Academic literature on the topic 'Lumbar vertebrae Examination'
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Journal articles on the topic "Lumbar vertebrae Examination"
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Kottlors, Michael, and Franz Xaver Glocker. "Dermatomyotomal supply in patients with variations in the number of lumbar vertebrae." Journal of Neurosurgery: Spine 12, no. 3 (March 2010): 314–19. http://dx.doi.org/10.3171/2009.9.spine09114.
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Object Variation in the number of lumbar vertebrae occurs in a small portion of the population. Either the fifth lumbar vertebra shows assimilation to the sacrum or the first sacral vertebra shows a lumbar configuration, resulting in 4 or 6 lumbar vertebrae, respectively. Etiologically, lumbar nerve root syndrome is diagnosed by comparing the anatomical level of the disc herniation to the compressed nerve root and to the pattern of the peripheral sensory and motor deficit. In case of a variation in the number of lumbar vertebrae, defining the lumbar nerve roots becomes difficult. Variations in the number of lumbar vertebrae make the landmarks (the twelfth rib and the first sacral vertebra) unreliable clues to define the nerve roots. The allocation of the clinically damaged segment to the spinal disorder seen in imaging studies is essential for differential diagnosis and spine surgery. Methods A retrospective study was conducted of clinical, electrophysiological, and imaging data among inpatients over a period of 21 months. Eight patients who had isolated monosegmental discogenic nerve root compression and a variation in the number of lumbar vertebrae were selected. Results Seven patients presented with 6 lumbar vertebrae, and 1 patient presented with 4 lumbar vertebrae and disc herniation on 1 of the 2 caudal levels. Compression of the second-to-last nerve root in patients with 6 lumbar vertebrae resulted either in clinical L-5 or S-1 syndrome, or a combination of both. Compression of the last caudal nerve root resulted in a clinical S-1 nerve root syndrome. Conclusions The findings suggest that the dermatomyotomal supply of the lumbosacral nerve roots can vary in patients with a variation in the number of lumbar vertebrae, and a meticulous clinical, radiological, and electrophysiological examination is essential.
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Prasad, S., V. Parikh, J. Shah, D. Patkar, and T. Patankar. "Avascular Necrosis of Two Contiguous Vertebral Bodies." Rivista di Neuroradiologia 13, no. 2 (April 2000): 269–72. http://dx.doi.org/10.1177/197140090001300218.
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Avascular necrosis of the vertebral body is extremely uncommon with majority of reported cases being secondary to traumatic compressive fractures. We describe the imaging findings of AVN of two contiguous lumbar vertebrae following osteoporotic compression fracture in an elderly patient with diffuse idiopathic skeletal hyperostosis which was confirmed on histopathological examination. The affection of two adjacent vertebrae and their intervening disc was an atypical feature and prompted us to consider neoplastic condition in the differential diagnosis.
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P, Neelima, and Ravi Sunder R. "OCCIPITALISATION OF ATLAS VERTEBRA AND ITS CLINICAL FRAMES OF REFERENCE- AN ANALYSIS." Journal of Ayurvedic Herbal and Integrative Medicine 1, no. 1 (October 23, 2021): 58–61. http://dx.doi.org/10.29121/j-ahim.v1.i1.2021.15.
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Vertebral column is made of 33 vertebrae named as cervical, thoracic, lumbar, sacral and coccygeal vertebrae. Axial skeleton comprises of skull and vertebral column. 12 pairs of cranial nerves and 31 pairs of spinal nerves exit from the central nervous system which control the entire body. Malformations or fusion of vertebrae could be one of the etiologies of nerve compression syndromes. Vital structures emerge out through intervertebral foramina extending from cervical to coccygeal vertebrae. Occipitalisation of atlas, the first cervical vertebra is one of the emergencies leading to wide spectrum of presentations like chronic neck pain or foramen magnum syndrome or unconscious state due to compression of medulla oblongata. During routine examination of skull bones while teaching, one skull was found to exhibit assimilation of atlas. Photographs were captured and compared with normal skull. Thorough examination revealed incomplete occipitalisation of atlas. The anterior arch was completely fused but the posterior arch was bifid showing a split. The styloid process on right side seemed to be long and very close leading to compression of structures of styloid apparatus in addition. On observation, it was found to be a male skull. Fusion of vertebrae may be a congenital anomaly due to maldevelopment of somites in forming vertebrae. Skeletal element of caudal 4th occipital somite forms the occipital bone and when it is fused with the proximal 1st cervical somite leads to occipitalisation of atlas. Acquired conditions like atlantoaxial subluxation, chiari malformations or cervical vertebral fusion or foramen magnum abnormalities have been associated with assimilation of atlas. The present study reports occipitalisation of atlas which is incomplete with a bifid posterior arch. Prevalence of such anomalies may form the differential diagnosis of chronic headache or myelopathies.
