Medicina, Vol. 54 No. 1, 2018.
Ostalo
https://doi.org/10.21860/medflum2018_192888
Differential-diagnostic approach to sesamoid injuries of foot: case report
Jure Pupić-Bakrač
orcid.org/0000-0001-7653-2343
; Centar urgentne medicine i hitnog bolničkog prijema, Sveučilišna klinička bolnica Mostar, Mostar, Bosna i Hercegovina
Martin Kajić
; Klinika za kirurgiju, Sveučilišna klinička bolnica Mostar, Mostar, Bosna i Hercegovina
Ana Pupić-Bakrač
orcid.org/0000-0002-8493-7305
; Odjel obiteljske medicine, Dom zdravlja Mostar, Mostar, Bosna i Hercegovina
Sažetak
Introduction: The sesamoidal skeletal-tendon complex of the foot consists of two sesamoidal bones - medial and lateral. When their injury occurs, differential diagnosis is usually reduced to that between fracture and sesamoiditis. In clinical practice, the problem creates a distinction between fracture and sesamoiditis of bipartite sesamoid bone, which is a normal anatomical variant in 7-30% of people in the general population. The aim is to present a patient with acute sesamoid pain, which occured during a soccer match.
Case report: The 27-year-old male came due to the pain in the right toe area, which he felt during the soccer match, 24 hours before the reception. He could not associate pain to any specific event during the game, denying a direct impact on the foot. On clinical evaluation there was discreet swelling and hyperemia in the area of the first metatarsal head. Pain was aggravated on palpation and passive dorsiflexion. X-ray of the right foot was suspicious on bipartite medial sesamoid bone associated with sezamoiditis, but the fracture was not excluded. The patient was treated with conservative therapy and monitored on regular weekly controls. After 2 weeks the symptoms retreated, and the control X-ray confirmed the diagnosis of bipartite sesamoid bone. After 6 weeks, the patient returned to sports activities.
Conclusion: When we have a dubious diagnostic situations regarding sesamodial injuries, it is best to approach with conservative therapy and regular patient controls. By monitoring clinical course and taking control X-ray we'll establish a final diagnosis. In the case of persistent pain and/or control X-ray that suggests complications, an advanced imaging diagnostics is needed and, according to the findings, decidon on eventual invasive therapy. Sesamoid injuries can be easily cured in most cases, but setting the wrong diagnosis can lead to unnecessary complications.
Ključne riječi
Differential diagnosis; Foot; Sesamoid Bones
Hrčak ID:
192888
URI
Datum izdavanja:
1.3.2018.
Posjeta: 4.271 *