Complaints Of Neck Pain Research Articles

Comparison of trunk muscle endurance between women with and without chronic neck pain

PurposeTo compare trunk flexor, extensor, and lateral flexor muscle endurance between women with moderate to severe disability due to chronic neck pain (CNP) and asymptomatic women. DesignObservational case-control study. MethodsThirty women with CNP and Neck Disability Index scores ranging from 30% to 70% and 28 asymptomatic women were included. The visual analog scale was used to assess neck pain intensity at rest and during activity. To assess trunk muscles endurance, trunk flexor endurance test, Sorensen test, and side bridge endurance test were performed. ResultsAnalysis of covariance indicated that neck pain group had lower body mass index-adjusted endurance times of trunk flexor, extensor, and lateral flexor muscles with large effect sizes (p < .001, η2 = 0.378-0.696). Trunk flexor endurance time showed a moderately negative correlation with neck pain intensity at rest and a weakly negative correlation with neck disability score (r = –460 and –365, p < .05). ConclusionsWomen with moderate to severe disability due to CNP exhibited decreased trunk muscle endurance, which may be a predisposing factor for low back pain. Also, trunk flexor endurance was related to neck pain complaints. A holistic approach, addressing the entire spine rather than focusing solely on the cervical region, might be useful for managing CNP. Clinical ImplicationsThe findings of reduced endurance in trunk muscles should be considered when incorporating interventions in the management of CNP to effectively address pain and disability.

Posterior Longitudinal Ligament Calcification with Myelopathy - A Case Report

Background:: Ossification of the posterior longitudinal ligament (OPLL) constitutes a significant etiology of cervical myelopathy. The most common clinical presentations are myelopathy and radiculopathy, which result from a decrease in the spinal canal's volume and the spinal cord's subsequent compression by the ossified posterior longitudinal ligament. This results in motor and sensory deficits, especially in the extremities. Case Presentation:: A 48-year-old male presented with a complaint of neck pain that radiated to both upper limbs and was associated with numbness, tingling, and paranesthesia. He also had a history of lower back pain that radiated to the right leg, which was also associated with numbness and limited mobility to his cervical spine. Lhermitte's sign was positive. Sensory deficit to pinprick and touch was noted in the right upper limb and lower limbs. Flexion deformities of the right hand and elbow extension fingers were noted. Neuroimaging of the cervical spine showed cervical canal stenosis, OPLL, and myelopathy. Surgical management included internal fixation using plates and transpedicular screws, lateral mass fixation, and laminectomy of the third to sixth cervical vertebrae (C3-C6). Conclusion:: OPLL should be considered an integral component of the differential diagnosis when evaluating a patient with neck pain and consequent motor and sensory deficits of the extremities. OPLL with mild and/or non-progressive symptoms can be addressed with non-operative measures. Assessing preoperative neuroimaging is crucial before surgery to determine the degree of spinal cord compression and the presence of OPLL in all patients with cervical myelopathy. Surgical treatment options for posterior longitudinal ligament calcification include laminectomy and fusion, anterior decompression including transpedicular and costo-transversectomy, laminoplasty, and circumferential decompression via staged posterior and anterior approaches. Determining the most effective surgical approach for managing OPLL is still controversial, and selecting the appropriate procedure should be based on the patient's clinical presentation and level of pathological involvement.

Demographic, clinical, and paraclinical features of patients operated with the diagnosis of acute descending necrotizing mediastinitis: a retrospective study in Southern Iran