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Kamal, AHM Mostafa, Shamim Ara, Shahanaz Begum, Md Mesbahul Hoque, and Khadeza Khatun. "Sacralization : Sacrum with Five Pairs of Sacral Foramina." Bangladesh Journal of Anatomy 11, no. 2 (October 18, 2014): 54–57. http://dx.doi.org/10.3329/bja.v11i2.20670.
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Context : The sacrum generally is composed of five vertebrae fused to form a triangular bony mass with four pairs of sacral foramina. The sacrum may contain six vertebrae, by development of an additional sacral element or by incorporation of the fifth lumbar or first coccygeal vertebrae produces five pairs of sacral foramina. Sacralization is entirely undiagnosable without an X-ray examination and rarely present any symptoms. Sacra of six bodies with five pairs of sacral foramina are found frequently in the department of anatomy during routine study of bones. Material and Methods: The present study was performed on 218 (two hundred eighteen) adult human dry sacra of unknown sex. The study samples were distributed into male and female sex groups by discriminant function analysis The study was descriptive type and was conducted in the department of Anatomy, Dhaka Medical College, Dhaka, from January 2011 to December 2011. The sacrum was examined to assess the number of its vertebral segments and sacral foramina. Result : A typical sacrum consisting of 5 segments with four pairs of sacral foramina was observed in 78.9 % cases, while sacralisation with five pairs of sacral foramina was seen in 21.10 % of cases. Conclusion: The number of vertebrae in sacrum may be increased by fusion of fifth lumbar vertebra or first coccygeal vertebra producing sacralization. The knowledge of significant number of sacralization is necessary in managing spinal surgery and for diagnostic and therapeutic purpose in low back pain. DOI: http://dx.doi.org/10.3329/bja.v11i2.20670 Bangladesh Journal of Anatomy, July 2013, Vol. 11 No. 2 pp 54-57
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Yookwan, Watcharaphong, Sornsupha Limchareon, Sang-Hun Lee, Jun-Su Jang, Daesung Lee, and Krisana Chinnasarn. "Coarse X-ray Lumbar Vertebrae Pose Localization and Registration Using Triangulation Correspondence." Processes 11, no. 1 (December 27, 2022): 61. http://dx.doi.org/10.3390/pr11010061.
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Plain film X-ray scanners are indispensable for medical diagnostics and clinical procedures. This type of device typically produces two radiographic images of the human spine, including the anteroposterior and lateral views. However, these two photographs presented perspectives that were distinct. The proposed procedure consists of three fundamental steps. For automated cropping, the grayscale lumbar input image was initially projected vertically using its vertical pattern. Then, Delaunay triangulation was performed with the SURF features serving as the triangle nodes. The posture area of the vertebrae was calculated by utilizing the edge density of each node. The proposed method provided an automated estimation of the position of the human lumbar vertebrae, thereby decreasing the radiologist’s workload, computing time, and complexity in a variety of bone-clinical applications. Numerous applications can be supported by the results of the proposed method, including the segmentation of lumbar vertebrae pose, bone mineral density examination, and vertebral pose deformation. The proposed method can estimate the vertebral position with an accuracy of 80.32 percent, a recall rate of 85.37 percent, a precision rate of 82.36%, and a false-negative rate of 15.42 percent.
