- [Show abstract] [Hide abstract] ABSTRACT: To determine whether subjects with radiological evidence of osteitis condensans ilii exhibit symptoms and signs in common with sacroiliitis when compared with an age-matched control group and to examine demographic features. The Dunedin Hospital radiology database was searched for all subjects with changes of osteitis condensans ilii over a 10-year period. An age-matched control group with plain X-rays of the pelvis was recruited from the same database. All subjects were sent a questionnaire enquiring about back pain and details of previous pregnancies. Those who responded to the questionnaire were invited for clinical assessment. Thirty-five individuals with osteitis condensans ilii were identified over the 10-year period. All were female and reported prior pregnancy supporting an association between osteitis condensans ilii and pregnancy. Stress testing of the sacroiliac joints was associated with greater tenderness in the osteitis condensans ilii group with a mean of 1.8 positive tests out of a possible 4, compared to 0.8 in the control group (Wilcoxon rank-sum test P = 0.02). Comparison between the two groups showed no difference in number of pregnancies, newborn weight, presence of back pain, back pain assessed by the Oswestry Low Back Pain Questionnaire or loss of function using the Bath Ankylosing Spondylitis Functional Index (BASFI). Osteitis condensans ilii is associated with tenderness during sacroiliac joint compression tests and should be considered in the differential diagnosis when sacroiliac joint tenderness is elicited.
- [Show abstract] [Hide abstract] ABSTRACT: Introduction: There is little knowledge within the medical community of the existence of veterinary antibiotics in oil-based suspensions and the adverse effects that may occur with accidental human injection. Case report: A farmer injected an unknown quantity of Excenel RTU into her right thigh. Despite early debridement she developed a deep infection and recurrent chronic inflammation in the subcutaneous tissues and muscle secondary to the cottonseed oil suspension. Radical debridement and extensive split skin grafting was required but she still has had recurrences 12 months after injury. Discussion: Prompt surgical debridement should be performed as in cases of oil based veterinary vaccines. Despite being an antibiotic there is a significant risk of infection from a dirty needle following inoculation and multiple cultures should be taken and appropriate broad spectrum antibiotics used. Radical debridement and skin grafting necessitating specialist plastic surgical attention may be required.
- [Show abstract] [Hide abstract] ABSTRACT: Successful management of the idiopathic inflammatory myopathies requires an early and accurate diagnosis. The muscle biopsy remains the definitive test. However, false-negative biopsy results are common, as the disease is typically patchy in distribution. The advent of short tau inversion recovery sequences now allows rapid magnetic resonance imaging of the whole body to be performed, enabling identification of the muscles most suitable for biopsy. It also provides further diagnostic information through the form and anatomic distribution of the pathology. We report 2 cases illustrating the advantages of whole-body short tau inversion recovery magnetic resonance imaging before muscle biopsy. We encourage clinicians to use the technique in this context.