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Scapular Tuberculosis in the Paediatric Population: Suspicion and Early Treatment is the Key

Volume 8 | Issue 3 | September-December 2022 | Page: 11-15| Bushu Harna, Shivali Arya, Sukhmin Singh, Raj Kumar, Dhanajaya Sabat, Anil Arora DOI- https://doi.org/10.13107/ijpo.2022.v08.i03.144 Authors: Bushu Harna [1] MS Ortho., Shivali Arya [2] MD Rad., Sukhmin Singh [3] MS Ortho., Raj Kumar [4] MS Ortho., Dhanajaya Sabat [5] MS Ortho., Anil Arora [6] MS Ortho [1] Department of Orthopaedics, […]

A Review of Decision Making in Foot Problems in Cerebral Palsy

Volume 8 | Issue 3 | September-December 2022 | Page: 02-05| Rohan Parwani DOI- https://doi.org/10.13107/ijpo.2022.v08i03.142 Authors: Rohan Parwani [1] [1] Department of Orthopaedics, Shri M P Shah Medical College, Jamnagar, Gujarat, India. Address of Correspondence Dr. Rohan Parwani Assistant Professor, Department of Orthopaedics, Shri M. P Shah Medical College, Jamnagar, Gujarat, India. E-mail: arthorohan@gmail.com Abstract […]

Scapular Tuberculosis in the Paediatric Population: Suspicion and Early Treatment is the Key

A Review of Decision Making in Foot Problems in Cerebral Palsy

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Scapular Tuberculosis in the Paediatric Population: Suspicion and Early Treatment is the Key

Volume 8 | Issue 3 | September-December 2022 | Page: 11-15| Bushu Harna, Shivali Arya, Sukhmin Singh, Raj Kumar, Dhanajaya Sabat, Anil Arora

DOI- https://doi.org/10.13107/ijpo.2022.v08.i03.144

Authors: Bushu Harna [1] MS Ortho., Shivali Arya [2] MD Rad., Sukhmin Singh [3] MS Ortho., Raj Kumar [4] MS Ortho., Dhanajaya Sabat [5] MS Ortho., Anil Arora [6] MS Ortho

[1] Department of Orthopaedics, , Indus International Hospital, Panjab, India.
[2] Department of Orthopaedics, Government Medical College and Hospital, Chandigarh, India.
[3] Department of Orthopaedics, AIIMS Bilaspur, Himachal Pradesh, India.
[4] Department of Orthopaedics, AIIMS, New Delhi, India.
[5] Department of Orthopaedics, Maulana Azad Medical College, New Delhi, India.
[6] Department of Orthopaedics, Max Superspecialty Hospital, Parpatganj, New Delhi, India.

Address of Correspondence

Dr. Bushu Harna,
Consultant, Department of Orthopaedics, Indus International Hospital, Panjab, India.
E-mail: bushu.edu@gmail.com

Abstract

Background: Scapular tuberculosis (TB) in paediatric population is very rare and required clinician suspicion for early diagnosis and treatment.
Methods and Materials: We conducted a retrospective study involving 8 children with a diagnosis of TB of the scapula that was confirmed by histopathological examination. The patients were clinically assessed for signs and symptoms. Pediatric/adolescent shoulder survey (PASS) and numerical rating scale (NRS) scores were used to assess the improvement with treatment.
Results: The mean age of the patients was 10.5 years with a mean duration of symptoms around 4 months. All the patients had raised ESR and CRP values with MRI evidence of inflammation or cold abscess. In all the patients, either FNAC or biopsy was performed. Gene Xpert and histopathological examination confirmed the diagnosis of tuberculosis. All the patients were given (Anti-TB therapy) ATT according to their age/weight for a period of 12 months, as per the RNTCP guidelines. There was significant improvement in ESR, CRP, NRS, and PASS scores with MRI-evidence of disease resolution.
Conclusion: Scapular tuberculosis should be suspected in children presenting with vague shoulder or scapular pain. The patients should be investigated thoroughly and treated with anti-tubercular therapy.
Keywords: Flat bone tuberculosis, Scapular tuberculosis, Paediatric tuberculosis, Ant-tubercular therapy, Biopsy

References

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How to Cite this Article: Harna B, Arya S, Singh S, Kumar R, Sabat D, Arora A | Scapular Tuberculosis in the Paediatric Population: Suspicion and Early Treatment is the Key | International Journal of Paediatric Orthopaedics | September-December 2022; 8(3): 11-15 | https://doi.org/10.13107/ijpo.2022.v08.i03.144

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A Review of Decision Making in Foot Problems in Cerebral Palsy

Volume 8 | Issue 3 | September-December 2022 | Page: 02-05| Rohan Parwani

DOI- https://doi.org/10.13107/ijpo.2022.v08i03.142

Authors: Rohan Parwani [1]

[1] Department of Orthopaedics, Shri M P Shah Medical College, Jamnagar, Gujarat, India.