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Fitriana, Lutfatul, Hernastiti Sedya Utami, and Festyana Filauhid. "RADIOGRAPHIC EXAMINATION TECHNIQUES OF LUMBAL VERTEBRA IN CASE OF LOW BACK PAIN IN ISLAMIC HOSPITAL PURWOKERTO." Medical Imaging and Radiation Protection Research (MIROR) Journal 2, no. 2 (December 1, 2022): 36–40. http://dx.doi.org/10.54973/miror.v2i2.257.
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Low Back Pain (LBP) is a pain condition that attacks the lower part of the spine, caused by injury to muscles or ligaments, common causes include lifting the wrong weight, poor posture, not exercising regularly and so on. One of the radiological examinations to establish the diagnosis of LBP is a radiographic examination of the lumbar spine. In the examination procedure, the radiological examination of the lumbar spine, the patient's position during the examination was arranged to sleep supine on the examination table, while at RSI Purwokerto the examination of the lumbar vertebrae with the case of LBP the patient position setting was arranged to stand in front of the bucky stand. The research used in the preparation of this scientific article is a qualitative research with approach case study, the method of data collection is carried out by direct observation of the technique of radiographic examination of the lumbar spine with LBP cases at the Radiology Installation of Islamic Hospital Purwokerto and data collection methods by taking data from documents, including radiographs, medical records and radiographic readings. On radiographic examination of the lumbar spine with LBP cases with the patient standing, the results were: low back pain with normal lumbar curvature and no disc narrowing. Conclusions that can be drawn from the technique of examining the lumbar vertebrae at the Radiology Installation of the Islamic Hospital of Purwokerto were carried out with the AP and Lateral erect projections. the use of this projection can be more informative and can clarify the intervertebral space or narrowed intervertebral disc.
Keywords : Low Back Pain, Radiography, Erect
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Ramzan, Ameena, Taiba Zulfiqar, Abid Ali, and Khadija Bakhtawar. "Evaluation of Lumbar Spine Injuries on Computed Tomography." Pakistan Journal of Medical and Health Sciences 16, no. 10 (October 30, 2022): 676–78. http://dx.doi.org/10.53350/pjmhs221610676.
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Objective: To use computed tomography to examine the findings of lumbar spine trauma. Material and methodology: This cross-sectional study which was performed with a sample size of 50 patients in 6 months from October-2022 to march-2022 calculated via a convenient sampling technique by taking the mean from previously published studies. This study was carried out at 3 private hospitals in Sialkot, Pakistan after informed consent. Data were statistically analyzed using SPSS version 20. Frequency and percentages were mentioned. Results: Mostly patients were male 27(54%) and the least number of patients were females 23(43%). The most frequent age group was 55-65 years15 (30%). The most frequent weight was 66-75kg 20(40%) and the lowest weight was 46-55kg 8(16%). There is a high risk of lumber spine trauma in overweight patients. The most frequent type was simple 30(60%) and the least type was comminuted 5(10%). the most frequent findings were mild 30(60%) Single vertebral fracture 36(72%) is most common. L1 12(24%) was most common affected. Conclusion: Males have a higher incidence than females, with males. Vertebra number one is more influenced than the others in terms of the number of affected vertebrae. Simple fractures are the most common type of fracture. CT examination is best for evaluating lumbar spine injuries. Keywords: Computed tomography, Lumbar, Spine, Trauma
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Imran, S., and S. Sharma. "Transcutaneous ultrasonographic examination of the left kidney in healthy cows." Veterinární Medicína 59, No. 1 (February 14, 2014): 29–32. http://dx.doi.org/10.17221/7243-vetmed.