IntroductionDescending necrotizing mediastinitis (DNM) is a type of acute mediastinitis that is rarely reported but is regarded as a fatal disease despite improvements in technological methods and antibiotic therapies. We aimed to determine the demographic, clinical, and paraclinical features of patients diagnosed with acute DNM.MethodsIn this retrospective study, patients’ hospital records with a diagnosis of DNM admitted to the Namazi hospital in southern Iran during 18 years (2002–2019) were reviewed. Demographic and clinical features were recorded and subsequently analyzed via SPSS 22.ResultsOut of 67 mediastinitis patients, 25 (37.3%) were diagnosed as DNM with an average age of 37.2 ± 16.7 years, and 68% were male. Regarding etiology, 52.0% were due to neck infection. Based on the technique of surgery, 52% of the patients underwent the combined method, which was mostly among type I and IIA DNM, while thoracotomy was mostly performed on type IIB DNM (P = 0.08). Based on the incision, type IIA and IIB had the highest frequency of thoracotomy and cervicothoracic incisions (P = 0.02 and 0.002). Puss discharge was significantly lower in type I DNM (P = 0.01). Based on the presenting symptoms of our patients, the majority (72.0%) had a chief complaint of neck pain, followed by chills and fever (48%). There were no reports of mortality during our short-term follow-up.ConclusionWe report one of the largest retrospective studies of DNM patients in our referral center, with a high prevalence of the disease among younger populations, especially under 40 years. The method of treatment should be chosen based on the extent of infection and can be limited to neck exploration in upper mediastinal infections, though thoracic or combined approach in more broad infections.

Pengaruh Pemberian Terapi Latihan pada Nyeri Leher Non Spesifik Akibat Kesalahan Postur di Masyarakat Delik Sari, Gunung Pati

Health is a state of health, both physically, mentally, spiritually and socially, which enables everyone to live a productive life socially and economically. Public health is a condition that describes the level of health that occurs in society. Society is a group of individuals who live together, work together to obtain common interests and have an order of life, norms and customs that are adhered to in their environment. Public Health is a part of science that discusses and studies the prevention and treatment of disease in each individual. Physiotherapy as a health worker plays a very important role and must have the ability to maximize the potential for movement and function within the promotive, preventive, curative and rehabilitative scope. Therefore, it is proof that physiotherapy not only plays a curative and rehabilitative role but also plays a big preventive role. Nape pain or neck pain is generally not a serious condition that needs to be watched out for. This condition can heal in a few days or weeks without special treatment. However, neck pain can also occur due to certain diseases. Bending over, looking down for too long, often gritting your teeth, or reading in bed, using a cell phone for a long time can cause the neck muscles to become tense. Over time, this condition will cause Kornik's neck pain, which is a myofascial condition. Smartphones are a real manifestation of technological progress and are devices that work very complexly with access to the internet, social media and games. Excessive smartphone use can cause musculoskeletal disorders. Musculoskeletal disorders associated with smartphone use cause neck muscle fatigue caused by poor posture. Using smartphones for a long time can cause muscle tension. Apart from using smartphones, household activities can also cause neck pain such as ironing and washing. Providing exercise therapy in the form of Free Active Movement can reduce complaints of neck pain.

Physiotherapy Education Activities for Neck Pain Complaints In the Sanan Tempe Chips Worker Community

Neck pain is one of the musculoskeletal complaints that people often complain about. Unergonomic working posture is a risk factor that can cause neck pain. For tempe chips workers, unnatural working postures are carried out for long periods of time and in repetitive movements. The aim of this activity is to provide insight and preventative efforts to prevent neck pain in the Sanan tempe chips worker community. The method for carrying out activities is educational outreach regarding good working positions and ergonomics. Also provides preventive management and reduces complaints of neck pain. The results of the activity showed that after being given education, there was an increase in insight into and knowledge of the Sanan tempeh chips workers. This increases workers' awareness of the importance of adopting ergonomic working positions to prevent neck pain. Continuous preventive and curative activities still need to be carried out to reduce the incidence of neck pain in the Sanan tempeh chip worker community.

A Rare Case of Transverse Myelitis During Pregnancy, In A 23-Year-Old Female in A Resource-Limited Setup

Background: Transverse myelitis(TM) is a rare, acquiredneuro-immune spinal cord disorder that can present with the rapid onset of weakness, sensory alterations, and bowel or bladder dysfunction. Case presentation: We report a case of 23- a year- old woman, gravid two, para zero with one previous abortion, at a gestation age of 38 weeks and five days presented to the obstetric emergency of our hospital with complaints of neck pain for two days and weakness of upper limb and lower limb and inability to walk for one day with no history of trauma. She was delivered by emergency cesarean section due to fetal bradycardia (fetal heart tone ranging from 107 to 115 beats per minute) which was confirmed by a cardiotophographic machine. The caesarian section went well, where the alive baby girl with Apgar scores of six and ten in one and five minutes respectively, and her birth weight of 3.4 kilograms (kg) followed by postoperative order with the uncomplicated postpartum period. During treatment, magnetic resonance imaging (MRI) of the spine was done and a diagnosis of TM was made. She was managed with parenteral steroids and physiotherapy. She was later discharged from our hospital in good health plus an uneventful postnatal follow-up. We present this case as a rare diagnosis to our facility with successful management during pregnancy and the possibility of recovery in a resource-limited setup. Conclusion: Transverse myelitis (TM) is a rare phenomenon in pregnancy, therefore obstetric care is needed, and if untreated in this critical condition, it may lead to complications such as deep vein thrombosis, urinary tract infections, and preterm labor. This will require an additional component of coordination between women and their families.

