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Spontaneous Iliopsoas Hematoma After Total Hip Arthroplasty In A Patient On Rivaroxaban: A rare case report

May 10, 2019/in May- Dec 2019 | Volume 5 | Issue 2

Vol 5 | Issue 2 | May-Dec 2019 | page: 08-10 | Danai Grammatikopoulou, Themistoklis Vampertzis, Eirini Iosifidou, Christina Barmpagianni, Eleni Melikidou, Fotios Girtovitis, Stergios Papastergiou DOI 10.13107/ti.2019.v05i02.090 Author: Danai Grammatikopoulou [1], Themistoklis Vampertzis [1], Eirini Iosifidou [1], Christina Barmpagianni [2], Eleni Melikidou [3], Fotios Girtovitis [4], Stergios Papastergiou [1] [1] Orthopaedics Department, Agios Pavlos […]

Bilateral femoral neck fracture in pregnancy- outcome of conservative and operative treatment: a case report

May 10, 2019/in May- Dec 2019 | Volume 5 | Issue 2

Vol 5 | Issue 2 | May-Dec 2019 | page: 11-13 | Hemjit Das, Shyam Sunder. S DOI 10.13107/ti.2019.v05i01.092 Author: Hemjit Das [1], Shyam Sunder. S [1] [1] Department Of Orthopaedics, Assam Medical college and hospital, Dibrugarh, Assam, India-786002. India. Address of Correspondence Dr. Shyam Sunder. S, Department Of Orthopaedics, Assam Medical college and hospital, Dibrugarh, Assam, […]

Spontaneous Iliopsoas Hematoma After Total Hip Arthroplasty In A Patient On Rivaroxaban: A rare case report

May 10, 2019/in May- Dec 2019 | Volume 5 | Issue 2

Bilateral femoral neck fracture in pregnancy- outcome of conservative and operative treatment: a case report

May 10, 2019/in May- Dec 2019 | Volume 5 | Issue 2

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Spontaneous Iliopsoas Hematoma After Total Hip Arthroplasty In A Patient On Rivaroxaban: A rare case report

May 10, 2019/in May- Dec 2019 | Volume 5 | Issue 2

Vol 5 | Issue 2 | May-Dec 2019 | page: 08-10 | Danai Grammatikopoulou, Themistoklis Vampertzis, Eirini Iosifidou, Christina Barmpagianni, Eleni Melikidou, Fotios Girtovitis, Stergios Papastergiou

DOI 10.13107/ti.2019.v05i02.090

Author: Danai Grammatikopoulou [1], Themistoklis Vampertzis [1], Eirini Iosifidou [1], Christina Barmpagianni [2], Eleni Melikidou [3], Fotios Girtovitis [4], Stergios Papastergiou [1]

[1] Orthopaedics Department, Agios Pavlos General Hospital of Thessaloniki, Thessaloniki, Greece;
[2] Aristotle University of Thessaloniki, Faculty of Medicine, Thessaloniki, Greece;
[3] Radiology Department, Agios Pavlos General Hospital of Thessaloniki, Thessaloniki, Greece;
[4] Blood Centre, AHEPA University Hospital, Thessaloniki, Greece.

Address of Correspondence
Dr. Themistoklis Vampertzis,
Orthopaedic Department, Agios Pavlos General Hospital Thessaloniki, Thessaloniki, Greece.
E-mail: themisvamper@yahoo.com

