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  1. AU="Miradouro, José"
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  1. Artikel: Diffuse Idiopathic Skeletal Hyperostosis (DISH)-Phagia: A Case Report and Review of Literature of a Rare Disease Manifestation.

    Soares, Diogo / Bernardes, Francisco / Silva, Marta / Miradouro, José / Lopes, Daniel

    Cureus

    2023  Band 15, Heft 10, Seite(n) e47221

    Abstract: Diffuse idiopathic skeletal hyperostosis (DISH), also called Forestier disease, is a clinical entity characterized by ossification of the anterolateral ligaments of the spine. DISH is more commonly diagnosed in older males, with an estimated prevalence ... ...

    Abstract Diffuse idiopathic skeletal hyperostosis (DISH), also called Forestier disease, is a clinical entity characterized by ossification of the anterolateral ligaments of the spine. DISH is more commonly diagnosed in older males, with an estimated prevalence of 42% in patients older than 65 years. As the disease affects predominantly the thoracic spine, dysphagia is a rare presentation of this entity observed in only 0.6-1.0% of the cases. We present a clinical case of an 84-year-old male with complaints of progressive dysphagia and foreign body sensation within one year of evolution. Computed tomography imaging revealed an anterior C4-C5 osteophyte compressing the posterior hypopharyngeal wall. Flexible endoscopy revealed a deformed and stenotic hypopharynx. The patient underwent surgical treatment with anterior cervical osteophyte resection using the Smith-Robinson approach. The patient showed significant improvement in preoperative symptoms, and no recurrence was detected at six months of follow-up. We also aim to discuss the clinical and radiological characteristics of the disease, as well as the crucial steps for a correct diagnosis and treatment of this rare disease.
    Sprache Englisch
    Erscheinungsdatum 2023-10-17
    Erscheinungsland United States
    Dokumenttyp Case Reports
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.47221
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel: Plastia em Z modificada do ligamento patelar com reforço de tendão quadricipital no tratamento da patela baixa

    Costa, Tiago António Almeida Orange / Bernardes, Francisco / Miradouro, José / Pereira, Joana / Barreira, Pedro / Carvalho, João

    Revista Brasileira de Ortopedia

    2024  

    Abstract: A Patela Baixa é uma patologia do joelho pouco frequente, mas limitante devido à rigidez articular e dor localizada na região anterior do joelho. Pode decorrer após trauma, imobilização prolongada ou intervenção cirúrgica local. O achado patológico ... ...

    Abstract A Patela Baixa é uma patologia do joelho pouco frequente, mas limitante devido à rigidez articular e dor localizada na região anterior do joelho. Pode decorrer após trauma, imobilização prolongada ou intervenção cirúrgica local. O achado patológico marcante é o encurtamento e o aumento na espessura do ligamento patelar. Foram descritas várias técnicas cirúrgicas para o seu tratamento, não existindo nenhum tratamento padronizado. Descrevemos o caso de uma doente de 73 anos de idade que apresentava rigidez do joelho, deficit funcional importante e patela baixa após artroplastia total do joelho. Foi submetida a um procedimento cirúrgico de partes moles recentemente descrito, com excelente evolução funcional, melhorando de um Lysholm Knee Score de 16 para 81 pontos, permitindo a mobilização e regresso às atividades de vida diárias precocemente.

    Patella Baixa is an infrequent knee pathology, but it is limiting due to joint stiffness and localized pain in the anterior region of the knee. It may occur after trauma, prolonged immobilization or local surgical intervention. The striking pathological finding is the shortening and increase in thickness of the patellar ligament. Several surgical techniques have been described for its treatment, and there is no standardized treatment. We describe the case of a 73-year-old female patient who presented with knee stiffness, significant functional deficit, and patella baja after total knee arthroplasty. She underwent a recently described soft tissue surgical procedure, with excellent functional evolution, improving from a Lysholm Knee Score of 16 to 81 points, allowing early mobilization and return to daily life activities.
    Schlagwörter artroplastia do joelho ; articulação do joelho ; ligamento patelar ; patela ; tendões ; arthroplasty, replacement, knee ; knee joint ; patellar tendon ; patella ; tendons
    Sprache Portugiesisch
    Erscheinungsdatum 2024-04-19
    Verlag Thieme Revinter Publicações Ltda.
    Erscheinungsort Stuttgart ; New York
    Dokumenttyp Artikel
    ZDB-ID 2411301-3
    ISSN 1982-4378 ; 0102-3616 ; 1982-4378
    ISSN (online) 1982-4378
    ISSN 0102-3616 ; 1982-4378
    DOI 10.1055/s-0043-1770967
    Datenquelle Thieme Verlag

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  3. Artikel: Caso raro de um Schwannoma no pé – Relato de caso

    Miradouro, José Carlos Sousa / Costa, Tiago / Silva, Nuno / Afonso, João

    Revista Brasileira de Ortopedia

    2022  

    Abstract: Um schwannoma é uma lesão pouco frequente, sendo um tumor que deriva da bainha de mielina dos nervos periféricos; na maioria dos casos, este tumor é benigno e raramente se apresenta na região do pé e tornozelo. Os pacientes afetados por esse tipo de ... ...

