| Autor: |
Ya-Ning Huang, I-Wei Chang, Sung-Tse Li, Wei-Te Lei |
| Jazyk: |
angličtina |
| Rok vydání: |
2023 |
| Předmět: |
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| Zdroj: |
Journal of Medical Case Reports, Vol 17, Iss 1, Pp 1-4 (2023) |
| Druh dokumentu: |
article |
| ISSN: |
1752-1947 |
| DOI: |
10.1186/s13256-023-04232-1 |
| Popis: |
Abstract Background Tarlov’s cyst is often underdiagnosed since it is difficult to identify without imaging assistance. Herein, we report the case of a young girl who presented with an 8-year history of chronic osteomyelitis of bilateral proximal phalanges and metatarsal bones caused by a Tarlov’s cyst that did not contain a nerve root. The chronic wound in the forefoot is an unusual presentation and resulted from the Tarlov’s cyst accompanied with tethered conus syndrome. Case presentation A 10-year-old Asian girl presented with an 8-year history of chronic osteomyelitis of bilateral proximal phalanges and metatarsal bones. She received sequestrectomy five times, however the immune function tests were all normal. A neurological examination revealed diminished sensation and a slapping gait pattern. Magnetic resonance imaging (MRI) demonstrated a lobulated cyst at the right aspect of the sacrum (S) 1 to sacrum (S) 3 canal near the dorsal root ganglion. Tethered conus syndrome was highly suspected. She received laminectomy of lumbar (L) 5 and S1–S2, which led to the diagnosis of a right S1–S3 epidural cyst. The final diagnosis from the histopathological examination was a right sacral Tarlov’s cyst. The clinical conditions of diminished sensation and slapping gait pattern greatly improved after successful surgical treatment. Conclusion In children who present with a recalcitrant chronic wound in the forefoot accompanied with a slapping gait pattern and foot hypoesthesia to pain, aggressive imaging examinations such as spine MRI should be arranged for further evaluation, especially in immunocompetent children. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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