{"title":"Gorham disease presenting as progressive osteolysis subsequent to a femoral neck fracture in a young patient: A rare case report","authors":"Daigo Shiraishi, Junya Shimizu, Makoto Emori, Yasutaka Murahashi, Ima Kosukegawa, Atsushi Teramoto","doi":"10.1016/j.joscr.2025.01.001","DOIUrl":"10.1016/j.joscr.2025.01.001","url":null,"abstract":"<div><h3>Background</h3><div>Gorham disease is characterized by unexplained osteolysis of bones over a period of several months, with the osteolytic areas being replaced by lymphovascular proliferation. The progression of the disease is unpredictable, as the expansion of the lesions may stop abruptly and regress spontaneously. Gorham disease is very rare and difficult to diagnose.</div></div><div><h3>Case presentation</h3><div>A 19-year-old male patient was referred to our hospital for further examination of osteolytic lesions after a femoral neck fracture. Histopathological analysis of the first biopsy resulted in the diagnosis of a hemangioma. However, because of progressive osteolysis, a second biopsy was performed; and he was diagnosed with Gorham disease. He underwent a wide resection and total hip arthroplasty. Two years postoperatively, he was able to walk unassisted and he had no signs of recurrence.</div></div><div><h3>Conclusions</h3><div>When osteolytic lesions are present in young patients, the differential diagnosis should include Gorham disease.</div></div>","PeriodicalId":100743,"journal":{"name":"JOS Case Reports","volume":"4 3","pages":"Pages 79-82"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908443","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"New visualization of cervical nerve roots by ultrasound: Identification by 0–1 sign","authors":"Yuyu Ishimoto , Hiroshi Iwasaki , Kotaro Oda , Hiroshi Yamada","doi":"10.1016/j.joscr.2024.12.003","DOIUrl":"10.1016/j.joscr.2024.12.003","url":null,"abstract":"<div><h3>Introduction</h3><div>Ultrasound-guided cervical nerve root block is an effective technique that avoids radiation exposure. However, there is currently no standard technique for visualizing cervical nerve roots using ultrasound. The most common method is to search for the cervical nerve by moving the transducer from the brachial plexus in the direction of the head, using nerves and the scalene muscle as landmarks. However, this approach often poses difficulties for novice ultrasound operators because it can be difficult to identify these landmarks. We propose a new technique to visualize the cervical nerve root by using the common carotid artery and the C6 anterior tubercle as landmarks. Our aim was to quantitatively measure the anatomical positions of these landmarks to facilitate identification by novice ultrasound operators.</div></div><div><h3>Case reports</h3><div>Included in this study were 32 healthy volunteers (19 men, 13 women; mean age, 34.5 ± 10.5 years) who provided informed consent to inclusion in the study. The new technique called the ‘0–1 sign’ as the common carotid artery and the C6 anterior tubercle are morphologically likened to ‘0’ and ‘1’, respectively. Our aim was to measure the distance between the ‘0’ and ‘1’ and the distance of ‘1’ from the skin so as to allow beginners in ultrasound to quickly locate these landmarks.</div></div><div><h3>Conclusions</h3><div>Our new procedure for cervical nerve root visualization under ultrasound uses the 0–1 sign as an indicator. The results suggested that the 0–1 sign technique is a simple and effective method for cervical nerve root visualization and may serve as a reliable reference for ultrasound-guided cervical nerve root blocks.</div></div>","PeriodicalId":100743,"journal":{"name":"JOS Case Reports","volume":"4 3","pages":"Pages 71-74"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Operative treatment of neglected painful costal cartilage nonunion in a karate player","authors":"Masayoshi Ikeda , Daisuke Nakajima , Yuka Kobayashi , Ikuo Saito","doi":"10.1016/j.joscr.2024.12.002","DOIUrl":"10.1016/j.joscr.2024.12.002","url":null,"abstract":"<div><h3>Background</h3><div>Costal cartilage fractures are one of the common traumas in contact sports, and persistent pain from its nonunion severely limits sports activities. We report the surgical treatment of a karate athlete with this type of trauma.