Subluxation

Cervical spine synovial cysts are rare degenerative spinal abnormalities when compared to more frequently noticed degenerative cyst in the lumbar spine. Many times, cervical synovial cysts can be asymptomatic. However, as in the cervical spine, synovial cysts can cause nerve root compression and in the cervical spine can cause spinal cord compression, especially, when acute hemorrhage and/or a marked increase in the size of the cyst occurs, and thus, they can result in radiculopathy and/or myelopathy. The authors report a unique case of a 69-yearsold female who presented with a right C7-T1 synovial cyst causing right C8 radiculopathy and early myelopathy. This case is felt to be unique, because the diagnosis of the right C8 radiculopathy was confirmed on Electromyography (EMG) testing. The patient was also found not to have any signs of carpal tunnel syndrome. In addition, the diagnosis was further supported by a myelogram Computed Tomography (CT) scan done after the Magnetic Resonance Imaging
(MRI). The MRI showed multiple levels of degenerative spondylosis, namely at C4-5, C5-6, and C6-7 with the question of stenosis at C7-T1, wrose on the right. The myelogram CT scan showed a much more clear-cut synovial cyst causing right sided C8 neural impingement and foraminal encroachment. Flexion/extension x-rays and the myelogram showed that the patient had a very minimal subluxation and a synovial cyst in the cervicothoracic junction is treated with spinal fusion. The authors showed, in the case, that even with slight subluxation, it is safe
to treat a patient with a more minimally invasive C7-T1 laminotomy, foraminotomy and postoperative Flexion/extension x-rays and showed no sign of cervical instability after she was treated for her synovial cyst. She had nearly complete resolution of symptoms post operatively
and did not develop instability in the follow-up period.

Introduction: Traumatic eye injuries (TEI) involved about 3% of cases referred to the emergency departments of developing countries. Lens dislocation is one of the critical cases of ophthalmic emergencies. The present study was aimed to evaluate the diagnostic accuracy of ultrasonography in detection of traumatic lens dislocation. Methods: In this cross-sectional study the findings of ultrasonography and orbital computed tomography (OCT) of head and face trauma patients, referred to Imam Reza hospital, Tabriz, Iran, from July 2013 to June 2014, have been compared. The sensitivity, specificity, positive and negative likelihood ratio, positive and negative predictive value, and accuracy of ultrasonography were calculated. Cohen's kappa coefficient was presented to assess the agreement of ultrasonography with OCT findings. Results: One hundred thirty patients with the mean age of 35.4±18.0 were evaluated (75.4% male). Sensitivity and specificity of ultrasonography were 84.6% (95% Cl: 53.7-97.3) and 98.3% (95% Cl: 93.3- 99.7), respectively. Also, positive and negative likelihood ratio were calculated 49.5 (95% Cl: 12.3-199.4) and 0.15 (95% Cl: 0.04- 0.56), respectively. Cohen's kappa coefficient of 0.83 (95% Cl: 0.66-1.0; p<0.0001) was representative of excellent agreement of these two tests. Conclusion: The finding of this project was representative of 84.6% sensitivity, 98.3% specificity, and 96.9% accuracy of ultrasonography in detection of traumatic lens dislocation. It seems that in cases which OCT is not possible, ultrasonography could be an acceptable option to assess traumatic eye injuries.

Aim: The aim of this study was to evaluate the efficacy of autologus blood injection in the management of recurrent temporomandibular joint (TMJ) dislocation. Methods: A total of 11 patients, 4 males, 7 females, mean age of 58.6 years and suffering from recurrent dislocation of TMJ, were included in the study. In all the patients the procedure included anesthesia-local or sedation, arthrocentesis which was followed by autologous blood injection in the upper joint cavity. The peri-articular tissues were also infiltrated with autologous blood. Post procedure advice included restricted mouth activity and liquid diet for a month. Results: The results indicate that success rate of treatment of recurrent dislocation of TMJ is 72.8% which can be considered as impressive. The recurrence was noticed in 27.2% cases after one year follow up. Conclusion: Autologus blood injection is an effective, simple, non-invasive, and safe procedure for treatment of recurrent dislocation of TMJ and can be performed on outpatient basis.