The Correlation Between Working Posture and Work Duration and Non-Specific Neck Pain Symptoms in Computer User Employees

Introduction: Longer work processes with non-ergonomic working postures by employees who use computers can certainly cause musculoskeletal tension. One of the musculoskeletal disorders (MSDs) associated with computer use is complaints of non-specific neck pain caused by a non-ergonomic posture of the neck muscles over a long period, which causes muscle tension. This study aims to determine the relationship between working posture and duration of work using a computer on non-specific neck pain complaints among Hasanuddin University Rectorate employees.Method: A cross-sectional research design was carried out on 121 administrative employees aged 22 years who met the inclusion and exclusion criteria. Assessment of working posture uses the Baseline Risk Identification of Ergonomic Factor (BRIEF) questionnaire, and for non-specific neck pain complaints using the Nordic Body Map (NBM) questionnaire. The Spearman's rho correlation test analyzes the relationship between variables.Results: 49 out of 121 respondents had a high-risk working posture for non-specific neck pain, and 59 out of 121 had a long working duration. Working posture is positively correlated with symptoms of non-specific neck pain (p = 0.001; r = 0.598). In contrast, work duration did not correlate with symptoms of non-specific neck pain (p = 0.063; r = 0.169).Conclusion: High-risk working postures can predict the incidence of non-specific neck pain in office administration employees. This can be a consideration for office leaders to pay attention to the working posture of their employees.Key words: Duration, non-specific neck pain, working posture

The relationship between analysis of upper limb function, physical activity, and neck pain in wood carvers

Background: Indonesia has a large workforce and frequent work accidents. The work of woodcarving artisans in Ubud village has a high risk of accidents. Neck pain is a common problem these artisans face due to static movements, vibrations, and excessive physical activity. Ergonomics in the work environment is the key to preventing pain and fatigue, but non-ergonomic working positions often occur in wood artisans. Therefore, this study aims to explore the relationship between rapid upper limb assessment (RULA) analysis, physical activity, and complaints of neck pain among woodcarvers.&#x0D; Methods: This type of research is an analytic observational with a cross-sectional design. The sampling technique is total sampling. The number of subjects obtained is 31 people according to predetermined criteria. The instruments used were the International Physical Activity Questionnaire (IPAQ) questionnaire to measure physical activity levels, the RULA form to assess work position, and the Numeric Rating Scale (NRS) questionnaire to measure complaints of neck pain. This study used two techniques, namely univariate and bivariate analysis, using the SPSS program.&#x0D; Results: Based on bivariate analysis using Spearman’s rho non-parametric method on 31 respondents, a significant correlation was found between RULA analysis and complaints of neck pain with a correlation coefficient of 0.55 and also found that there is a significant relationship between physical activity and complaints of neck pain with a correlation coefficient of 0.83.&#x0D; Conclusion: There is a relationship between RULA analysis and complaints of neck pain in woodcarving craftsmen in Ubud Village and there is a relationship between physical activity and complaints of neck pain in complaints of neck pain in woodcarving craftsmen in Ubud Village.