Abstract

Introduction: Pain in the inguinal region, frequently spreading to the femur, is a common symptom with a variable differential diagnosis. Spontaneous iliopsoas hematoma is a rarely reported adverse effect of anticoagulation therapy that can present with pain in the hip, with or without previous injury or surgery at the region. This case report aims to remind clinicians of this rare condition that can result in major complications.
Case Presentation: An 83 year old male patient presented to our Emergency Department with pain at the right hip which within a week expanded to the lower back and anterior femur. During clinical examination restriction of movement due to soreness was noted, the hip joint was kept in slight flexion, while there were no abnormal vascular findings. Medical history included a right-sided total hip replacement 8 years ago, chronic atrial fibrilation, chronic cardiac failure and hypertension. He was on anticoagulant (rivaroxaban) and anti-hypertensive regimen. Laboratory results showed low hematocrit (HTC) and hemoglobin (HB), elevated prothrombin time (PT) and increased international normalized ratio (INR). Imaging showed a large iliopsoas hematoma. Conservative treatment was decided. Subsequently, the hematocrit normalized, the hematoma regressed and the pain receded.
Conclusion: Despite being a frequent cause of complain, pain of the hip, lumbar or femur region could be the result of a more complex pathology. Such cases should therefore not be overlooked but examined thoroughly, especially if presenting with suspicious signs or symptoms or in a setting of co morbidities. When complains are with regard to an area that has been operated on, as in our case, clinicians should not attribute all symptoms on the presence of prior surgery.
Keywords: Anticoagulation, spontaneous hematoma, iliopsoas, total hip arthroplasty.

References

1.Kim SW, Kim DH, Jung S-N. Spontaneous Iliopsoas Hematoma: A Rare Complication of Anticoagulant Use. Archives of Plastic Surgery. 2015;42(4):507-510. doi:10.5999/aps.2015.42.4.507.
2.Yegen SF, Ekiz T, Gilikli BE, Dogan A. Spontaneous Iliopsoas Haematoma Presenting with Groin Pain under Warfarin Therapy. Pain Physician. 2015 Nov;18(6):E1145-6.
3.Boţianu AM, Demian S, Macarie I, Georgescu D, Oltean G, Băţagă S. Acquired haemophilia complicated with gastrointestinal bleeding and spontaneous iliopsoasmuscle haematoma in woman with chronic C hepatitis under treatment with pegylated IFNalpha 2a and ribavirin. J Gastrointestin Liver Dis. 2012 Mar;21(1):93-5
4.Kumar A, Mondal S, Sethi P, Manchanda S, Biswas A, Wig N. Spontaneous iliopsoas haematoma in a patient with dengue haemorrhagic fever (DHF): A casereport. J Vector Borne Dis. 2017 Jan-Mar;54(1):103-105.
5.Selton J, Perrin J, Ropion H, et al. Iliopsoas Hematoma in Gauchers D i s e a s e . I n t e r n a l Me d i c i n e . 2 0 1 1 ; 5 0 ( 2 1 ) : 2 6 4 3 – 2 6 4 7 . doi:10.2169/internalmedicine.50.5215.
6.Keikhaei B, Shirazi AS. Spontaneous iliopsoas muscle hematoma in a patient with von Willebrand disease: a case report. Journal of Medical Case Reports. 2011;5(1). doi:10.1186/1752-1947-5-274.
7.Sarcon A, Botta GP, Patel N, Saven A. Spontaneous Iliopsoas Muscle Hemorrhage Secondary to Ibrutinib (Imbruvica; Pharmacyclics). Journal of Investigative Medicine High Impact Case Reports. 2016;4(2):232470961664845. doi:10.1177/2324709616648457.
8.Yogarajah M, Sivasambu B, Jaffe EA. Spontaneous iliopsoas haematoma: a complication of hypertensive urgency. Case Reports. 2015;2015(feb26 1). doi:10.1136/bcr-2014-207517.
9.Lee KS, Jeong IS, Oh SG, Ahn BH. Subsequently occurring bilateral iliopsoas hematoma: a case report. Journal of Cardiothoracic Surgery. 2015;10(1). doi:10.1186/s13019-015-0386-7.
10.Rock J, Basheer A, Jain R, Anton T. Bilateral iliopsoas hematoma: Case report and literature review. Surgical Neurology International. 2013;4(1):121. doi:10.4103/2152-7806.118561.
11.Podger H, Kent M. Femoral nerve palsy associated with bilateral spontaneous iliopsoas haematomas: a complication of venous thromboembolism therapy. Age and Ageing. 2016;45(1):175-176. doi:10.1093/ageing/afv176.
12.Andreani L, Nucci AM, Giuntoli M, Lisanti M .Compressive Femoral Neuropathy Associated with Iliopsoas Hematoma Complicating Hip Hemiarthroplasty: A Case Report. J Orthop Case Rep. 2017 Sep- Oct;7(5):3-6. doi: 10.13107/jocr.2250-0685.872.
13.Torres GM, Cernigliaro JG, Abbitt PL, Mergo PJ, Hellein VF, Fernandez S, Ros PR. Iliopsoas compartment: normal anatomy and pathologic processes. Radiographics. 1995 Nov; 15(6): 1285–1297. doi: 10.1148/radiographics.15.6.8577956
14.Retselas I, Vaiopoulos C, Chronopoulos P, Kaisidis G, Fotopoulou C, Skandalos I. Spontaneous iliopsoas muscle haematoma during anticoagulant treatment. Hell J Surg 2015;87:434-6
15. Llitjos JF, Daviaud F, Grimaldi D, et al. Ilio-psoas hematoma in the intensive care unit: a multicentric study. Annals of Intensive Care. 2016;6:8. doi:10.1186/s13613-016-0106-z.

