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Cervical spondylotic myelopathy is the most important cause of myelopathy in the elderly. It is defined as spinal cord dysfunction secondary to the compression of the cord caused by degenerative disease of the cervical spine. Cervical spondylotic myelopathy is a slowly progressing disease and disability caused by cervical spondylotic myelopathy can be life threatening. Despite its severity, it may remain undiagnosed for a long time. We report the case of an 80-year-old female with cervical spondylotic myelopathy leading to paraparesis. She progressively had difficulty in walking, which worsened in the last year. She had knee pain for several years, with a known diagnosis of bilateral gonarthrosis. She had been walking with the aid of a cane when her symptoms worsened and became unable to walk independently in the past months. Her walking disability was attributed to advanced bilateral gonarthrosis. Upon physical examination, she had bilateral knee contractures, extensor plantar responses, and tonus was slightly increased in the legs. Muscle strength was also decreased in the right upper and bilateral lower extremities. Magnetic resonance imaging of the cervical spine revealed spondylotic myelopathy from C3 to C6. Cervical decompression and a stabilization operation were performed. She responded well to the rehabilitation programme. Cervical spondylotic myelopathy should always be considered for elderly patients with walking disabilities, and physicians should be aware that this disease develops insidiously and coexisting diseases leading to disability may mask the symptoms and delay the diagnosis. [ABSTRACT FROM AUTHOR]

Introduction: Osteoporosis causes bones to lose their resilience, increases fragility and results in bone fracture even with minimal trauma during daily activities. We aimed to examine the patients who were treated for atypical fractures in terms of long-term bisphosphonate usage for the treatment of osteoporosis. Materials and Method: A retrospective study was conducted on 21 patients who underwent surgery for an atypical femur fracture between years 2007-2013. Demographic data, history of bisphosphonate treatment, trauma type, patient complaints prior to fracture, fracture type and the type of treatment used for the fracture were assessed. Results: The number of cases with atypical fractures was 21 and all of them had history of prolonged bisphosphonate use. The number of female patients was 19, and 2 patients were male, with an average age of 76.4 years. The number of patients with diaphyseal femur fractures was 17 and 4 patients had subtrochanteric femur fractures. Among the patients that have been using a bisphosphonate, alendronate (70 mg) was the most frequently used medication. The average length of bisphosphonate usage was 8.1 years and the average length of time that elapsed until a fracture occurred subsequent to the start of drug usage was 7.2 years. Prior to fracture, all of the patients had complaints of thigh pain that lasted on average for 8.5 months. Conclusion: Bisphosphonates are one of the widely used agents used in the treatment of osteoporosis. Thigh pain in patients with prolonged bisphosphonate usage should alarm the physicians for possible atypical fracture in the future. [ABSTRACT FROM AUTHOR]

Relapsing seronegative symmetrical synovitis with pitting edema (RS3PE) is a clinical syndrome characterized by acute onset of symmetrical joint involvement with pitting edema of the hands and feet. The etiology and pathogenesis of RS3PE is still unknown, though environmental and infectious agents may play a role in its development. RS3PE might be associated with rheumatologic diseases; while coexistence of RS3PE with neoplasms is also reported. Prognosis of RS3PE is good, with high response to low dose corticosteroids. A 72 year old man, who also suffers from prostate adenocarcinoma, with RS3PE syndrome is reported. He had no symptoms of prostatism or systemic symptoms. Adenocarcinoma was detected during the investigation for a possible coexisting malignancy. He responded well to the steroid treatment. Aged patients diagnosed with RS3PE syndrome should be carefully investigated for coexistence with neoplasms and followed for a future malignant process. Low dose corticosteroids should be initiated in all patients, together with the appropriate treatment for the malignancy in patients with neoplastic RS3PE. [ABSTRACT FROM AUTHOR]