    Abstract Um schwannoma é uma lesão pouco frequente, sendo um tumor que deriva da bainha de mielina dos nervos periféricos; na maioria dos casos, este tumor é benigno e raramente se apresenta na região do pé e tornozelo. Os pacientes afetados por esse tipo de patologia são geralmente assintomáticos. Ainda assim, às vezes eles têm sintomas neurológicos sensoriais ou motores se o tumor for grande o suficiente para causar a compressão direta ou indireta do nervo afetado. Um paciente do gênero masculino de 55 anos se apresentou ao nosso departamento com inchaço não traumático e dor no aspecto lateral do pé direito e da perna. A ressonância magnética (RM) da perna direita revelou uma lesão bem-circunscrita, medindo 2,5 por 1 cm, mostrando hipointensidade nas sequências T1 e hiperintensidade em T2, compatível com um tumor superficial de células do nervo peronal. Foi realizada excisão cirúrgica da lesão e o exame histopatológico confirmou a suspeita inicial – Schwannoma do nervo peroneal superficial. O pós-operatório foi tranquilo, com melhora progressiva da dor e recuperação funcional completa sem déficits neurológicos. Exame clínico rigoroso associado aos exames de RM permitem diagnóstico adequado, bem como a exclusão de outras patologias com apresentação clínica semelhante. Assim, o cirurgião tem que estar atento a todos os dados para um diagnóstico e tratamento eficazes nesse tipo de patologia rara que não pode ser negligenciada.

    A Schwannoma is an infrequent lesion. This tumor derives from the myelin sheath of the peripheral nerves; in most cases, it is benign and rarely presents in the foot and ankle region. Patients affected by this type of pathology are usually asymptomatic. Still, they sometimes have sensory or motor neurologic symptoms if the tumor is large enough to cause direct or indirect compression of the affected nerve. A 55-year-old male patient presented to our department with non-traumatic swelling and pain in the lateral aspect of the right foot and leg. A magnetic resonance imaging (MRI) scan of the right leg revealed a well-circumscribed lesion, measuring 2,5 by 1 cm, showing hypointensity on T1 sequences and hyperintensity on T2, compatible with a superficial peroneal nerve sheath cells tumor. Surgical excision of the lesion was performed, and the histopathological examination confirmed the initial suspicion—Schwannoma of the superficial peroneal nerve. The postoperative period was uneventful, with progressive improvement of pain and complete functional recovery without neurological deficits. Rigorous clinical examination associated to MRI scans allow adequate diagnosis as well as the exclusion of other pathologies with similar clinical presentation. Thus, the surgeon has to be aware of all the data for an effective diagnosis and treatment in this type of rare pathology that cannot be neglected.
    Schlagwörter schwanoma ; pé ; neoplasias da bainha neural ; nervo fibular ; schwannoma ; foot ; nerve sheath neoplasms ; peroneal nerve
    Sprache Portugiesisch
    Erscheinungsdatum 2022-09-28
    Verlag Thieme Revinter Publicações Ltda.
    Erscheinungsort Stuttgart ; New York
    Dokumenttyp Artikel
    ZDB-ID 2411301-3
    ISSN 1982-4378 ; 0102-3616 ; 1982-4378
    ISSN (online) 1982-4378
    ISSN 0102-3616 ; 1982-4378
    DOI 10.1055/s-0042-1756150
    Datenquelle Thieme Verlag

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  4. Artikel: Fratura isolada de Tillaux em adulto – Revisão da Literatura com base em um relato de caso raro

    da Silva, Nuno Vieira / Esteves, Ana / Ribeiro, Pedro / Miradouro, José / Pereira, Joana / Marinheiro, Julio

    Revista Brasileira de Ortopedia

    2022  

    Abstract: A fratura isolada de Tillaux representa uma rara e frequentemente mal diagnosticada fratura de tíbia distal anterolateral em adultos. Normalmente ocorre em adolescentes que se aproximam da maturidade esquelética por avulsão do ligamento tibiofibular ... ...

    Abstract A fratura isolada de Tillaux representa uma rara e frequentemente mal diagnosticada fratura de tíbia distal anterolateral em adultos. Normalmente ocorre em adolescentes que se aproximam da maturidade esquelética por avulsão do ligamento tibiofibular anteroinferior. Este estudo de revisão de literatura baseada em caso tem como objetivo lembrar a existência dessa identidade em adultos, resumir seu mecanismo de lesão, diagnóstico e procedimentos de tratamento. De acordo com a literatura, este é apenas o oitavo caso descrito: uma mulher de 46 anos sofreu uma fratura isolada de Tillaux com 4 mm de deslocamento e realizaram-se redução e fixação aberta com parafuso canulado duplo. Após a reabilitação adequada, alcançou-se um excelente desfecho funcional e radiológico. É importante reconhecer e tratar adequadamente essas lesões distintas para evitar maiores instabilidades, alterações degenerativas e limitação da função articular do tornozelo. Um diagnóstico precoce e a osteossíntese apropriada desempenham um papel significativo em um prognóstico de recuperação bem-sucedido.

