Foot pain is a prevalent musculoskeletal complaint with plantar fasciitis being one of the most common underlying etiologies. Diagnostic imaging studies are rarely performed for patients with plantar fasciitis. We report the case of a 34-year-old woman with a six-month history of left heel pain that was worsened by prolonged standing and walking. She was diagnosed as having plantar fasciitis. Considering the lack of clinical improvement on conservative measures, the patient underwent a plain radiograph, which demonstrated a geographic radiolucent lesion in the calcaneus with well-defined non-sclerotic margins. Subsequently, a computed tomography scan re-demonstrated the lesion as having a fat-attenuation appearance that was classic of lipoma. The patient underwent surgical excision of the tumor and the histopathological examination of the specimen revealed spindle cell lipoma. The patient had complete resolution of the pain following the surgery. Intraosseous lipoma is a very rare benign primary bone tumor. The case demonstrated that the intraosseous lipoma may have similar clinical features to plantar fasciitis. Hence, physicians should keep a high index of suspicion for the alternate diagnoses of plantar fasciitis in patients who do not exhibit any clinical improvement despite a prolonged period of conservative management.

Traumatic atlantoaxial rotatory subluxation (AARS) is a condition that is extremely rare in adults when compared to the pediatric population. The most common symptoms of this condition are torticollis and post-traumatic neck pain. Our patient is a 41-year-old male who presented to the emergency room within hours of the injury. He came by himself with his relative as a case of road traffic accident. He was the first passenger and had been restrained during the car accident, with no ejection or rollover. He presented with stiffness/pain and reduced range of motion in the neck. Computed tomography (CT) of the cervical spine showed rotatory subluxation of C1 over the C2 with a locked facet. Within 24 hours of the RTA and patient admission, we attempted cervical traction. The reduction was not successful. So, we decided to reduce AARS through a surgical approach. The patient was taken to the operating room for open reduction and fixation using the Harms technique for C1-C2 fusion. The patient recovered from the surgery uneventfully, without any complications, recovered cervical mobility, and improved torticollis. Surgical management through open reduction and internal fixation is recommended for AARD cases in which close reduction fails due to a locked facet.

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Lymphatics are found in almost every organ in the body, and they produce a variety of waste products that must be eliminated. lymphatic leakage is a typical occurrence. It can cause immunodeficiency as well as nutritional issues. Furthermore, it has a significant morbidity and death rate, depending on the existence of an underlying illness. Lymphatic leakage can be congenital, traumatic, or cancerous, and occurs when the lymphatic system is disrupted. It might take the following forms: Chylothorax, Lymphatic Fistula, Chylous Ascites. treatment of lymph leaks includes: reduction of lymphatic flow through physiological or pharmacological manipulation; replacement of fluid and electrolytes, as well as interventional procedure and/or direct surgical closure. In this review we’ll be discussing lymphatic system anatomy, its leakage and its management.

Introduction Impact of COVID-19 pandemic on the orthopedic residency programs was substantial worldwide. Orthopedic residency programs eventually survived such a hardship with implementation of certain measures. The impact of COVID-19 pandemic on the orthopedic trainees was variable relative to the country in which orthopedic residency program is based. This study aimed to assess the experience of the orthopedic residents during COVID-19 pandemic in Saudi Arabia and consequences on mental health, academic performance, and clinical training. Methods A cross-sectional study was conducted from June 2021 to August 2021. An online survey was sent to the orthopedic residents in Saudi Arabia. The questionnaire was arranged into four sections pertaining to demographic data, academic activity, mental health, and clinical activity. Results One-hundred forty-four orthopedic residents participated with mean age of 28.7 ± 5.67 years. Males were 108 (75%) and females were 36 (25%). Fifty-four (37.5%) residents worked in COVID-19 isolation unit. One-hundred twenty residents (83.3%) treated COVID-19 patients. Thirty residents (20.8%) had positive COVID-19 tests. Eighty-four (58.3%) residents were quarantined. Overall online education was difficult (41%). Half of the participants faced online difficulties in technicality, maintaining attention, and interaction with audience and examiners. Prospective research conduction was difficult (71.4%). More than 50% of residents experienced difficulties with isolation, quarantine, socialization, and anxiety of disease transmission. Physical examination was difficult for 50% of trainees. No shortage of PPE supply was reported. Getting hands-on surgical training was very difficult (47.8%). Conclusion COVID-19 pandemic had an adverse impact on Saudi orthopedic residents in terms of academic performance, mental wellbeing, and clinical training. After all, adequate level of orthopedic training quality was maintained. In crises, collaborative efforts are needed to minimize undesirable consequences on the trainees’ competency level. Residency program decision makers should utilize all available strategies to optimize the training environment to achieve the required competency level.