Bipolar clavicle dislocation is thought to be a rare injury pattern. Even experienced orthopaedic surgeons may have not come across this entity during their careers. We report a misdiagnosed case of a 65-year-old male who underwent a motorcycle accident and was surgically treated six months post-injury. This case has been the ground for research since then. We have come to the conclusion that this type of injury is probably not so uncommon as previously thought. Careful evaluation is of immense importance during diagnosis protocol, and practitioners should be aware of this injury pattern in order to avoid misdiagnosis.
Shoulder pain is a common cause of morbidity in the general population. Differential diagnosis may be difficult. Soft tissue shoulder disorders are the most common causes of shoulder pain. Noninvasive imaging techniques can reveal rotator cuff (RC) pathologies. These include ultrasonography (US) and MRI. Minimally invasive techniques such as magnetic resonance arthrography (MRA) can also be recruited when required.
We conducted a retrospective study of 61 consecutive patients with shoulder pain, who had undergone preoperative imaging in the form of US or MRI and subsequently proceeded to arthroscopic surgery. Nineteen patients had a US and 42 had an MRI preoperative imaging evaluation. This evaluation was compared to the operative findings. The US sensitivity was 87%, while specificity was 63%. The MRI accuracy rose to a sensitivity of 95% when specificity was 72%. The positive predictive value (PPV) was 64% for US and 76% for MRI. The negative predictive value (NPV) was 87% for US and 94% for MRI. The overall accuracy of the ultrasound was 73% and of the MRI 83%.
Salmonella osteomyelitis is an uncommon pathological condition. Usually, it is associated with hemoglobinopathies or other underlying disorders. Osteomyelitis due to Salmonella is extremely rare in a previously healthy patient. We present a case of a 12-year-old previously healthy male who suffered Salmonella osteomyelitis of the proximal tibia as well as the diagnostic algorithm and therapy protocol. In our case, Salmonella osteomyelitis was identified by direct inoculation of the sample in blood culture bottles. Traditional cultures were negative. The practice of blood culture bottles seems to be essential for diagnosis, so the appropriate treatment is performed.
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