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The aim of this study was to assess the feasibility of a new technique for transcutaneous ultrasonographic imaging coupled with transrectal manoeuvering for the examination of the left kidney using 10 clinically healthy Jersey/Red Sindhi crossbred cows. The areas extending caudally from the tuber-coxae, cranially up to the 11<sup>th</sup> intercostal space, dorsally from the lumbar transverse processes, and ventrally up to the midflank on both sides (left and right) were shaved. The transducer was placed in the right and left paralumbar fossae, the 3<sup>rd</sup> (between vertebrae L3 and L4) and the 4<sup>th</sup> (between vertebrae L4 and L5) lumbar spaces, respectively. For transrectal manoeuvring of the left kidney, the arm was inserted in to the rectum beyond the elbow to palpate and push the left kidney gently towards the right abdominal wall. The left kidney was imaged in its entirety from the right paralumbar fossa in all of the cows. However, it could not be imaged with clarity without a gentle transrectal push towards the right abdominal wall at the time of imaging. The left kidney was also imaged via the 3<sup>rd</sup> (between vertebrae L3 and L4) and the 4<sup>th</sup> (between vertebrae L4 and L5) lumbar spaces in only eight of 10 cows, but the quality of imaging was poor in comparison to the transflank imaging. Moreover, in four of ten cows, the right and left kidneys were imaged together in one ultrasonographic image. On the basis of our results we consider transcutaneous ultrasonography, simultaneously supported with transrectal manoeuvring, to be suitable for evaluation of the left kidney in cows. The findings reported in this study may be of assistance to veterinary surgeons by providing a basis for use in clinical procedures such as transcutaneous ultrasonography-guided renal biopsies.
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Csóka, Ádám, Örs Petneházy, Dániel Fajtai, Máté Sándor, Szilvia Orsi-Gibicsár, and Tamás Donkó. "Automatic method for determining the number of lumbar and thoracic vertebrae in rabbits using Computer Tomography images." Acta Agraria Kaposváriensis 25, no. 2 (December 15, 2021): 41–51. http://dx.doi.org/10.31914/aak.2626.
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There are several studies dealing with the phenotypic variance of the vertebral number in the spinal column of rabbits. According to the literature the number of thoracic and lumbar vertebrae varies between 11-13 and 6-8, respectively. The length of the m. longissimus dorsi (MLD) - a valuable meat part of rabbits - is determined by the length of the vertebral column therefore the number of vertebrae may have economic importance in breeding. The aim of this study was to create an automatic counter using computed tomography (CT) images. In the first step, a skeleton binary mask was created using the radiodensity range between 120 and 3071 HU, then the lumbar and thoracic regions were processed by two different methods. The lumbar part was evaluated based on the frequency of the bone voxels along the axial plane. The number of thoracic vertebrae was determined from the number of ribs. The left and right ribs were processed separately. The developed method was tested on CT examination of 40 Hycole rabbits compared to manual evaluation. The results of the automatic algorithm had few errors: in one case in the lumbar region (2.5%) and in 3 cases in the thoracic region (5%). The automated evaluation process takes a few seconds per individual and then the program visualizes the results on a graph. The incorrectly evaluated rabbits are recognizable on graphs and they can be easily corrected with a minimal time investment.
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Matres-Lorenzo, Luis, Antoine Bernardé, and Fabrice Bernard. "Video-assisted removal of metal pellet fragments from the vertebral canal following gunshot injury and long-term outcome in a cat." Veterinary and Comparative Orthopaedics and Traumatology 29, no. 05 (September 2016): 439–43. http://dx.doi.org/10.3415/vcot-16-02-0025.
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Summary Objective: To describe the surgical management and long-term outcome of a spinal gunshot injury in a cat. Clinical report: A two-year-old, 4.2 kg castrated European Shorthair male cat was referred for evaluation of bilateral acute hind-limb paralysis with loss of deep pain perception in the right hindlimb associated with a perforating gunshot wound in the left side of the flank. Based on the clinical findings, the injury was localized to the fourth lumbar-first sacral spinal cord segment. The orthogonal spinal radiographs and computed tomography examination showed several metal pellet fragments within the vertebral canal of the sixth lumbar vertebra. A left mini-hemilaminectomy of the sixth lumbar vertebra pedicle combined with a mini dorsal laminectomy over the sixth to seventh lumbar vertebrae disc space were performed. A 2.4 mm 30° arthroscope was then introduced within the spinal canal to improve visibility and help with the fragment extraction. The cat was discharged from the hospital five days after surgery and the owners were encouraged to continue passive and active physiotherapy movements. Results: The cat was ambulatory with a plantigrade stance eight weeks following surgery. At the last follow-up examination (24 months postoperatively), the cat was able to jump on chairs, although intermittent urinary and faecal incontinence, proprioceptive deficits, and plantigrade stance were still present. Clinical significance: Decompressive surgery may promote neurological status improvement following spinal gunshot injury.
