RESUMEN
Calcaneal apophysitis, known as Sever's disease, manifests as heel pain and is prevalent among children and adolescents, particularly during growth spurts and periods of heightened physical activity. Although Sever's disease is well-documented, its co-occurrence with other foot pathologies in pediatric patients is relatively uncommon. We present here a unique case of a 14-year-old female patient who presented with significant heel pain and discomfort associated with flat feet, impacting her daily activities and physical performance. Clinical examination revealed tenderness at the heel consistent with Sever's disease, along with symptoms suggestive of posterior tibial tendinopathy and radiographic evidence of Achilles tendon calcification. The primary diagnoses included Sever's disease, posterior tibial tendinopathy, and calcification of the Achilles tendon. Management involved a thorough assessment comprising physical examination and imaging studies to confirm the diagnoses. Pharmacological and non-pharmacological interventions such as activity modification, stretching exercises, and orthotic devices were implemented to alleviate symptoms and improve foot mechanics. Over the course of treatment, the patient showed gradual improvement in pain levels and functional abilities, indicating a positive response to therapy. Long-term follow-up aimed at preventing recurrence and optimizing foot health was recommended to ensure sustained recovery and overall well-being. In this case study, we aim to elucidate the clinical presentation, diagnostic challenges, and management approach employed in addressing these concurrent foot conditions. By exploring this case, we hope to contribute valuable insights to the understanding and management of pediatric foot pathologies, particularly in cases involving multiple co-existing conditions.
RESUMEN
Droopy shoulder syndrome (DSS) manifests as discomfort or abnormal sensations in the neck, shoulder, chest, and upper limbs, resulting from tension on the brachial plexus caused by abnormally low shoulder positioning. This case report examines the presentation and management of a patient with DSS, a rare but crucial precursor to thoracic outlet syndrome (TOS). The patient, a 22-year-old male, presented with progressive pain and tingling in his left upper limb, shoulder, chest, and neck. Comprehensive examination and imaging studies led to a diagnosis of DSS. Physical therapy prevented progression to full-blown TOS, highlighting the importance of early recognition and intervention. This case underscores the diagnostic challenges and therapeutic strategies essential for managing this syndrome, preventing complications, and restoring patient function.
RESUMEN
Despite being less commonly discussed than other motor symptoms such as tremors and bradykinesia, hypertonia of the hallux holds diagnostic and prognostic significance in Parkinson's disease (PD). This motor anomaly is dissected within the context of the broader clinical spectrum of PD symptoms, emphasizing its importance alongside its cardinal symptoms. This case report underscores the importance of accurate clinical assessment especially thorough neurological evaluation in discerning hallux hypertonia, potentially enabling early disease recognition and intervention. By synthesizing these clinical insights, we trust that this case report contributes to an enhanced understanding of hypertonia of the hallux as a distinctive clinical presentation in PD fostering improved diagnostic precision.