How to Cite this article: Grammatikopoulou D, Vampertzis T, Iosifidou E, Barmpagianni C, Melikidou E, Girtovitis F, Papastergiou S. Spontaneous Iliopsoas hematoma after total hip arthroplasty in a patient on Rivaroxaban: A rare case report. Trauma International May -Dec 2019;5(2): 8-10.

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Bilateral femoral neck fracture in pregnancy- outcome of conservative and operative treatment: a case report

May 10, 2019/in May- Dec 2019 | Volume 5 | Issue 2

Vol 5 | Issue 2 | May-Dec 2019 | page: 11-13 | Hemjit Das, Shyam Sunder. S

DOI 10.13107/ti.2019.v05i01.092

Author: Hemjit Das [1], Shyam Sunder. S [1]

[1] Department Of Orthopaedics, Assam Medical college and hospital, Dibrugarh, Assam, India-786002. India.

Address of Correspondence
Dr. Shyam Sunder. S,
Department Of Orthopaedics, Assam Medical college and hospital,
Dibrugarh, Assam, India-786002.
E-mail: shyam.arun90@gmail.com

Abstract

Introduction: Transient osteoporosis of pregnancy is usually benign in nature. Rarely serious complication like fragility fracture of neck of femur can occur. Usually idiopathic in nature and self-limiting. So far only 12 such cases and bilateral in only 2 patients have been reported in literature. Since, X-rays are usually avoided in pregnancy this condition is usually missed leading to late diagnosis.
Case report: A 26-year-old primigravida was referred to our institute on her 7th month of gestation with bilateral hip pain and limp. She developed bilateral hip pain on her 5th month of gestation which was progressive in nature. Her radiograph showed bilateral femoral neck fracture. To avoid radiation hazard to the fetus fracture fixation was delayed till caesarean section on her 38th week of gestation. Closed reduction and internal fixation with three CC screws was done for left femur neck fracture. Fixation was planned for right side fracture simultaneously but since the patient did not consent for bilateral surgery she was asked to review after one month for right femur neck fracture fixation. The patient who lost to follow-up showed up after 6 months walking comfortably. Radiological examination showed that in the nonoperated side the fracture united in Varus with shortening of 0.5 cm.
Conclusion: Musculoskeletal problems during pregnancy should not be overlooked. MRI should be used for early diagnosis whenever feasible. Fracture Neck of femur in pregnancy in-spite of delayed diagnosis and treatment has a better prognosis even with conservative treatment.
Keywords: transient osteoporosis, pregnancy, femoral neck fracture, spontaneous healing.