</div></div><div><h3>Case presentation</h3><div>A 35-year-old man sustained a seventh costal cartilage fracture from a kick to the left chest during a karate match a year ago. The patient had a residual deformity of the chest rib area and reported persistent and chronic pain. Operatively, the displaced costal cartilage fracture ends were freshened, reduced, and fixed with nonabsorbable threads. Postoperatively, the patient reengaged in sports activities without disabling painful symptoms.</div></div><div><h3>Conclusions</h3><div>Surgical treatment is an option for painful displaced costal cartilage nonunion in contact sports athletes.</div></div>","PeriodicalId":100743,"journal":{"name":"JOS Case Reports","volume":"4 3","pages":"Pages 67-70"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JOS Case ReportsPub Date : 2025-09-01Epub Date: 2025-03-27DOI: 10.1016/j.joscr.2025.02.003
Shuro Furuichi, Hirosuke Endo, Shigeru Mitani
{"title":"A case of Aitken Classification Type A proximal femoral focal deficiency treated with plate fixation for pseudarthrosis","authors":"Shuro Furuichi, Hirosuke Endo, Shigeru Mitani","doi":"10.1016/j.joscr.2025.02.003","DOIUrl":"10.1016/j.joscr.2025.02.003","url":null,"abstract":"<div><h3>Background</h3><div>Proximal femoral focal deficiency is a rare congenital anomaly with diverse clinical features and significant treatment challenges.</div></div><div><h3>Case presentation</h3><div>A female patient was diagnosed with Aitken type A proximal femoral focal deficiency at 1 month of age and surgically managed. She began walking after 17 months. At 34 months, she developed progressive varus and flexion deformities of the femur and complained of thigh pain. At 38 months, we excised the pseudoarthrosis, corrected the deformity, and performed plate fixation. At 4 years, growth suppression surgery was performed on the unaffected left leg. At 7 years, the affected lower limb was 13.5 cm shorter than the contralateral limb, requiring a 12-cm shoe lift.</div></div><div><h3>Conclusions</h3><div>A patient with Aitken type A proximal femoral focal deficiency presented with pseudarthrosis of the femur and was successfully treated surgically, resulting in thigh pain resolution.</div></div>","PeriodicalId":100743,"journal":{"name":"JOS Case Reports","volume":"4 3","pages":"Pages 91-95"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A severe equinovarus foot in a child with primary lymphedema","authors":"Mami Sugano , Toru Yamaguchi , Yoshihisa Kawakami , Tomoyuki Nakamura , Haruhisa Yanagida , Kazuyuki Takamura","doi":"10.1016/j.joscr.2024.12.004","DOIUrl":"10.1016/j.joscr.2024.12.004","url":null,"abstract":"<div><h3>Background</h3><div>Primary lymphedema is a rare disease, and there is no study on the treatment of joint disability or foot deformity with lymphedema.</div></div><div><h3>Case presentation</h3><div>A 6 years and 9 months old boy with primary congenital lymphedema presented with a severe untreated equinovarus foot. The posteromedial release was performed, and 1 year later, he gained a plantigrade foot and the ability to stand and walk with Ankle-Foot Orthoses.</div></div><div><h3>Conclusion</h3><div>Reports describing the treatment of foot deformities associated with primary congenital lymphedema are lacking. We successfully treated an acquired severe equinovarus foot considering the skin fragility associated with lymphedema.</div></div>","PeriodicalId":100743,"journal":{"name":"JOS Case Reports","volume":"4 3","pages":"Pages 75-78"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JOS Case ReportsPub Date : 2025-09-01Epub Date: 2025-03-17DOI: 10.1016/j.joscr.2025.02.002
Narimichi Takino, Takuya Nakamura, Hideji Nishida