Address of Correspondence

Dr. Rohan Parwani
Assistant Professor, Department of Orthopaedics, Shri M. P Shah Medical College, Jamnagar, Gujarat, India.
E-mail: arthorohan@gmail.com

Abstract

Ambulatory children with cerebral palsy suffer from a range of problems. There are issues with stance, stability, posture, and endurance. The foot plays a significant role in the pathogenesis and treatment of these problems, especially in the lower limb. Our review article tries to highlight the foot problems and their solutions. The most common deformity in a child with cerebral palsy is the hindfoot equinus. This fixed deformity leads to poor balance in stance and reduced power generated during the push-off phase. Proper identification of the gait pattern and the role of the foot in deranging the gait can help decide ways to enhance the walk of a cerebral palsy child. Physiotherapy and stretching are vital to improving muscle physiology and growth. The weak muscles need to be supplemented with splints. There is also a significant role in the judicious use of surgery in cerebral palsy. Deciding which surgery to employ is critical and often contributes to the success or a disastrous failure. Our article highlights various facets of decision-making and ways to arrive at a proper decision.
Keywords- Cerebral palsy, Foot, Equinus, Gait

References

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3. Sees JP, Miller F. Overview of foot deformity management in children with cerebral palsy. J Child Orthop. 2013;7(5):373-377.
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5. Brunner R, Rutz E. Biomechanics and muscle function during gait. J Child Orthop. 2013;7(5):367-371.
6. Atbaşı Z, Erdem Y, Kose O, Demiralp B, Ilkbahar S, Tekin HO. Relationship Between Hallux Valgus and Pes Planus: Real or Fiction? J Foot Ankle Surg. 2020 May-Jun;59(3):513-517.
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8. Davids JR, Holland WC, Sutherland DH. Significance of the confusion test in cerebral palsy. J Pediatr Orthop. 1993 Nov-Dec;13(6):717-21.
9. Maas, Josina & Dallmeijer, Annet & Huijing, Peter & Brunstrom-Hernandez, Janice & Kampen, Petra & Jaspers, Richard & Becher, Jules. (2012). Splint: The efficacy of orthotic management in rest to prevent equinus in children with cerebral palsy, a randomised controlled trial. BMC pediatrics. 12. 38. 10.1186/1471-2431-12-38.
10. Ganjwala D, Shah H. Management of the Knee Problems in Spastic Cerebral Palsy. Indian J Orthop. 2019;53(1):53-62.
11. Givon U. Beyin felcinde kas zayifliği [Muscle weakness in cerebral palsy]. Acta Orthop Traumatol Turc. 2009 Mar-Apr;43(2):87-93.
12. Chambers MA, Moylan JS, Smith JD, Goodyear LJ, Reid MB. Stretch-stimulated glucose uptake in skeletal muscle is mediated by reactive oxygen species and p38 MAP-kinase. J Physiol. 2009;587(Pt 13):3363-3373.
13. Graham, H.K.. (2001), Botulinum toxin type A management of spasticity in the context of orthopaedic surgery for children with spastic cerebral palsy. European Journal of Neurology, 8: 30-39.
14. Kadhim M, Miller F. Crouch gait changes after planovalgus foot deformity correction in ambulatory children with cerebral palsy. Gait Posture. 2014 Feb;39(2):793-8.
15. Sung KH, Chung CY, Lee KM, Lee SY, Park MS. Calcaneal lengthening for planovalgus foot deformity in patients with cerebral palsy. Clin Orthop Relat Res. 2013;471(5):1682-1690.
16. Bishay S, Morshed GM, Tarraf Y, Pasha N (2016) Double Column Foot Osteotomy to Correct Flexible Valgus Foot Deformity in Children with Spastic Cerebral Palsy. Clin Res Foot Ankle 4:198.

How to Cite this Article: Parwani R | A Review of Decision Making in Foot Problems in Cerebral Palsy | International Journal of Paediatric Orthopaedics | May-August 2022; 8(2): 02-05.
https://doi.org/10.13107/ijpo.2022.v08.i03.142

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

Scapular Tuberculosis in the Paediatric Population: Suspicion and Early Treatment is the Key

A Review of Decision Making in Foot Problems in Cerebral Palsy

Scapular Tuberculosis in the Paediatric Population: Suspicion and Early Treatment is the Key

A Review of Decision Making in Foot Problems in Cerebral Palsy

Full Sized Blog Element (Big Preview Pic)

Scapular Tuberculosis in the Paediatric Population: Suspicion and Early Treatment is the Key

Authors: Bushu Harna [1] MS Ortho., Shivali Arya [2] MD Rad., Sukhmin Singh [3] MS Ortho., Raj Kumar [4] MS Ortho., Dhanajaya Sabat [5] MS Ortho., Anil Arora [6] MS Ortho

Abstract

(Article Text HTML) (Full Text PDF)

A Review of Decision Making in Foot Problems in Cerebral Palsy

Authors: Rohan Parwani [1]

Abstract

(Article Text HTML) (Full Text PDF)

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