Case Report
Volume 12 Issue 9 - 2021
Misdiagnosis is a Notable Cause of a Patient‘s Lifetime Agony
Ali Al Kaissi1* and Susanne Gerit Kircher2
1Orthopedic Hospital of Speising, Pediatric Department, Vienna, Austria
2Center of Pathobiochemistry and Genetics, Medical University of Vienna, Austria
*Corresponding Author: Ali Al Kaissi, Orthopedic Hospital of Speising, Pediatric Department, Vienna, Austria.
Received: July 08, 2021; Published: August 30, 2021




Abstract

Background: Clinical and radiological misconceptions lead towards clinical fallacy. Clinical fallacy is a major part of misconception and misdiagnosis and can easily occur leading to ineffective therapy and long-term suffering for patients.

Case Report: A 38-year-old Austrian female sought my opinion, after she spent almost 3 decades seeking convincing diagnosis for her lifetime agony. She has been a client of different medical disciplines in Austria since she was 13-year-old. Recently, Ehlers-Danlos syndrome-hypermobility type (EDS-ht) has been recognized. For more than 2 decades, she complained of unpleasant symptoms which include: blurring of vision, cervical pain, lack of concentration, and syncope. Psychosomatic disorder was the only diagnosis made through various medical disciplines. Long lists of unnecessary antipsychotics have been prescribed since her early life. The author started a process of comprehensive clinical and radiological documentation.

Results: Clinical examination showed, normal craniofacial contour with no dysmorphic features. Musculo-skeletal examination revealed ligamentous hyper laxity corresponds to 6 out of nine in accordance with Beighton scale. No evident skin stigmata, and no elasticity of the skin were noted. Lateral skull radiograph revealed the presence of ossified/calcified interclinoid ligament. Contrast- enhanced computed tomography angiography of the cervical and cerebral arteries showed the followings; bilateral kinking of the right and left internal carotid arteries. Interestingly, sharp angle of more than 90°more marked of the carotid arteries, compatible with grade I dolichoarteriopathies (DICAs).

Conclusion: Precise clinical and radiological phenotypic interpretations are the first step towards reaching etiology understanding. Medical malpractice is a notable cause of the patient´s persistent agony. Lateral skull radiograph showed the presence of ossified/calcified interclinoid ligament of the sella-turcica associated with hyperostosis of the skull base. The significance of diagnosing the ossified interclinoid ligament and hyperostosis of the skull base in that it might affect the surrounding neurovascular structures. This ossified bridge might influence the blood flow in the internal carotid artery or cause dysfunction of the muscles of the eyes owing to possible compression of the oculomotor nerve. Angiographic studies confirmed bilateral acute kinking of the internal carotid arteries.

Keywords: Ehlers-Danlos Syndrome (Hypermobile Type); Musculoskeletal Agony; Tomographic Studies; Dolichoarteriopathy

References

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Citation: Ali Al Kaissi and Susanne Gerit Kircher. “Misdiagnosis is a Notable Cause of a Patient‘s Lifetime Agony". EC Orthopaedics 12.9 (2021): 40-45.

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