• Title/Summary/Keyword: Buttock pain

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Ankylosing spondylitis associated with balanced reciprocal X-1 translocation (X염색체와 1번 염색체간 균형전위와 동반된 강직척추염)

  • Kim, Young Hoon;Lee, Jung Ouk
    • Journal of Yeungnam Medical Science
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    • v.34 no.1
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    • pp.80-83
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    • 2017
  • A number of research papers have reported more frequent occurrence of rheumatic/autoimmune disease among patients with hypogonadism or a chromosomal anomaly with potential X-chromosome defects. A 30-year-old female patient came to the hospital with a main cause of bilateral buttock pain, which began two years ago and worsened seven days ago. Ankylosing spondylitis with invasion of both sacral-iliac joints was observed. On magnetic resonance imaging, although the uterus was observed normally, an ovary was not observed. In a chromosome test, balanced reciprocal X-1 translocation of 46,X,t(X;1)(p10;q10) was diagnosed. Here, we report on the first case involving ankylosing spondylitis accompanied by balanced reciprocal X-1 translocation.

Acute Spinal Epidural Hematoma Following Unilateral Laminectomy for Bilateral Decompression

  • Lee, Dong-Yeob;Lee, Sang-Ho;Jang, Jee-Soo
    • Journal of Korean Neurosurgical Society
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    • v.40 no.1
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    • pp.35-37
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    • 2006
  • We present a case of acute spinal epidural hematoma[EDH] following unilateral laminectomy for bilateral decompression[ULBD]. A 45-year-old male presented with severe multi-level spinal stenosis underwent ULBD on the left side at the L2-3 and L3-4 level. Five hours after operation, paraparesis developed along with severe bilateral buttock pain. The CT scan showed an acute spinal EDH at the L2-3 level. The acute spinal EDH was successfully decompressed after emergency decompressive surgery with performing an additional laminectomy on the contralateral side at the L2-3 level. Although ULBD is an effective minimally invasive surgical technique for treating spinal stenosis, the possibility of acute spinal EDH should be kept in mind, as happened in our case.

A literatual studies on the suppurative osteomylitis(附骨疽) (附骨疽에 關한 文獻的 考察)

  • Hwang, Do-gun;Roh, Sek-seon
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.11 no.1
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    • pp.99-140
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    • 1998
  • In the literatual studies on the suppurative osteomylitis(附骨疽), the results were as follows. Suppurative osteomylitis(附骨疽) is called 'Mudujur(無頭疽)', is concerned with Pyogenic osteomyelitis in western medicine. The pathogenic factors of Suppurative osteomylitis were caused by exposing to wind-cold-wetness evil, or body weakness, or wound a bodily injury caused by physical means. The symptoms of Suppurative osteomylitis was alternating episodes of chills and fever, pain on buttock or thigh in onset. The differential diagnosis of Suppurative osteomylitis was divided three parts. One was the stagnation of virulent fire-evil. Another was the deficiency of both vital energy & blood. The other was wind-cold-wetness evil. The treatments of Suppurative osteomylitis was clearing away heat-evil and wetness evil, removing blood stasis and promoting meridian. In the frequency of prescription, the most numerous prescription were Osintang(五神湯) and Hwangyunhaidoktang(黃連解毒湯), the next were Neitakganghwaltang(內托羌活湯), Taibangpungtang(大防風湯) etc.

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A Clinical Study on Patients of Low Back Pain by DITI (적외선 체열촬영을 이용한 요통환자의 임상적 관찰)