{"title":"Bilateral neglected femoral neck fracture due to vitamin D deficiency osteomalacia treated with total hip arthroplasty: A case report","authors":"Narimichi Takino, Takuya Nakamura, Hideji Nishida","doi":"10.1016/j.joscr.2025.02.002","DOIUrl":"10.1016/j.joscr.2025.02.002","url":null,"abstract":"<div><h3>Background</h3><div>Bilateral femoral neck fractures in young adults are rare and often result from trauma or underlying conditions like osteomalacia. Osteomalacia-related fractures are often treated late due to poor bone quality and untreated metabolic issues. In this case, the patient presented with a high-positioned dislocated hip resulting from old femoral neck fractures, which were successfully treated with total hip arthroplasty (THA).</div></div><div><h3>Case presentation</h3><div>A 31-year-old man with severe food allergies and atopic dermatitis developed bilateral femoral neck fractures due to vitamin D deficiency-induced osteomalacia. Poor bone quality initially made surgery unfeasible, leaving him wheelchair-bound for 13 years. After treating the vitamin D deficiency and improving bone quality, bilateral THA was performed at age 44. Fifteen weeks postoperatively, the patient was able to walk independently.</div></div><div><h3>Conclusions</h3><div>Osteomalacia-associated fractures require complex management due to delayed treatment. Recovery in this case was achieved by addressing osteomalacia first, followed by bilateral THA.</div></div>","PeriodicalId":100743,"journal":{"name":"JOS Case Reports","volume":"4 3","pages":"Pages 87-90"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
JOS Case ReportsPub Date : 2025-09-01Epub Date: 2025-03-16DOI: 10.1016/j.joscr.2025.02.001
Yuki Yoshida, Takeshi Ikegami
{"title":"Glenosphere dissociation combined with nonunion of a clavicular fracture following reverse shoulder arthroplasty","authors":"Yuki Yoshida, Takeshi Ikegami","doi":"10.1016/j.joscr.2025.02.001","DOIUrl":"10.1016/j.joscr.2025.02.001","url":null,"abstract":"<div><h3>Background</h3><div>Reverse shoulder arthroplasty (RSA) effectively improves outcomes for cuff tear arthropathy but carries a risk of complications. Glenosphere dissociation is a rare complication, and its occurrence with a shoulder girdle fracture has not been reported.</div></div><div><h3>Case presentation</h3><div>A 77-year-old female who had undergone RSA presented with chronic shoulder pain and a palpable mass. Imaging revealed glenosphere dissociation and clavicular nonunion with scapular malalignment. Surgical intervention included replacing the glenosphere and polyethylene liner, stabilizing the shoulder. Postoperative care involved sling immobilization, leading to pain relief and no recurrent dislocation despite limited functional recovery due to scapular malalignment.</div></div><div><h3>Conclusion</h3><div>We presented a rare case of glenosphere dissociation combined with clavicular nonunion following RSA. While pain relief was achieved by repairing the dislocation, clavicular nonunion contributing to scapular malalignment may hinder functional recovery. Surgical intervention for clavicular stabilization may be necessary in cases prioritizing shoulder function.</div></div>","PeriodicalId":100743,"journal":{"name":"JOS Case Reports","volume":"4 3","pages":"Pages 83-86"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Chronic tibial osteomyelitis by Cutibacterium (Propionibacterium) acnes with characteristic imaging findings","authors":"Taiga Furukawa, Tomoaki Fukui, Yohei Kumabe, Ryosuke Kuroda, Keisuke Oe","doi":"10.1016/j.joscr.2024.11.002","DOIUrl":"10.1016/j.joscr.2024.11.002","url":null,"abstract":"<div><h3>Background</h3><div>Osteomyelitis caused by <em>Cutibacterium (Propionibacterium) acnes</em> (<em>C. acnes</em>) is rare, and there are no reports on the use of the Masquelet technique for its treatment.