References

1. Lakhanpal s, Ginsburg W, Luthra H, Hunder G. Transient regional osteoporosis, a study of 56 cases and review of the literature. Ann Intern Med. 1987;(106: 444-450).
2. Aynaci O, Kerimoglu S, Ozturk C, Sarcoglu M. Bilateral non-traumatic acetabular and femoral neck fractures due to pregnancy-assosiated osteoporosis. Arch Orthop Trauma Surg. 2008;(128 :313-316).
3. Munker R, Niedart C, Niedart F, Schmidt RB. Bilateral fracture of the femoral neck following transient osteoporosis in pregnancy. Z Orthop thre Grenzgeb. 2007;(145:88-90).
4. Willis-Owen C, Daurka J, Chen A, Lewis L. Bilateral femoral neck fractures due to transient osteoporosis of pregnancy. Cases J. 2008;(1:120).
5. Kyoko K, Nobuyuki K. Bilateral femoral neck fractures resulting from pregnancy assosiated osteoporosis showed bone marrow edema on magnetic resonance imaging. The journal of obstetrics and gynaecology research. 2017 jun; 43((6 )1067-1070).
6. Cohen I, Melamed E, Lipkin A, Robinson D. Transient osteoporosis of pregnancy complicated by a pathologic sub-capital hip fracture. J Trauma. 2007; 62(1281-3).
7. Rishi V, Wahi P, Mahajan A. Transient osteoporosis of hip (migratory ). JK Science. 2008; 10(194-6).
8. Smith R, Athanosou NA, Ostlere SJ, Viponf SE. pregnnacy assosisted osteoporosis. QJM. 1995; 88(865-878).
9. Alioune GB, Lamine S, Badara D, Alioune DB, Andre DS, Charles DB. Bilateral fracture of femoral neck during pregnancy:A case of spontaneous Healing. SM journal of orthopaedics. 2017.
10. British tF. thyroid disorders and osteoporosis ,revised 2018. ; 2018.
11. Dominika T, Marek B. the influence of thyroid disfunction on bone metabolism. thyroid research. 2014;(7:12).
12. CDC. CDC guidelines. US Govt emergency.cdc.gov.
13. Vakil C. Radiation and medical procedures.how do we do no harm? Canadian family physician. 2017 oct; 63((10)774-775).
14. Lu-Yao GL ,Keller RB, Littenberg B. Outcomes after displaced fractures of the femoral neck. a meta analysis of one hundred and six published reports. J bone Joint Surg Am. 1994; 76(15-25).

How to Cite this article: Das H, Sunder Shyam. S. Bilateral femoral neck fracture in pregnancyoutcome of conservative and operative treatment: a case report. Trauma International May – Dec 2019: 5(2):11-13.

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Spontaneous Iliopsoas Hematoma After Total Hip Arthroplasty In A Patient On Rivaroxaban: A rare case report

Bilateral femoral neck fracture in pregnancy- outcome of conservative and operative treatment: a case report

Spontaneous Iliopsoas Hematoma After Total Hip Arthroplasty In A Patient On Rivaroxaban: A rare case report

Bilateral femoral neck fracture in pregnancy- outcome of conservative and operative treatment: a case report

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Spontaneous Iliopsoas Hematoma After Total Hip Arthroplasty In A Patient On Rivaroxaban: A rare case report

Author: Danai Grammatikopoulou [1], Themistoklis Vampertzis [1], Eirini Iosifidou [1], Christina Barmpagianni [2], Eleni Melikidou [3], Fotios Girtovitis [4], Stergios Papastergiou [1]

Abstract

References

(Abstract)(Full Text HTML) (Download PDF)

Bilateral femoral neck fracture in pregnancy- outcome of conservative and operative treatment: a case report

Author: Hemjit Das [1], Shyam Sunder. S [1]

Abstract

References

(Abstract)(Full Text HTML) (Download PDF)

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