Is cervicodynia associated with head load carrying in construction site workers in Lucknow

Background: Cervicodynia is one of the most common musculoskeletal symptoms reported by construction workers, particularly those involved in head-load carrying jobs. One of the reasons for this could be accelerated degenerative changes in the cervical spine as a result of continuous stress on it owing to head-load carrying. Apart from carrying a heavy load on the head, frequently have to work in an awkward posture involving “repeated movement of the back and limbs and work above the shoulder during loading on the head and unloading as well as stacking bricks.” In response to the continuous stresses on the neck muscles, Cervicodynia is a commonly occurring phenomenon among construction workers, particularly head-load carrying workers. Aims and Objectives: This cross-sectional study aims to determine the association between cervicodynia and head-load carrying in construction site workers in Lucknow. Materials and Methods: A total 68 workers were enrolled in the study and their details were recorded in the questionnaire Pro forma and they were asked to provide their job details. Those workers responding affirmatively to cervicodynia, the intensity, and its distribution along the brachial plexus and vertigo was recorded. Data were recorded on a separate case recording sheet, and statistical analysis was done using SPSS Version 21.0 statistical Analysis Software. The values were represented in number (%) and Mean±SD. The Chi-square test and Student’s “t” test was used. The level of significance was P&lt;0.05. Results: Out of 68 workers, 57.4% were male, whereas 42.6% were female with a mean age of 32.15 years. The overall complaints of neck pain were 55.9%. Workers with complaints of neck pain carry significantly higher weight per round, carry weight for significantly longer duration, and cover significantly longer distance with weight. Conclusion: It can be concluded that cervicodynia is a common occurrence among construction workers, particularly, head-load carriers. Although univariate analysis highlighted the role of occupational factors in the occurrence of neck pain, on multivariate assessment, only age emerged as an independent predictor.

A solitary osteolytic lesion with pathological fracture in the cervical spine - a case report

BackgroundLangerhans cell histiocytosis (LCH) is a rare disorder. The treatment options vary depending on how many organs are involved and how extensive the disease is. In this report, a case of LCH with isolated 6th cervical vertebra (C6) collapse was presented. This case was treated with anterior corpectomy and instrumented fusion, followed by local radiotherapy (RT), with a good clinical outcome up to postoperative six months.Case presentationThis was a 47-year-old female patient with a complaint of neck pain and bilateral shoulder pain for two months before consultation. She was initially treated with analgesics, but the pain was persistent. Further radiological evaluations revealed an osteolytic lesion within the C6 vertebral body with a pathological fracture. Magnetic resonance imaging (MRI) with contrast of the cervical spine revealed diffused hypointense signal changes on the T1-weighted images and hyperintense signal changes on the T2-weighted images in the C6 vertebral body, with significant contrast-enhanced infiltration signals. Furthermore, in positron emission tomography-computed tomography (PET-CT), focal hypermetabolism and abnormal uptake signals were seen only in the C6 vertebral body. The patient underwent an anterior cervical corpectomy with instrumented fusion. The histopathological results confirmed the diagnosis of LCH. The patient reported significant pain relief on postoperative day one. Moreover, she was treated by local RT at postoperative one month. Good clinical outcomes were achieved in the form of no pain and recovery in neck mobility up to postoperative six months. No evidence of recurrence was observed at the final follow-up.ConclusionsThis case report describes a treatment option for a solitary C6 collapse with LCH managed by anterior corpectomy and instrumented fusion, followed by local RT, with a good clinical outcome at postoperative six months. More studies are needed to elucidate whether such a treatment strategy is superior to surgery or RT alone.

Women with migraine presents similar altered performance in the craniocervical flexion test than women with chronic nonspecific neck pain: An observational study

BackgroundAlthough patients with migraine show cervical muscle impairments previous studies investigating motor performance have not characterized the sample of patients with migraine according to the presence/absence of neck pain complaints. ObjectiveTo verify if there are differences in the clinical and muscular performance of the superficial neck flexors and extensors during Craniocervical Flexion Test in women with migraine, considering the presence or absence of concomitant symptoms of neck pain. MethodsThe cranio-cervical flexion test performance was assessed by its clinical stage test and by the surface electromyographic activity of the sternocleidomastoid, anterior scalene muscles upper trapezius and splenius capitis. It was assessed in 25 women with migraine without neck pain, 25 women with migraine and neck pain, 25 women with chronic neck pain and 25 pain-free control women. ResultsPoorer performance of the cervical muscles was found during the execution of the cranio-cervical flexion test, in addition to higher muscle activity, especially in the sternocleidomastoid, splenius capitis, and upper trapezius muscles in the neck pain, migraine without neck pain, and migraine with neck pain groups in comparison with the results obtained for healthy women in the control group. No difference was observed between the groups of women experiencing pain. Analysis of the extensor/flexor muscle electromyographic ratio showed that there was no difference between the groups. ConclusionPoor cervical muscle performance was observed in both women with chronic nonspecific neck pain and women with migraine regardless of the presence of neck pain.

