Year 2024, Volume 8 - Issue 4

Background: Osteomyelitis of the elbow is a rare but potentially serious inflammatory condition affecting the elbow joint. The condition is characterized by infection of the bone and surrounding tissue, usually caused by pathogenic bacteria. Although less frequent than osteomyelitis seen in other parts of the body, such as the hips or knees, elbow osteomyelitis requires special attention due to its complex localization and the diagnostic challenges it presents. Case Presentation: We will discuss the case of a 46-year-old patient who presented with an osteosynthesis-treated olecranon fracture and poor follow-up, who subsequently presented to the emergency department with osteomyelitis of the elbow. Conclusion: Elbow osteomyelitis is a complex and potentially devastating condition requiring a multidisciplinary clinical approach and early management. In light of the case study presented and the review of existing literature, several important conclusions can be drawn to improve the management of this condition.

Background: The use of cation exchange resins such as sodium polystyrene sulfonate (SPS) in the treatment of hyperkalemia has been associated with potential damage to the gastrointestinal tract. Case Description: We present a clinical case of a 63-year-old male patient admitted following a single-lung transplant who presented a complex postoperative period associating renal failure and hyperkalemia, therefore administering SPS. 17 days afterward, the patient presented a clinical exacerbation with acute abdominal pain, due to a sigmoid perforation. The patient underwent urgent surgery, performing an open sigmoidectomy and terminal colostomy. The anatomo-pathological study of the surgical specimen revealed abundant SPS crystals in the depth of the colonic wall. Conclusions: Close patient surveillance and a high clinical suspicion are essential to prevent potentially fatal complications from the use of SPS. Due to low incidence of this complication, the evidence in literature is limited to case reports and retrospective studies.

Background: Tuberculosis (TB) is a challenging disease; however, it is preventable and curable in most cases. In 2022, TB was the second most common single infection leading to death worldwide after coronavirus disease. Almost 10 million people get infected with TB every year. TB manifests clinically in two types: pulmonary and extrapulmonary; the pulmonary type is the most common. Case presentation: A 17-month-old medically free male infant was referred to our institution with right distal leg pain, swelling and skin changes, started 1 month ago. Since then, both pain and swelling worsened and led to limping. The father denied any history of recent trauma, fever, cough, night sweating, infections, contact with sick patients, skin rashes in other body parts, or any other systematic changes. The baby was delivered at full term by cesarian-section due to placenta previa, with a birth weight of 3500 g, Prenatal and postnatal history is unremarkable. The patient was vitally stable and appeared healthy with no dysmorphic features. He was able to bear weight on his feet; however, his gait and walking abilities could not be assessed. Local examination showed swelling, erythema, and tenderness over the right distal tibia with an intact range of motion. The patient was admitted and initial investigations were done for him. After close observation and multiple investigations, a diagnosis of TB-induced right tibial osteomyelitis was made, and first-line management was initiated. Conclusion: This report highlights the importance of orthopedic surgeons in considering TB-induced osteomyelitis in the differential diagnosis of vague musculoskeletal symptoms.

Background: Creutzfeldt Jacob disease is a rapidly progressive neurodegenerative disorder, which is invariably fatal and results in death within 1 year of onset. Patient presents with a variety of non-specific neuropsychiatric symptoms, like myoclonus, cerebellar symptoms, visual impairment, and behavioural abnormalities. The symptoms are rapidly progressive and cause early functional impairment in the patient. Case presentation: In this report, we discussed a case of 49 years old male presented with multiple neuropsychiatric symptoms. After a series of extensive diagnostic examinations and follow-up, the patient was diagnosed as probable sporadic Creutzfeldt-Jakob disease based on 2018 Centres for Disease Control and Prevention (CDC) criteria, with key findings of myoclonus, behavioural and cerebellar problems, visual abnormalities, abnormal hyperintensity signals on diffusion-weighted MRI and characteristic EEG waves. CSF 14-3-3 protein was significantly high. Conclusion: Sporadic CJD is a rare and fatal rapidly progressive neurodegenerative disorder, which claims prompt and precise diagnosis to help the clinicians in distinguishing it from potentially treatable neuropsychiatric disorders. This aspect elevates the significance of our report, as it aids not only the medical professionals but also the affected families. Early diagnosis enables family to prepare for disease course and appropriate management strategies.

Background: Disorders of Sexual Development (DSD) encompass congenital conditions with inconsistencies between sex chromosomes, gonads, and sexual anatomy. This study aimed to evaluate the outcomes of a genitoplasty technique in DSD patients, focusing on functionality and cosmetics. Methods: A prospective cohort case series was conducted at a university hospital in Riyadh, Saudi Arabia. Ten DSD patients underwent genitoplasty procedures with excision of urogenital membrane and use of local flap of labia minora for reconstruction. Data, including demographic information, operative findings, immediate and delayed postoperative information, were collected. Results: The single-stage genitoplasty technique demonstrated improved delayed cosmetic outcomes. Patients undergoing single-stage genitoplasty with excision of urogenital membrane and use of local flap of labia minora for reconstruction. This approach yielded superior long-term aesthetic outcomes, eliminating the need for additional surgeries. Conclusion: The new novel technique showed delayed satisfactory cosmetic outcomes compared to the previous one. Additionally, the new technique significantly reduced the need for subsequent interventions, such as second genitoplasty. These findings support the potential benefits of the new novel technique in improving long-term outcomes for individuals with DSD.