilateral superficial peroneal nerve entrapment in a young female patient who was treated successfully by bilateral surgical decompression.

Guyon tunnel syndrome secondary to excessive healing tissue in a child: a case report

We describe a case of an 8-year-old boy who developed a combined motor and sensory neuropathy of the distal ulnar nerve, after sustaining a superficial injury to the right flexor carpi ulnaris tendon at the level of the distal wrist crease. Guyons canal syndrome is a very rare entity during childhood. We have noted only one prior description of this syndrome in the pediatric age group in a review of the English literature.

Sciatica of nondisc origin: hydatid cyst of the sciatic nerve. Case report.

The authors report on an 81-year-old woman with a primary hydatid cyst located in the posteromedial aspect of the thigh. She presented with sciatica, and the cyst was also associated with neurological dysfunction because of its intra-neural location. Diagnosis of a cyst in a nerve body is very rare, and the one reported here might be the first such case. So far, in all the previously reported cases in which there were also neurological findings, the cysts in the vertebral column were compressing the spinal cord or there was an intrapelvic mass compressing the sciatic nerve. Hydatid cyst should be considered in the differential diagnosis of sciatica, especially when treating patients who live in or have emigrated from areas of the world where Echinococcus granulosus is prevalent.

Granular cell tumor of the posterior tibial nerve as a rare cause of heel pain: a case report.

Granular cell tumor of peripheral nerves is extremely rare. We present the case of a patient with a well-capsulated intraneural granular cell tumor involving the posterior tibial nerve, who presented with chronic heel pain mimicking plantar fasciitis. Magnetic resonance imaging revealed a well-defined intraneural soft-tissue mass within the substance of the posterior tibial nerve. Histopathologic examination showed a granular cell tumor, which is extremely rare in the peripheral nerves. Heel pain is one of the common conditions handled by physicians, podiatrists, and orthopedic surgeons. Posterior tibial nerve lesions at the leg should be kept in mind in the differential diagnosis of patients with persistent heel and foot pain. Magnetic resonance imaging is a useful method in the anatomical evaluation of focal intraneural lesions.

Guyon’s Canal Syndrome Secondary to Ulnar Artery Stenosis Caused by a Constricting Fibrous Band; a Rare Cause of Ulnar Nerve Compression

1030 uyon’s canal syndrome secondary to space occupying lesions such as ganglia, lipomas and anomalous muscles are well recognized. On rare occasions, vascular lesions of the ulnar artery inside the Guyon’s canal may result in ulnar nerve compression. These include hemangiomas, aneurysms, thromboses, a tortuous ulnar artery and arteriovenous malformations.1-5 We report a case with dilatation of the ulnar artery in the Guyon’s canal secondary to a constricting fibrous band, as the cause of ulnar nerve compression. Guyon’s Canal Syndrome Secondary to Ulnar Artery Stenosis Caused by a Constricting Fibrous Band; a Rare Cause of Ulnar Nerve Compression