Characteristics of Neck Pain in Medical Students of Muhammadiyah Jakarta University Class of 2019 After Online Class for One Semester

Introduction: Neck pain is a very common complaint in everyday life. Neck pain is a multifactorial disease with many associated risk factors. In population studies, 20-60% of women and 15-40% of men have experienced neck pain. Neck pain is a health problem that can develop and interfere with a person daily activity. Method: This research is a descriptive analytic survey research, which aims to know about neck pain of the students of the Medical Education Study Program Class of 2019. approach used in this study is "cross sectional study", with a total sample of 113 respondents. Result and Discussion: From the 113 respondents the results of research conducted through a questionnaire, there were 76 respondents (67,3%) who experienced neck pain. In the category based on the length of sitting, 76 respondents (67,3%) experienced complaints of neck pain and the results of statistical analysis (P = 0.455) where there was a significant relationship between the length of sitting and complaints of neck pain. In the category of the relationship between the most frequent learning position, there were 76 respondents (67,3%) and the results of statistical analysis (P = 0.586), there was no significant relationship in the most frequent learning position with neck pain complaints and in the learning location category 76 respondents (67,3%) and the results of statistical analysis (P = 0.315), namely that there was no significant relationship in the category of study location with neck pain complaints. Conclusion: There is no significant relationship between learning position and length of sitting with complaints of neck pain in students of 2019 Medicine Program of Muhammadiyah Jakarta University. Because, the sitting position and length of sitting are not the only factors that cause neck pain complaints

A Case Narrative on Left Shoulder Hand Syndrome

Background: The case report deals with Shoulder-hand syndrome which is relatively a rare clinical entity classified as a type 1 complex regional pain syndrome and it shows manifestations like a painful 'frozen shoulder' with disability, swelling, vasomotor or dystrophic changes in the homolateral hand. The pathophysiology of this syndrome isn't well understood but may involve a predominant sympathetic factor affecting the neural and vascular supply to the affected parts. Symptoms include pain, swelling, redness, noticeable changes in temperature and hypersensitivity (particularly to cold and touch). Case Presentation: A 52 year old female patient was admitted in general medicine department with complaints of neck pain for 1½ years, edema in both legs and restriction in movement of the left shoulder. She had a medical history of diabetes and hypertension. Conclusion: Early diagnosis and treatment is most effective and can completely reverse the disease progression. The current therapy mainly focusses on alleviating the signs and symptoms of the disease rather than actual cure.

Physiotherapy management of a patient with neck pain having block vertebra: a case report

Congenital fused/blocked vertebrae are an incidental finding in most cases. It remains asymptomatic unless there is a traumatic event or there is an increased biomechanical load which may be attributed to a task that is not typically performed by the individual. Symptomatic cases can present with several musculoskeletal symptoms including neck pain. Physiotherapy management strategies may help patients recover from the mechanical strains on the cervical neuromuscular structures. The present case is of a 21 year-old male engineering student who was referred for physiotherapy, he presented with complaints of neck pain (non-radiating in nature) for a week. The intensity of the pain had been intermittently increasing/decreasing for about a year and there were about 2–3 episodes in a month for approximately one year. He presented with an X-ray that showed C3–C4 cervical vertebrae synostosis (block vertebrae). The patient was managed using pain education and exercises along with ergonomic advice. Patient-reported pain decreased significantly from the initial visit and he was able to sit for a longer duration and had a considerable improvement in function.