Books on the topic "Lumbar vertebrae Examination"
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Lee, Diane. The pelvic girdle: An approach to the examination and treatment of the lumbo-pelvic-hip region. 2nd ed. Edinburgh: Churchill Livingstone, 1999.
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The pelvic girdle: An approach to the examination and treatment of the lumbo-pelvic-hip region. Edinburgh: C. Livingstone, 1989.
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The pelvic girdle: An approach to the examination and treatment of the lumbo-pelvic-hip region. 3rd ed. Edinburgh: Churchill Livingstone, 2004.
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McKenzie, Robin. The lumbar spine: Mechanical diagnosis and therapy. Waikanae, NZ: Spinal Publications, 2003.
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National Center for Health Statistics (U.S.) and National Health and Nutrition Examination Survey (U.S.), eds. Lumbar spine and proximal femur bone mineral density, bone mineral content, and bone area, United States, 2005-2008: Data from the National Health and Nutrition Examnination Survey (NHANES). Hyattsville, Md: U.S. Dept. of Health and Human Services, Centers for Disease Control and Prevention, National Center for Health Statistics, 2012.
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National Institutes of Health (U.S.). Clinical Center, ed. Preparing for a lumbar puncture. [Bethesda, Md.?]: National Institutes of Health, Clinical Center, 1994.
Find full textBook chapters on the topic "Lumbar vertebrae Examination"
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Parilovsky, Оlexander, and Ivan Yatsenko. "FORENSIC VETERINARY CHARACTERISTICS OF FRACTURES, FRACTURE DISLOCATIONS, DISLOCATIONS AND SUBLUXATIONS OF THE BONES IN THE ANIMAL SKELETONS QUALIFIED AS SEVERE INJURIES." In Priority areas for development of scientific research: domestic and foreign experience. Publishing House “Baltija Publishing”, 2021. http://dx.doi.org/10.30525/978-9934-26-049-0-42.
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The article presents forensic veterinary characteristics of fractures, fracture dislocations, dislocations and subluxations of skeletal bones in animals classified as severe injuries, including open and closed fractures of the upper and lower jaws, which lead to inability to receive normal food and water after healing; fracture or fracture dislocation of one or more thoracic or lumbar vertebrae along with spinal cord dysfunction or in the presence of clinically established severe shock; fracture of the dorsal or ventral arch of the first cervical vertebra; fractures and fracture dislocations of arches from the second to the seventh cervical vertebrae, as well as fractures of the dentate gyrus of the second cervical vertebra, including or excluding violation of the integrity and function of the spinal cord; dislocations and subluxations of the cervical vertebrae with life-threatening phenomena; closed fractures of the hyoid bone, closed and open injuries of the endocrine glands, which are located in the neck (thyroid, parathyroid, thymus - in young animals) - with life-threatening phenomena; open fractures of the humerus, femur and tibia; pelvic fractures with life-threatening phenomena. These injuries are classified as severe due to the fact that they harm the health of the animal and are life-threatening at the time of infliction, or after a certain period of time. They lead to the emergence and development of life-threatening phenomena and without necessary and sufficient veterinary care may end in death. A bone fracture is a complete violation of its anatomical integrity. Fractures can be non-fragmentary with the division of the bone into two fragments, fragmentary, and traumatic epiphysiolysis (with separation of bone part). If traumatic dislocation is accompanied by a fracture of the articular end of the bone, this condition should be diagnosed as fracture dislocation. For forensic veterinary examination of animals in case of fractures of tubular bones, such important features as the type of deformation (displacement (cutting), bending, compression, torsion, tension), the direction of the fracture line, the depth of penetration of fragments, the place of application of fractures, differentiation of injury, establishing the characteristics of the subject, the sequence of injury and the mechanism of injury should be taken into account. The empirical basis of the study is the analysis of expert opinions on the results of forensic veterinary examinations on animal cruelty, conducted in the Bureau of Forensic Veterinary Research at Kharkiv State Zooveterinary Academy from 2010 to 2020, as well as at the laboratory of forensic research of the National Research Center “Institute of Forensic Science named after Professor M.S. Bokarius” of the Ministry of Justice of Ukraine from 2017 to 2020. The aim of the study was to provide forensic veterinary characteristics of fractures of the skeletal bones in animals qualified as serious injuries. Modern methods of scientific cognition are used, in particular: general scientific (system-structural analysis, logical-grammatical, modelling), as well as special (clinical and pathomorphological).