    Isolated Tillaux fracture is a rare anterolateral distal tibia fracture frequently misdiagnosed in adults. It typically occurs in adolescents nearing skeletal maturity by avulsion of the anterior-inferior tibiofibular ligament. This case-based literature review study aims to elicit the existing information regarding this fracture in adults, and summarize its injury mechanism, diagnosis, and treatment procedures. According to the literature, this is only the eighth case described: a 46-year-old woman that suffered an isolated Tillaux fracture with 4 mm of displacement, and open reduction and fixation with double cannulated screws were performed. After proper rehabilitation, an excellent functional and radiological outcome was reached. It is important to recognize and appropriately treat these distinct injuries to prevent further instability, degenerative changes, and ankle joint function limitation. Early diagnosis and appropriate osteosynthesis play a significant role in a successful recovery prognosis.
    Schlagwörter fraturas do tornozelo ; traumatismos do tornozelo ; fraturas da tíbia ; parafusos ósseos ; ankle fractures ; ankle injuries ; tibial fractures ; bone screws
    Sprache Portugiesisch
    Erscheinungsdatum 2022-03-11
    Verlag Thieme Revinter Publicações Ltda.
    Erscheinungsort Stuttgart ; New York
    Dokumenttyp Artikel
    ZDB-ID 2411301-3
    ISSN 1982-4378 ; 0102-3616 ; 1982-4378
    ISSN (online) 1982-4378
    ISSN 0102-3616 ; 1982-4378
    DOI 10.1055/s-0042-1743270
    Datenquelle Thieme Verlag

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  5. Artikel ; Online: High thoracic kyphosis: impact on total thoracic kyphosis and cervical alignment in patients with adolescent idiopathic scoliosis.

    Moreira Pinto, Eduardo / Alves, Jorge / de Castro, Alfredo Mendes / Silva, Marcos / Miradouro, José / Teixeira, Artur / Miranda, António

    Spine deformity

    2020  Band 8, Heft 4, Seite(n) 647–653

    Abstract: Purpose: To evaluate the impact of proximal thoracic segment (T1-T5) on global thoracic kyphosis, as well as its influence on cervical alignment (lordotic, kyphotic or straight) in patients with adolescent idiopathic scoliosis (AIS).: Methods: We ... ...

    Abstract Purpose: To evaluate the impact of proximal thoracic segment (T1-T5) on global thoracic kyphosis, as well as its influence on cervical alignment (lordotic, kyphotic or straight) in patients with adolescent idiopathic scoliosis (AIS).
    Methods: We conducted a retrospective study of 80 patients with AIS. The inclusion criteria were patients between 10 and 18 years of age with a posteroanterior (PA) and lateral full-length radiographs, excluding those subjected to surgery, orthotic treatment, with other spinal disease or with poor X-ray quality. The parameters evaluated were age, sex, pelvic incidence (PI), sacral slop (SS), pelvic tilt (PT), global sagittal balance (GSB), scoliotic curvatures (differentiated according to primary curve, lumbar modifier and sagittal modifier), cervical spine alignment, thoracic sagittal Cobb angle between T1 and T5, T5 and T12 and between T1 and T12.
    Results: In patients with AIS, the proximal sagittal thoracic Cobb segment, contrary to the distal, demonstrated a significant positive correlation with cervical spine alignment (p < 0.05). As there is an increase in proximal thoracic angle, there is an increase in cervical lordosis. We also demonstrated that the correlation between an increase in scoliotic curvature and a decrease in kyphosis only occurred in the distal thoracic segment (T5-T12). Relative to the spinopelvic parameters, the PI was not related with the dorsal kyphosis or shape of the cervical spine.
    Conclusions: In AIS, proximal (T1-T5) and distal (T5-T12) thoracic kyphosis have different contributions on the global thoracic sagittal curvature and in the phenomenon of hypokyphosis. On the other hand, only the proximal segment is significantly related to the shape of the cervical spine.
    Level of evidence: IV.
    Mesh-Begriff(e) Adolescent ; Bone Malalignment/diagnostic imaging ; Bone Malalignment/etiology ; Cervical Vertebrae/diagnostic imaging ; Child ; Female ; Humans ; Kyphosis/diagnostic imaging ; Kyphosis/etiology ; Male ; Radiography ; Retrospective Studies ; Scoliosis/diagnostic imaging ; Scoliosis/etiology ; Thoracic Vertebrae/diagnostic imaging
    Sprache Englisch
    Erscheinungsdatum 2020-02-18
    Erscheinungsland England
    Dokumenttyp Journal Article
    ZDB-ID 2717704-X
    ISSN 2212-1358 ; 2212-134X ; 2212-1358
    ISSN (online) 2212-1358 ; 2212-134X
    ISSN 2212-1358
    DOI 10.1007/s43390-020-00069-6
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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