A case of glossopharyngeal neuralgia successfully treated with levetiracetam

BackgroundGlossopharyngeal neuralgia is a condition that causes severe pain in the throat during swallowing. Although carbamazepine is a viable option for treating glossopharyngeal neuralgia, there are minimal data regarding the effect of alternative agents to treat it. We report on glossopharyngeal neuralgia, which is successfully controlled by levetiracetam.PresentationA woman in her 70s checked into our hospital with a chief complaint of neck pain lasting 5 years. She had a history of carbamazepine-induced interstitial pneumonia. As a result, we prescribed oral levetiracetam 1000 mg daily in addition to mirogabalin, which was previously prescribed. This effectively reduced the numerical rating scale from 9 to 1 with no adverse effects. Finally, she underwent microvascular decompression, and her symptoms were resolved.ConclusionLevetiracetam may be an option for patients with glossopharyngeal neuralgia who cannot receive carbamazepine. However, levetiracetam is for off-label use according to the Japanese medical system.

Integrative Ayurveda approach to manage Degenerative Cervical Myelopathy (DCM)-A Case Report

Cervical myelopathy involves compression of spinal cord caused by degenerative process of cervical vertebrae or due to trauma. Cervical myelopathy is characterized by pain, stiffness in cervical region and tingling sensation in both upper and lower limb, clumsiness of hands, weakness and difficulty in handling small objects. Available treatment modalities are NSAID’s, Steroids, physiotherapy and cervical support for pain management. Surgery is necessary if conservative treatment fails. In Ayurveda some Para surgical modalities are used to treat this condition like Agnikarma and Raktamokshan along with Shaman Aushadhi. In this case study a 39 years old male patient came to outdoor patient department with complaints of neck pain, neck stiffness and tingling sensation in upper limbs while heaviness and weakness in both upper and lower limbs for last 4 months and especially tingling of upper limb during extension of neck. Patient have alleged history of weight fallen on head in flexed position of neck before 4 months. This case was managed with 4 sittings of Agnikarma with 7 days interval between each sitting and 2 sittings of wet cupping with 15 days interval along with Rasna Saptak Kwath, Erandamula Kwatha, Navjivan Rasa, Ashwagandha Arishta, Karpasasthyadi Taila for 3 months. Patient got relief from symptoms as well as improved routine life with increased in spinal canal diameter at C3-C4 level. This single case demonstrates that TCM can be managed by Ayurveda para surgical procedures along with adjuvant drugs.

Prevalence of Text Neck Syndrome among Doctors

Purpose: The aim of this study was to investigate the prevalence of text neck syndrome (TNS) among doctors of North India and to assess the impact of increase in duration of time spent with mobile phones on TNS. Methods: The present study is an observational cross-sectional questionnaire based survey that included doctors practicing in North India. An electronic survey of 28 questions consisting of open-ended, closed-ended questions, and five-point Likert scale questions was developed using Google Form, which was sent to all the participants on October 19, 2020 through social media. Logistic regression analysis was performed to find relationship between discrete variables. The independence of attributes was measured through chi-squared test. Results: There was significant increase in the duration of mobile usage after lockdown as compared with pre lockdown period [ c2 = 68.87; df = 16; p &lt; 0.001]. There were more complaints of neck pain in respondents whose duration of mobile usage per day was greater than 5-6 hr [odds ratio = 9.6; p = 0.005]. There was no significant difference between time duration of mobile usage across gender [c2 = 8.41; df = 4; p &lt; 0.08]. Similarly, There was no significant difference between time duration of mobile usage across gender in prelockdown period [c2 = 3.97; df = 4; p &lt; 0.41], while males reported to spend more time on mobile during post lockdown period [c2 = 8.41; df = 4; p &lt; 0.08]. Conclusion: We ascertained a statistically significant increase in TNS after lockdown during unrivaled era of COVID-19 pandemic which was associated with more exposure to mobile phones. Additionally we confirmed that, there was no significant difference between time duration of mobile usage across gender.

The Report of a Surgical Residual Langas Inside the Renal Pelvis 16 Years after Surgery “Case Report”

Background &amp; Objective: Gossypiboma is the meaning of a residual foreign body such as gas in the abdomen following surgical operation, which is a rare complication of surgery. Residual of a foreign body causes mass, fistula, abscess and, obstruction after surgical operation. Computed tomography (CT) scan is a very useful method in the diagnosis of Gossipiboma. In patients who referred with abdominal pain and unexplained manifestations after surgery, Gossypiboma should be considered.&#x0D; Case presentation: A retrospective case study was performed in the year 2020 in a patient with a history of open kidney stone surgery in Hospital of Zabol. A 60-year-old male patient who referred with complaint of neck pain to an orthopedic doctor, which due to a history of kidney stone, the doctor orders an ultrasound of the kidneys. In the ultrasound, a number of stones are observed in the right kidney of this patient. After performing CT scan and Intravenous pyelography (IVP), a foreign body is identified inside the renal pelvis. In the following, the history taken from the patient, the history of open kidney stone surgery during 16 years ago in this patient is determined. During this period, the patient did not have any symptoms, including infection or pain in the mentioned area.&#x0D; Conclusion: In patients with a history of surgery who are referred with abdominal pain or mass, the residual foreign body should be included in the list of differential diagnoses.