  • Jin, Jae-do;Han, Moo-Gyu;Lee, Jeong-Hoon;Lee, seung-woo;Han, Sang-Won
    • Journal of Acupuncture Research
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    • v.18 no.4
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    • pp.22-31
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    • 2001
  • Objective : This study is designed to evaluate the correlation between the data of DITI (Digital Infrared Thermographic Imaging) and the clinical symptoms in the patients with low back pain. Methods : Among the outpatients with back pain who visited to Department of Acupunture & Moxibustion, Tae gu Oriental Hopital of Kyung San University from January 2000 to August, we selected 115 cases that examined DITI. We evaluated the correlation between the data of DITI examination and the clinical symptoms (Distribution of Sex and Age, Duration of Disease, Main Sign, Grade of Clinical Symptoms, Diagnosis according to Symptoms(辨證),) in the patients with low back pain. Results & Conclusion : 1. The thermal changes in terms of the duration of disease : The acutest period has the highest thermal change. Also, the longer the duration of disease was, the higher the termal change was. It increased in the order of the acutest period, the less acute period, and the the chronical period. 2. Thermal changes due to the main symptom : The degree of thermal change was as follows (from the highest to the lowest): first, back and knee pain, second, back and leg pain, third, back and buttock pain, fourth, numbness of leg, and fifth, back and dorsum pain. 3. Thermal changes in terms of the grade of clinical symptoms : The more servious the symptoms were, the higher the thermal change was. It was increased in the order of Gr 1, Gr 2, Gr 3, and Gr 4. 4. Thermal changes depdning on symptoms diagnosis : Chwaseom(挫閃) has the highest temperature, $0.87{\pm}0.49^{\circ}C$. 5. Thermal changes before and after treatment : Before treatment, the average thermal change was $0.83^{\circ}C$ but after treatment, it was decreased to $0.38^{\circ}C$. For the above symptoms, if DITI is used, the diagnosis is easier based on the medical history of the patient who has back pain, and the degree of pain. However, if thermal change is soly used for diagnosis, it will be hard to determine the nature of sickness. Therefore, it should be folllowed by other supplementary examination.

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Case Report of a Patient with Herpes Zoster and Hyperemesis Gravidarum (임신오조와 대상포진이 병발된 환자에 대한 치험 1례)

  • Lee, Ji-Hyun;Kim, Gun-Hee;Song, Mi-Hwa;Choi, Chang-Min
    • The Journal of Korean Obstetrics and Gynecology
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    • v.28 no.2
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    • pp.165-173
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    • 2015
  • Objectives : The purpose of this study is to report the effect of Korean medical treatment in patient with Herpes Zoster and hyperemesis gravidarum during pregnancy. Methods : 10 weeks pregnant patient with Herpes Zoster and hyperemesis gravidarum was treated by herbal medicine ( Bosaeng-tang ) and acupuncture. We measured visual analogue scale (VAS) and observed the change of skin lesion. Results : After treatment, vesicles and crusts of right buttock and lower leg clearly dis appeared. Patient no more suffered from nausea and vomiting. VAS (Visual analogue scale) of pain changed 8 to 0. After 7months, the patient gave birth to a healthy child. Conclusions : This case report shows that the Korean medical treatment is useful and safe in the treatment of Herpes Zoster and hyperemesis gravidarum during pregnancy.

Non-Traumatic Myositis Ossificans in the Lumbosacral Paravertebral Muscle

  • Jung, DaeYoung;Cho, Keun-Tae;Roh, Ji Hyeon
    • Journal of Korean Neurosurgical Society
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    • v.53 no.5
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    • pp.305-308
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    • 2013
  • Myositis ossificans (MO) is a benign condition of non-neoplastic heterotopic bone formation in the muscle or soft tissue. Trauma plays a role in the development of MO, thus, non-traumatic MO is very rare. Although MO may occur anywhere in the body, it is rarely seen in the lumbosacral paravertebral muscle (PVM). Herein, we report a case of non-traumatic MO in the lumbosacral PVM. A 42-year-old man with no history of trauma was referred to our hospital for pain in the low back, left buttock, and left thigh. On physical examination, a slightly tender, hard, and fixed mass was palpated in the left lumbosacral PVM. Computed tomography showed a calcified mass within the left lumbosacral PVM. Magnetic resonance imaging (MRI) showed heterogeneous high signal intensity in T1- and T2-weighted image, and no enhancement of the mass was found in the postcontrast T1-weighted MRI. The lack of typical imaging features required an open biopsy, and MO was confirmed. MO should be considered in the differential diagnosis when the imaging findings show a mass involving PVM. When it is difficult to distinguish MO from soft tissue or bone malignancy by radiology, it is necessary to perform a biopsy to confirm the diagnosis.