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Pinto, Marcus V. R., and P. James B. Dyck. "Difficult-to-Treat Polyradiculoneuropathy." In Mayo Clinic Cases in Neuroimmunology, edited by Andrew McKeon, B. Mark Keegan, and W. Oliver Tobin, 135–37. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780197583425.003.0043.
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A 51-year-old healthy man sought care for a 6-month history of progressive, distal, lower extremity weakness, imbalance, and numbness in the feet. Neurologic examination showed a steppage gait, upper and lower extremity weakness, distal greater than proximal, absent tendon reflexes, and large fiber–predominant sensation loss in the feet. Nerve conduction studies showed marked temporal dispersion and slowed conductions. Cerebrospinal fluid analysis showed an increased protein concentration, 1 white blood cell/µL, and normal glucose level. Lumbar spine magnetic resonance imaging showed enlargement and enhancement of the nerve roots in the cauda equina, along with hypointensity in lumbar vertebral bodies. He underwent right sural nerve biopsy that showed an inflammatory demyelinating process. The patient was diagnosed with chronic inflammatory demyelinating polyradiculoneuropathy and started on intravenous immunoglobulin. He was markedly worse at 12-week follow-up, with severe proximal and distal weakness and requiring the use of a walker. The diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy was revisited. Lumbar spine magnetic resonance imaging again showed enhancement of the nerve roots. Because of concern for neurolymphomatosis, a proximal fascicular nerve biopsy of the right sciatic nerve was performed. It showed the hallmark pathologic features of chronic inflammatory demyelinating polyradiculoneuropathy: endoneurial inflammation and signs of long-standing demyelination and remyelination with stacks on Schwann cell processes. The diagnosis of chronic inflammatory demyelinating polyradiculoneuropathy was confirmed. Intravenous immunoglobulin was stopped, and the patient was started on an aggressive plasma exchange regimen. He had modest improvement. Azathioprine was also started. The patient continued to improve. He remained on this regimen for 2 years. Over the next year, the intravenous methylprednisolone dose was reduced. He was weaned off plasma exchange and intravenous methylprednisolone. At the last follow-up the disease was still in remission. Chronic inflammatory demyelinating polyradiculoneuropathy was described and named in 1975. It is a fairly symmetric peripheral neuropathy that usually presents with proximal and distal weakness, imbalance, and large fiber sensory dysfunction. Cerebrospinal fluid analysis shows albuminocytologic dissociation in 80% to 95% of those with typical chronic inflammatory demyelinating polyradiculoneuropathy.
Conference papers on the topic "Lumbar vertebrae Examination"
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Dickerson, Clark R., Subrata Saha, and Charlotte Hotchkiss. "QCT Cortical Shell Thickness as a Predictor of Vertebral Body Strength for Cynomolgus Monkeys." In ASME 1999 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 1999. http://dx.doi.org/10.1115/imece1999-0437.
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Abstract Many studies have investigated the ability of vertebral trabecular BMC measurements to predict overall vertebral strength. Far fewer investigations, however, have examined the use of cortical shell data to predict maximum strength. In this study, we are investigating the load-carrying characteristics of the cortical region of vertebral bodies Lumbar vertebrae from macaca fascicularis were examined by QCT and mechanically tested in compression. Our results show that cortical thickness, as determined by QCT, is a significant predictor of vertebral maximum stress (R = 0.62, p < 1 E−5). This relationship is improved when the cortical thickness is compared to load (R = 0.77, p < 5 E−10). This information reveals that the cortical shell plays a major role in determining the load carrying capacity of lumbar vertebrae, and that examination of cortical thickness will give an approximation of maximum vertebral stress and load.
