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Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_19 | Pages 18 - 18
1 Apr 2013
Mestha P Singh AK Pimple MK Tavakkollizadeh A Sinha J
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Introduction

The purpose of this study was to assess the rate of revision subacromial decompression and identify different pathologies.

Materials/Methods

We analysed the patients who underwent Revision Arthroscopic Subacromial decompression from our prospective database of shoulder patients. Between April 2003 and Dec 2010, 797 patients underwent arthroscopic subacromial decompression. Patients who underwent any other procedure i.e. biceps tenotomy, capsular release, cuff repair were excluded from the study. Of these, 37 underwent a revision subacromial decompression (Revision rate 4.6%). The indication for revision procedure was persistent pain or restricted movements not responding to physiotherapy and injections.


Orthopaedic Proceedings
Vol. 88-B, Issue SUPP_II | Pages 299 - 299
1 May 2006
Singh AK Murray SA
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Background: Paget’s disease of the sacrum is rare. A monostotic lesion in the sacrum is reported. A case with an unusual presentation is discussed.

Introduction: A 53 years old man was referred to our unit with a 5–6 months history of abdomen discomfort and tenesmus.

He had a history of low back pain and was noted to have an area of increasing numbness over the left buttock. A prominence of the left sacroiliac region was noticed and on rectal examination a bony hard mass was palpable posteriorly.

A plain x-ray of the pelvis showed a gross expansion and enlargement of the sacrum with lucent area and widespread new bone formation.

Biochemical test revealed a raised alkaline phosphatase level.

A MRI scan reported a large tumour arising from the sacrum. with a differential of chordoma, paget’s sarcoma or an osteochondroma.

In addition a bone scan reported raised uptake in the pelvis.

An open incision biopsy was performed and the histology report was consistent with appearance of paget’s disease with no evidence of sarcoma.

Interestingly the patient symptoms improved after the biopsy. He was commenced on biphosphonates. A surveillance scan is to be performed in due course.

Conclusion: This case was unusual in terms of clinical presentation and location.

Furthermore even the most sophisticated imaging modalities may fail to establish the diagnosis and biopsy is then necessary. This should always be performed in specialized centers, in order to minimise complications.