Does Single Blind Anterior Glenohumeral Steroid Injection Performed by Short Experienced Clinicians Could Provide Clinical Efficacy in Patients with Frozen Shoulder?

  • Hong, Jin Ho;Ryu, Ho Young;Park, Yong Bok;Jeon, Sang Jun;Park, Won Ha;Yoo, Jae Chul
    • Clinics in Shoulder and Elbow
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    • v.17 no.3
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    • pp.102-106
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    • 2014
  • Background: The purpose of this study was to evaluate the effect of single blinded anterior intra-articular corticosteroid injection to the glenohumeral joint performed by short experienced clinicians in frozen state adhesive capsulitis patients. Methods: From March to June of 2013, among the patients who visited the shoulder outpatient clinic due to shoulder pain for 5-6 months and those patient diagnosed as frozen state adhesive capsulitis was selected. The diagnosis were based on base, first the global limitation of range of motion, defined as forward elevation <100, external rotation at side <10, internal rotation less than buttock, and abduction <70. Second, the patients had additional radiologic evaluations showing no major pathologies for such stiffness. Clinical outcome, were performed with pain visual analog scale (PVAS) and functional visual analog scale (FVAS), American Shoulder and Elbow Surgeons Shoulder score (ASES), preinjection and postinjection after 2-4 weeks. Finally 82-patients were enrolled. Mean age of the patients was 55.1 years and mean follow-up duration was 25.17 days. Results: The mean preinjection PVAS was 6.91 and postinjection was 3.11, there was 3.8 decreases from preinjection status (p < 0.001). The mean FVAS score showed 4.26 at preinjection and 6.63 afterwards (p < 0.001). The ASES score showed 27.89 increases after injection (p < 0.001). There were 64-patients (78.04%) who reported more than 3 points of decrease of PVAS, who could be judged as effective treatment. Conclusions: Single anterior glenohumeral steroid injection by short experienced clinicians to the patients with frozen state adhesive capsulitis has shown relatively high efficacy in clinical result evaluated by means of PVAS.

Characteristics of the Buttock Interface Pressure According to Wheelchair Propulsion Speed and Various Back Reclined Seating Position (휠체어 추진속도 및 등받이 경사각도에 따른 둔부 압력 변화 특성)

  • Kwon, Hyuk-Cheol;Kong, Jin-Yong
    • Physical Therapy Korea
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    • v.12 no.2
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    • pp.1-10
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    • 2005
  • Pressure ulcers are serious complications of tissue damage that can develop in patients with diminished pain sensation and diminished mobility. Pressure ulcers can result in irreversible tissue damage caused by ischemia resulting from external loading. There are many intrinsic and extrinsic contributors to the problem, including interface tissue pressure, shear, temperature, moisture, hygiene, nutrition, tissue tolerance, sensory and motor dysfunction, disease and infection, posture, and body support systems. The purposes of this study were to investigate the relationship between buttock interface pressure and seating position, wheelchair propulsion speed. Seated-interface pressure was measured using the Force Sensing Array pressure mapping system. Twenty subjects propelled wheelchair handrim on a motor-driven treadmill at different velocities (40, 60, 80 m/min) and seating position used recline ($100^{\circ}$, $110^{\circ}$, $120^{\circ}$) with a wheelchair simulator. Interface pressure consists of average (mean of the pressure sensor values) and maximum pressure (highest individual sensor value). The results of this study were as follows; No significant correlation in maximum/average pressure was found between a static position and a 40 m/min wheelchair propulsion (p>.05). However, a significant increase in maximum/average pressure were identified between conditions of a static position and 60 m/min, and 80 m/min wheelchair propulsion (p<.05). No significant correlation in maximum pressure were found between a $90^{\circ}$ recline (neutral position) and a $100^{\circ}$, $110^{\circ}$, or $120^{\circ}$ recline of the wheelchair back (p>.05). No significant difference in average pressure was found between conditions of a $90^{\circ}$ recline and both a $100^{\circ}$ and $110^{\circ}$ recline of wheelchair back. However, a significant reduction in average pressure was identified between conditions of a $90^{\circ}$ and $120^{\circ}$ recline of wheelchair back (p<.05). This study has shown some interesting results that reclining the seat by $120^{\circ}$ reduced average interface pressure, including the reduction or prevention in edema. And interface pressure was greater during dynamic wheelchair propulsion compared with static seating. Therefore, the optimal seating position and seating system ought to provide postural control and pressure relief. We need an education on optimal seating position and a suitable propulsion speeds for wheelchair users.