Role of Ultrasound and Color Doppler in Assessment of Thyroid Nodules

Thyroid nodules, both macroscopic and microscopic, are widespread in the general population with up to 80% of people having them at autopsy. Ultrasonography is now widely available to diagnose thyroid nodules. Objective: To determine the role of ultrasound and colour doppler in assessment of thyroid nodule. Methods: This cross-sectional study was conducted at Aziz Bhatti Shaheed Teaching Hospital Gujrat, Pakistan from 1st February to 20th June, 2022. In this study total 70 patients with thyroid nodules were included who visited the hospital OPD with the complaint of neck pain and difficulty in swallowing. It included individuals with all ages of wither gender. People with the history of previous neck surgery were excluded. A linear high frequency transducer was used on Toshiba Aplio XG ultrasound machine. Data were analysed by SPSS version 22. Results: Total 70 patients were included in this study. Their age ranged from minimum 25 to maximum 74 with median age 47.50 years. As regard age, the mean age of study population was 46.057 ± 11.910. The diagnosis was confirmed by ultrasound and color doppler. As regard ultrasound findings, we classified type of nodule as irregular nodule (n) 2.9%, left solitary nodule (n) 21.4%, right solitary nodule (n) 30.0%, isthmus nodule (n) 7.1%, multi-nodule goiter (n) 18.6%, bilateral nodule (n) 10.0%, heterogenous thyroid nodule (n) 7.1%, complex thyroid nodule (n) 2.9% were present. As regard color doppler flow present in (n) 32.9% and no flow seen in (n) 67.1%. Conclusions: Ultrasound is a rapid and secure way to evaluate thyroid nodules. It is the most accurate and cost-effective method for evaluating and monitoring thyroid nodules.

Enhanced magnetic resonance imaging manifestations of paediatric intervertebral disc calcification combined with ossification of the posterior longitudinal ligament: case report and literature review

BackgroundSince the first description of paediatric intervertebral disc calcification (IDC) by Báron in 1924, only approximately 400 cases have been reported in the literature. Paediatric IDC combined with ossification of the posterior longitudinal ligament (OPLL) is an even rarer condition, with only 8 cases described in detail to date. In this paper, we present a review of the disease characteristics described in the relevant English language literature and discuss the possible mechanisms of lesion enhancement in contrast-enhanced magnetic resonance imaging (MRI).Case presentationIn May 2020, a 6-year-old Han nationality girl presented with the chief complaint of neck pain that had lasted for a week. She did not report a history of trauma or a past illness. On admission, there was no personal and family history, congenital diseases, or non-specific infections such as tuberculosis, among others. Further physical examination revealed that the movement of her cervical spine was limited. Computed tomography (CT) and MRI revealed ossification of the intervertebral discs and posterior longitudinal ligament (PLL) at the C4/5 levels and an absence of obvious spinal cord compression. When contrast-enhanced MRI was performed, significant enhancement was observed in the intervertebral discs and PLL at the C4/5 level. We adopted a non-interventional approach and performed an imaging re-examination 8 months later. Both the plain and contrast-enhanced MRI scans indicated swelling in the C4/5 intervertebral discs and disappearance of the previously observed enhancement in the nucleus pulposus (NP) and PLL at the corresponding levels; CT examination revealed that the ossified lesions had been completely resorbed.ConclusionObvious lesion enhancement in contrast-enhanced MRI is an extremely rare manifestation of paediatric IDC combined with OPLL. However, the exact mechanisms of this phenomenon remain unclear. We surmise that it may be caused by a series of biophysical changes related to vertebral endplate injury and repair, but further research will be required for in-depth investigation.