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An unusual case of persistent groin pain after total hip arthroplasty: a case report
INTRODUCTION: Arthroplasty is a well-established routine elective surgical procedure in orthopaedics. To a great extent, diagnosis, treatment and post-operative rehabilitation in these patients is standardised. In a busy clinic, surgeons from time to time tend to focus their attention on common caus...
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Formato: | Texto |
Lenguaje: | English |
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BioMed Central
2011
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3049745/ https://www.ncbi.nlm.nih.gov/pubmed/21324110 http://dx.doi.org/10.1186/1752-1947-5-67 |
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author | Konala, Praveen Schaefer, Thomas K Iranpour, Farhad Friederich, Niklaus F Hirschmann, Michael T |
author_facet | Konala, Praveen Schaefer, Thomas K Iranpour, Farhad Friederich, Niklaus F Hirschmann, Michael T |
author_sort | Konala, Praveen |
collection | PubMed |
description | INTRODUCTION: Arthroplasty is a well-established routine elective surgical procedure in orthopaedics. To a great extent, diagnosis, treatment and post-operative rehabilitation in these patients is standardised. In a busy clinic, surgeons from time to time tend to focus their attention on common causes of joint pain, but it may lead them to overlook sinister but less common pathologies. Here we report a case of a patient with groin pain due to pre-operatively undetected pelvic metastases from a pyeloureteral carcinoma who underwent total hip arthroplasty. There are several case reports which deal with primary or secondary tumours which were either discovered at the time of replacement surgery or developed at the site of prosthesis years after total hip or knee replacement. To the best of our knowledge, this is the first case report in which a metastatic cancer was missed pre-operatively and intra-operatively both by the radiologist and by the orthopaedic surgeon and should be reported so that surgeons are reminded to be careful when dealing with seemingly routine cases. CASE PRESENTATION: A 79-year-old Caucasian woman presented to the arthroplasty clinic with groin pain. Initial radiographs showed subtle bilateral abnormalities in the pelvis. Neither the radiologist nor the orthopaedic surgeon recognized it. A diagnosis of osteoarthritis of the hip was established, and she underwent total hip arthroplasty. Despite initial improvement, the patient came back with worsening hip pain three months later. Further radiological examination revealed multiple metastatic lesions throughout the pelvis due to a pyeloureteral carcinoma. CONCLUSIONS: This case report emphasizes the importance of meticulous, unbiased pre-operative assessment of patients and their radiographs, even in so-called routine clinical cases. Often subtle radiological changes are classed as normal, especially if they are bilateral. Further radiological imaging should be recommended in all cases where unexplained clinical features or radiological findings are present. |
format | Text |
id | pubmed-3049745 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-30497452011-03-08 An unusual case of persistent groin pain after total hip arthroplasty: a case report Konala, Praveen Schaefer, Thomas K Iranpour, Farhad Friederich, Niklaus F Hirschmann, Michael T J Med Case Reports Case Report INTRODUCTION: Arthroplasty is a well-established routine elective surgical procedure in orthopaedics. To a great extent, diagnosis, treatment and post-operative rehabilitation in these patients is standardised. In a busy clinic, surgeons from time to time tend to focus their attention on common causes of joint pain, but it may lead them to overlook sinister but less common pathologies. Here we report a case of a patient with groin pain due to pre-operatively undetected pelvic metastases from a pyeloureteral carcinoma who underwent total hip arthroplasty. There are several case reports which deal with primary or secondary tumours which were either discovered at the time of replacement surgery or developed at the site of prosthesis years after total hip or knee replacement. To the best of our knowledge, this is the first case report in which a metastatic cancer was missed pre-operatively and intra-operatively both by the radiologist and by the orthopaedic surgeon and should be reported so that surgeons are reminded to be careful when dealing with seemingly routine cases. CASE PRESENTATION: A 79-year-old Caucasian woman presented to the arthroplasty clinic with groin pain. Initial radiographs showed subtle bilateral abnormalities in the pelvis. Neither the radiologist nor the orthopaedic surgeon recognized it. A diagnosis of osteoarthritis of the hip was established, and she underwent total hip arthroplasty. Despite initial improvement, the patient came back with worsening hip pain three months later. Further radiological examination revealed multiple metastatic lesions throughout the pelvis due to a pyeloureteral carcinoma. CONCLUSIONS: This case report emphasizes the importance of meticulous, unbiased pre-operative assessment of patients and their radiographs, even in so-called routine clinical cases. Often subtle radiological changes are classed as normal, especially if they are bilateral. Further radiological imaging should be recommended in all cases where unexplained clinical features or radiological findings are present. BioMed Central 2011-02-15 /pmc/articles/PMC3049745/ /pubmed/21324110 http://dx.doi.org/10.1186/1752-1947-5-67 Text en Copyright ©2011 Konala et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Konala, Praveen Schaefer, Thomas K Iranpour, Farhad Friederich, Niklaus F Hirschmann, Michael T An unusual case of persistent groin pain after total hip arthroplasty: a case report |
title | An unusual case of persistent groin pain after total hip arthroplasty: a case report |
title_full | An unusual case of persistent groin pain after total hip arthroplasty: a case report |
title_fullStr | An unusual case of persistent groin pain after total hip arthroplasty: a case report |
title_full_unstemmed | An unusual case of persistent groin pain after total hip arthroplasty: a case report |
title_short | An unusual case of persistent groin pain after total hip arthroplasty: a case report |
title_sort | unusual case of persistent groin pain after total hip arthroplasty: a case report |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3049745/ https://www.ncbi.nlm.nih.gov/pubmed/21324110 http://dx.doi.org/10.1186/1752-1947-5-67 |
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