</div></div><div><h3>Case presentation</h3><div>A 21-year-old male patient visited a local hospital after spraining his left leg. Abnormal linear changes were noted on radiography and magnetic resonance imaging (MRI); however, the leg pain improved over time. Four years later, the patient was referred to our department because he experienced left leg pain again without any particular trigger, and a new linear lesion was found on imaging. Osteomyelitis was suspected. Curettage and filling with vancomycin-loaded bone cement were performed. Intraoperative tissue culture revealed <em>C. acnes</em>. Two months later, the cement was removed, and autologous iliac bone grafting was performed. Bony union was confirmed 5 months after the last surgery.</div></div><div><h3>Conclusion</h3><div>Osteomyelitis caused by <em>C. acnes</em> can show characteristic imaging findings.</div></div>","PeriodicalId":100743,"journal":{"name":"JOS Case Reports","volume":"4 2","pages":"Pages 58-62"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Nonunion of fourth metatarsal base stress fracture in athletes treated with locking plate fixation and iliac bone grafting: A three-case report","authors":"Shota Morimoto, Futoshi Morio, Toshiya Tachibana, Tomoya Iseki","doi":"10.1016/j.joscr.2024.08.003","DOIUrl":"10.1016/j.joscr.2024.08.003","url":null,"abstract":"<div><h3>Background</h3><div>Fourth metatarsal base stress fractures have been reported to cause complications, such as a substantial rate of delayed union and nonunion when treated nonoperatively. This report details three cases of nonunion of basal stress fractures of the fourth metatarsal in athletes who were successfully treated with a combination of locking plate fixation and iliac bone grafting.</div></div><div><h3>Case presentation</h3><div>Three male athletes presented with nonunion of fourth metatarsal base stress fracture and underwent surgical treatment. In all cases, the nonunion site was decorticated, and iliac cancellous bone was grafted to the nonunion site. The bone fragments were reduced in a correct bone alignment and fixed using a locking plate. All the athletes obtained bone union and returned to the original sport at 12 weeks postoperatively.</div></div><div><h3>Conclusions</h3><div>Surgical treatment combining locking plate fixation and iliac bone grafting for nonunion of a fourth metatarsal base stress fracture in athletes produced satisfactory results.</div></div>","PeriodicalId":100743,"journal":{"name":"JOS Case Reports","volume":"4 2","pages":"Pages 44-47"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169677","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Stress fracture of the talar body associated with talocalcaneal coalition in a female basketball player treated by a combination of osteosynthesis using screw fixation and resection of coalition: A case report","authors":"Shota Morimoto, Tomoya Iseki, Futoshi Morio, Toshiya Tachibana","doi":"10.1016/j.joscr.2024.08.001","DOIUrl":"10.1016/j.joscr.2024.08.001","url":null,"abstract":"<div><h3>Background</h3><div>This report details the case of a 15-year-female basketball player who was surgically treated for a stress fracture of the talar body associated with talocalcaneal coalition.</div></div><div><h3>Case presentation</h3><div>A 15-year-old female basketball player presented with a stress fracture of the talar body associated with a talocalcaneal coalition. <u>The patient underwent surgical treatment with a combination of osteosynthesis using screw fixation and resection of the coalition in hope to reducing the risk of refracture and ensuring her return to original sport.</u> At 12 weeks after the surgery, the bone union was achieved, and the patient was able to return to her original sport at her pre-injury level.</div></div><div><h3>Conclusions</h3><div>In conclusion, stress fractures of the talus associated with talocalcaneal coalition should be considered as a rare cause of atraumatic ankle pain. In addition, this surgical technique may be an effective option for stress fractures of the talus associated with talocalcaneal coalition.</div></div>","PeriodicalId":100743,"journal":{"name":"JOS Case Reports","volume":"4 2","pages":"Pages 35-39"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144169675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}