Eight-year chronic wound caused by Tarlov’s cyst: a case report
Abstract Background Tarlov’s cyst is often underdiagnosed since it is difficult to identify without imaging assistance. Herein, we report the case of a young girl who presented with an 8-year history of chronic osteomyelitis of bilateral proximal phalanges and metatarsal bones caused by a Tarlov’s c...
| Հիմնական հեղինակներ: | , , , |
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| Ձևաչափ: | Հոդված |
| Լեզու: | English |
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BMC
2023-12-01
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| Շարք: | Journal of Medical Case Reports |
| Խորագրեր: | |
| Առցանց հասանելիություն: | https://doi.org/10.1186/s13256-023-04232-1 |
| _version_ | 1827590522123845632 |
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| author | Ya-Ning Huang I-Wei Chang Sung-Tse Li Wei-Te Lei |
| author_facet | Ya-Ning Huang I-Wei Chang Sung-Tse Li Wei-Te Lei |
| author_sort | Ya-Ning Huang |
| collection | DOAJ |
| description | Abstract Background Tarlov’s cyst is often underdiagnosed since it is difficult to identify without imaging assistance. Herein, we report the case of a young girl who presented with an 8-year history of chronic osteomyelitis of bilateral proximal phalanges and metatarsal bones caused by a Tarlov’s cyst that did not contain a nerve root. The chronic wound in the forefoot is an unusual presentation and resulted from the Tarlov’s cyst accompanied with tethered conus syndrome. Case presentation A 10-year-old Asian girl presented with an 8-year history of chronic osteomyelitis of bilateral proximal phalanges and metatarsal bones. She received sequestrectomy five times, however the immune function tests were all normal. A neurological examination revealed diminished sensation and a slapping gait pattern. Magnetic resonance imaging (MRI) demonstrated a lobulated cyst at the right aspect of the sacrum (S) 1 to sacrum (S) 3 canal near the dorsal root ganglion. Tethered conus syndrome was highly suspected. She received laminectomy of lumbar (L) 5 and S1–S2, which led to the diagnosis of a right S1–S3 epidural cyst. The final diagnosis from the histopathological examination was a right sacral Tarlov’s cyst. The clinical conditions of diminished sensation and slapping gait pattern greatly improved after successful surgical treatment. Conclusion In children who present with a recalcitrant chronic wound in the forefoot accompanied with a slapping gait pattern and foot hypoesthesia to pain, aggressive imaging examinations such as spine MRI should be arranged for further evaluation, especially in immunocompetent children. |
| first_indexed | 2024-03-09T01:19:00Z |
| format | Article |
| id | doaj.art-db0b6b8a3e3f4559abd3076398c40b61 |
| institution | Directory Open Access Journal |
| issn | 1752-1947 |
| language | English |
| last_indexed | 2024-03-09T01:19:00Z |
| publishDate | 2023-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Medical Case Reports |
| spelling | doaj.art-db0b6b8a3e3f4559abd3076398c40b612023-12-10T12:20:17ZengBMCJournal of Medical Case Reports1752-19472023-12-011711410.1186/s13256-023-04232-1Eight-year chronic wound caused by Tarlov’s cyst: a case reportYa-Ning Huang0I-Wei Chang1Sung-Tse Li2Wei-Te Lei3Department of Pediatrics, Hsinchu Municipal Mackay Children’s HospitalDepartment of Pathology, Taipei Medical University HospitalDepartment of Pediatrics, Hsinchu Municipal Mackay Children’s HospitalDepartment of Pediatrics, Hsinchu Municipal Mackay Children’s HospitalAbstract Background Tarlov’s cyst is often underdiagnosed since it is difficult to identify without imaging assistance. Herein, we report the case of a young girl who presented with an 8-year history of chronic osteomyelitis of bilateral proximal phalanges and metatarsal bones caused by a Tarlov’s cyst that did not contain a nerve root. The chronic wound in the forefoot is an unusual presentation and resulted from the Tarlov’s cyst accompanied with tethered conus syndrome. Case presentation A 10-year-old Asian girl presented with an 8-year history of chronic osteomyelitis of bilateral proximal phalanges and metatarsal bones. She received sequestrectomy five times, however the immune function tests were all normal. A neurological examination revealed diminished sensation and a slapping gait pattern. Magnetic resonance imaging (MRI) demonstrated a lobulated cyst at the right aspect of the sacrum (S) 1 to sacrum (S) 3 canal near the dorsal root ganglion. Tethered conus syndrome was highly suspected. She received laminectomy of lumbar (L) 5 and S1–S2, which led to the diagnosis of a right S1–S3 epidural cyst. The final diagnosis from the histopathological examination was a right sacral Tarlov’s cyst. The clinical conditions of diminished sensation and slapping gait pattern greatly improved after successful surgical treatment. Conclusion In children who present with a recalcitrant chronic wound in the forefoot accompanied with a slapping gait pattern and foot hypoesthesia to pain, aggressive imaging examinations such as spine MRI should be arranged for further evaluation, especially in immunocompetent children.https://doi.org/10.1186/s13256-023-04232-1Chronic osteomyelitisSlapping gait patternTethered conus syndromePerineural cyst |
| spellingShingle | Ya-Ning Huang I-Wei Chang Sung-Tse Li Wei-Te Lei Eight-year chronic wound caused by Tarlov’s cyst: a case report Journal of Medical Case Reports Chronic osteomyelitis Slapping gait pattern Tethered conus syndrome Perineural cyst |
| title | Eight-year chronic wound caused by Tarlov’s cyst: a case report |
| title_full | Eight-year chronic wound caused by Tarlov’s cyst: a case report |
| title_fullStr | Eight-year chronic wound caused by Tarlov’s cyst: a case report |
| title_full_unstemmed | Eight-year chronic wound caused by Tarlov’s cyst: a case report |
| title_short | Eight-year chronic wound caused by Tarlov’s cyst: a case report |
| title_sort | eight year chronic wound caused by tarlov s cyst a case report |
| topic | Chronic osteomyelitis Slapping gait pattern Tethered conus syndrome Perineural cyst |
| url | https://doi.org/10.1186/s13256-023-04232-1 |
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