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Clinical Features and Treatments of Upper Lumbar Disc Herniations

  • Kim, Duk-Sung;Lee, Jung-Kil;Jang, Jae-Won;Ko, Byung-Soo;Lee, Jae-Hyun;Kim, Soo-Han
    • Journal of Korean Neurosurgical Society
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    • v.48 no.2
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    • pp.119-124
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    • 2010
  • Objective : Disc herniations at the L1-L2 and L2-L3 levels are different from those at lower levels of the lumbar spine with regard to clinical characteristics and surgical outcome. Spinal canals are narrower than those of lower levels, which may compromise multiple spinal nerve roots or conus medullaris. The aim of this study was to evaluate the clinical features and surgical outcomes of upper lumbar disc herniations. Methods : We retrospectively reviewed the clinical features of 41 patients who had undergone surgery for single disc herniations at the L1-L2 and L2-3 levels from 1998 to 2007. The affected levels were L1-L2 in 14 patients and L2-L3 in 27 patients. Presenting symptoms and signs, patient characteristics, radiologic findings, operative methods, and surgical outcomes were investigated. Results : The mean age of patients with upper lumbar disc was 55.5 years (ranged 31 to 78). The mean follow-up period was 16.6 months. Most patients complained of back and buttock pain (38 patients, 92%), and radiating pain in areas such as the anterior or anterolateral aspect of the thigh (32 patients, 78%). Weakness of lower extremities was observed in 16 patients (39%) and sensory disturbance was presented in 19 patients (46%). Only 6 patients (14%) had undergone previous lumbar disc surgery. Discectomy was performed using three methods : unilateral laminectomy in 27 cases, bilateral laminectomy in 3 cases, and the transdural approach in 11 cases, which were performed through total laminectomy in 10 cases and unilateral laminectomy in 1 case. With regard to surgical outcomes, preoperative symptoms improved significantly in 33 patients (80.5%), partially in 7 patients (17%), and were aggravated in 1 patient (2.5%). Conclusion : Clinical features of disc herniations at the L1-L2 and L2-L3 levels were variable, and localized sensory change or pain was rarely demonstrated. In most cases, the discectomy was performed successfully by conventional posterior laminectomy. On the other hand, in large central broad based disc herniation, when the neural elements are severely compromised, the posterior transdural approach could be an alternative.

A Case of Sacral Tuberculosis Mimicking Metastatic Bone Tumor with Elevated CA 19-9 (CA 19-9 상승을 동반한 전이성 골종양으로 오인된 골결핵 1예)

  • Chang, Kyung-Yoon;Ha, Kyung-Sun;Park, Kyung-Seon;Sim, Eun-Hui;Byun, Jae-Ho
    • Journal of Yeungnam Medical Science
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    • v.28 no.2
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    • pp.196-201
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    • 2011
  • A 73-year-old male presented a six-month history of buttock pain radiating into his thigh. The MRI revealed a large enhancing mass lesion involving the sacrum, with extension into the sacral canal. The tumor markers were measured to distinguish skeletal metastasis of carcinoma from primary bone tumor. The CA 19-9 was elevated. Despite the investigation, the primary site of cancer could not be found. Sacral bone biopsy was done. The pathologic examination revealed necrosis, chronic granulomatous inflammation, and multinucleated giant cells, consistent with tuberculosis. Sacral tuberculosis is rare in patients with no history of tuberculosis. Such solitary osteolytic lesions involving the subarticular region of large joints may mimic bone neoplasms and may be called "tuberculous pseudotumors." This case report intends to emphasize that bone tuberculosis should be a differential diagnosis in the presence of atypical clinical and radiological features. As tuberculous lesions may be mistaken for neoplasms, a small amount of fresh tissue should be sent for culture even if clinical diagnosis of a tumor seems likely. Described herein is a case of sacral tuberculosis mimicking metastatic bone tumor with elevated CA 19-9.

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