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Yamasaki N, Mizumoto J, Shimizu T. Spinal Deformity Manifested by Urinary Tract Infection: A Case of Acute-on-Chronic Mobility Dysfunction. Cureus 2024; 16:e55475. [PMID: 38571861 PMCID: PMC10989209 DOI: 10.7759/cureus.55475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2024] [Indexed: 04/05/2024] Open
Abstract
A 53-year-old man with diabetes mellitus presented to the emergency department with a fever and impaired mobility. A preliminary diagnosis of urinary tract infection was made based on dysuria and pyuria. History-taking revealed a history of gait disturbance and difficult urination. A thorough physical examination suggested a spinal abnormality. MRI scan revealed a narrow spinal canal due to ossification of the posterior longitudinal ligament and diffuse idiopathic skeletal hyperostosis. Throughout the diagnostic process, we employed both vertical tracing to investigate the causes of urinary tract infection and horizontal tracing to explore comorbidities such as diabetes. Additionally, we introduced appropriate social security and support systems under the name of diagnostic excellence.
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Affiliation(s)
- Noriko Yamasaki
- Center for Medical Training, Ehime Seikyo Hospital, Matsuyama, JPN
| | - Junki Mizumoto
- Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine, The University of Tokyo, Tokyo, JPN
| | - Taro Shimizu
- Department of Diagnostic and Generalist Medicine, Dokkyo Medical University Hospital, Mibu, JPN
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The impact of diabetes on postoperative outcomes following spine surgery: A meta-analysis of 40 cohort studies with 2.9 million participants. Int J Surg 2022; 104:106789. [PMID: 35918006 DOI: 10.1016/j.ijsu.2022.106789] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/06/2022] [Accepted: 07/10/2022] [Indexed: 11/22/2022]
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Ikuma H, Hirose T, Nakamura D, Yamashita K, Ueda M, Sasaki K, Kawasaki K. The Prevalence and Characteristics of Diffuse Idiopathic Skeletal Hyperostosis (DISH): A Cross-Sectional Study of 1519 Japanese Individuals. Diagnostics (Basel) 2022; 12:diagnostics12051088. [PMID: 35626245 PMCID: PMC9140032 DOI: 10.3390/diagnostics12051088] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 04/23/2022] [Accepted: 04/23/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Diffuse idiopathic skeletal hyperostosis (DISH) is a pathology characterized by enthesis ossification, but there have been few reports on epidemiological surveys. This report presents a cross-sectional survey of DISH from thoracic to sacral spine in patients at the tertiary emergency medical center. Methods: The patients were divided into DISH (+) group and DISH (−) group for a retrospective comparative study. The primary outcome measures were the frequency of DISH and the patient demographic data, the secondary outcome measures were the previous medical history (diabetes mellitus, cardiovascular disease), the extent of aortic calcification, the frequency of hyperostosis around the costovertebral joint and the mortality rate within 3 months of the initial examination. Results: This survey examined a total of 1519 patients. There were 265 cases (17.4%) in the DISH (+) group and 1254 cases in DISH (−) group. The prevalence of DISH was concentrated at the thoracolumbar junction, particularly at T9. The mean age, ratio of male and hyperostosis around the costovertebral joint were significantly higher in the DISH (+) group (p < 0.001), but there was no significant difference in other variables. Conclusions: The pathology of DISH might involve the effects of age-related changes or biomechanical effects.
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Affiliation(s)
- Hisanori Ikuma
- Department of Orthopaedic Surgery, Kagawa Prefectural Central Hospital, 2-1, Asahi-Machi 1-Chome, Takamatsu 760-8557, Japan; (T.H.); (D.N.); (K.Y.); (M.U.); (K.K.)
- Correspondence: ; Tel.: +81-87-811-3333
| | - Tomohiko Hirose
- Department of Orthopaedic Surgery, Kagawa Prefectural Central Hospital, 2-1, Asahi-Machi 1-Chome, Takamatsu 760-8557, Japan; (T.H.); (D.N.); (K.Y.); (M.U.); (K.K.)
| | - Dai Nakamura
- Department of Orthopaedic Surgery, Kagawa Prefectural Central Hospital, 2-1, Asahi-Machi 1-Chome, Takamatsu 760-8557, Japan; (T.H.); (D.N.); (K.Y.); (M.U.); (K.K.)
| | - Kazutaka Yamashita
- Department of Orthopaedic Surgery, Kagawa Prefectural Central Hospital, 2-1, Asahi-Machi 1-Chome, Takamatsu 760-8557, Japan; (T.H.); (D.N.); (K.Y.); (M.U.); (K.K.)
| | - Masataka Ueda
- Department of Orthopaedic Surgery, Kagawa Prefectural Central Hospital, 2-1, Asahi-Machi 1-Chome, Takamatsu 760-8557, Japan; (T.H.); (D.N.); (K.Y.); (M.U.); (K.K.)
| | - Kazuhiro Sasaki
- Department of Emergency and Critical Care Medicine, Kagawa Prefectural Central Hospital, 2-1, Asahi-Machi 1-Chome, Takamatsu 760-8557, Japan;
| | - Keisuke Kawasaki
- Department of Orthopaedic Surgery, Kagawa Prefectural Central Hospital, 2-1, Asahi-Machi 1-Chome, Takamatsu 760-8557, Japan; (T.H.); (D.N.); (K.Y.); (M.U.); (K.K.)
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