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Nascimento, Ranier Colbek, and Sabrina Ribas Freitas. "A 29-YEAR-OLD PREGNANT WOMAN WITH METASTATIC BREAST CANCER: A CASE REPORT." In Abstracts from the Brazilian Breast Cancer Symposium - BBCS 2021. Mastology, 2021. http://dx.doi.org/10.29289/259453942021v31s2107.
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Pregnancy-associated breast cancer (PABC) is defined as a breast cancer diagnosed during pregnancy, lactation, or in the first postpartum year. PABC is a rare complication that occurs in approximately 0.01% to 0.03% of all pregnancies. The difficulty in diagnosis worsens the prognosis. D.G., 29-year-old, female, noted a mass in her right breast in June 2020. One month later with 13+4 weeks’ gestation, she presented to the obstetrics emergency with recurrent episodes of lower back pain. She was released home with pain relief and was instructed to realize a mammography due to the presence of a 4-cm mass on physical examination of the right breast. Patient returned 12 days later with severe low back pain, a BIRADS 4C mammography, and multiple liver lesions in total abdomen ultrasound. Core-needle biopsy demonstrated a stage II invasive ductal carcinoma with hormone receptors positive and human epidermal growth factor receptor 2 positive. There is involvement of the axilla and intramammary lymph nodes. Magnetic resonance imaging of the lower back and sacroiliac joint was performed and found multiple lesions suspected of metastasis in the inferior thoracic vertebrae, lumbar vertebrae, sacrum, ilium, and femurs. Computed tomography (CT) of the thorax identified a 2.3×1.8 cm irregular lesion in the right breast compatible with the primary neoplasm. Chemotherapy was initiated till she was 31 weeks’ gestation. After childbirth, she reinitiates chemotherapy. Three months later, the patient has convulsive episodes. Cranial CT was done and found multiple lesions compatible with brain metastasis, so she initiated brain radiotherapy. PABC can present itself as a challenging situation with nonspecific symptoms and at an advanced stage. Therefore, it is important to have the PABC in our list of differential diagnoses in this patient.
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Fenner, Fernanda, Francisco José Luis de Sousa, Hilton Mariano da Silva Jr, and Andrei Fernandes Joaquim. "Aortic thrombosis presenting with low back pain and paraplegia: a medical alert." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.741.
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Context:The importance of a thorough neurological examination of the patient should always include research into differential diagnoses such as vascular syndromes, increasingly common in our population. Case report: A 46-year-old man evaluated and screened by the Neurosurgery’s department team, after an initial complaint of sudden onset low back pain and acute weakness in both lower limbs. The patient was healthy before the event. Patient didn’t have pathological history or use of chronic medications, referring only to use sporadic medication for sexual impotence, approximately 6 months ago. Observation revealed pale cold lower limbs, with livedo reticularis. Pulses of the femoral artery were absent bilaterally. Neurological examination revealed complete flaccid paraplegia with neurological level of L1. Below this level loss of pain, light touch and temperature sensation (0/2 in all dermatomes on both extremities), muscle weakness (0/5 in all neurotomes bilaterally), absent tendon and plantar reflexes. Axial tomography of the lumbar spine didn’t reveal vertebral lesions or pressure within the spinal canal. Consultation of the vascular surgeon confirmed absence of blood flow through femoral arteries and emergency angiotomography of the abdominal aorta showed complete occlusion of the descending aorta, upper renal arteries. Patient underwent percutaneous embolectomy treatment, with successful revascularization of lower extremities; unfortunately died about 10 hours after surgery due the development of revascularization syndrome. Conclusions: Acute aortic occlusion is a catastrophic event and can present itself as flaccid paraplegia, leading to misdiagnosis and loss of valuable time for positive outcome. Vascular examination should always be performed on each patient with neurological deficit in lower limbs, especially patients with clinical history of peripheral vascular disease. Immediate start of treatment is imperative to improve survival rates.