8 Types of Fractures

1. Closed fracture – It is called a closed fracture because the bone breaks without causing an open wound in the skin.
2. Open fracture – It is the total opposite of the closed fracture. Aside from the fracture itself, there is a visible open wound, which increases the possibility of a deep bone infection.
3. Transverse fracture – A bone fracture that comes at a right angle to the axis of the bone.
4. Oblique fractures – It is characterized by the breakage of the bones in a curved or sloped pattern.
5. Greenstick fracture – It is also called an incomplete fracture. The bone bends but not completely broken. This type of fracture commonly happens in children.
6. Comminuted fracture – This is one of the worst types of bone fractures characterized by bones broken down into several pieces.
7. Stress fracture – There is really no actual break in the bones. What the person has is only a hairline fracture.
8. Buckled fractures – A fracture is called a buckled type if the end of the bone drives into each other. (1, 2, 3, 4, and 5)

Aside from the eight types of bone features mentioned above, there are other kinds of fracture and these are displaced and non-displaced fracture. How can you tell if a person has a displaced or non-displaced fracture?

A non-displaced fracture takes place if the bone breaks only in one spot and stays aligned. On the other hand, a displaced fracture is when the bone snaps into several pieces and cannot be aligned.

What causes a non-displaced fracture?

A greater force or pressure causes a non-displaced fracture. The force is strong enough for the bone to bear. The force is not only intense but occurs suddenly. Some of the incidents or situations that cause a non-displaced fracture includes the following:

• Fall
• Sports-related injury
• Direct strike on the body
• Overuse of the body
• Traumatic incidents such as vehicular accident and/or gunshot wound (3, 4, and 5)

What are the clinical manifestations of non-displaced fracture?

• The patient complains of severe pain
• There is obvious bruising and swelling on the site.
• The injured site has some sort of skin discoloration.
• The patient finds it difficult to move the affected area. In fact, applying even the lightest weight seems difficult.
• The injury site looks clammy, pale, and a bit angulated. (4, 5, and 6)

How to diagnose a non-displaced fracture?

To confirm the diagnosis of a non-displaced fracture, the doctor will perform several tests which include the following:

• Physical examination – The examining physician will ask a few questions to the patient so as to establish how the injury took place. After which, the doctor feels the affected area to find out the probability of non-displaced fracture or other types of fracture. The doctor uses both visual and mechanical approach to thoroughly assess the fracture.
• Diagnostic imaging studies – The doctor will also order imaging studies such as x-ray, CT scan, and/or MRI. (5, 6, and 7)

Who are at risk for non-displaced fracture?

• Those who have less bone density.
• Elderly and people with osteoporosis.
• Those with endocrine and intestinal disorders.
• Those who have a physical inactivity.
• Those who have vice such as excessive alcohol intake and smoking tobacco. (6, 7, and 8)

What are the possible complications of non-displaced fracture?

• vascular injury
• nerve injury
• fracture blister
• compartment syndrome
• visceral injury
• wound infection
• osteomyelitis
• avascular necrosis
• joint stiffness (8, 9)

Treatment for a non-displaced fracture?

Treating a non-displaced fracture can be done in many different ways. However, the treatment approach primarily depends on the severity and extent of fracture. How long does a non-displaced fracture take to heal? It all depends on the extent and severity of fracture as well as the treatment approach used.

• Pain management approach – One of the primary goals is to alleviate pain and inflammation the soonest time possible. The doctor will give pain medication so as to reduce the swelling and alleviate pain.
• Immobilization – depending on the extent and severity of the injury, the patient needs to be put on a cast or a splint until such time the bone is completely healed.
• Continuous monitoring – In some instances, the fracture could begin as a non-displaced fracture but later on progressed into a displaced fracture. Which is why it is important to continuously monitor the condition of the fracture to detect if it is progressing or getting worst.
• Physical therapy – If the fracture is severe, the patient should undergo a physical therapy to regain normal muscle strength.
• Casting – A medical cast made of plaster or fiberglass is put onto the injured site to immobilize the bones. The patient may need traction support too so as to stretch the muscles and tendons around the detached bone.

The goal of non-displaced fracture treatment is to put the detached bone back into the normal position and allow it to heal so as to facilitate the formation of new bone around the edge to connect to the detached parts. (1, 4, 6, 9, and 10)

Home remedies for non-displaced fracture

A broken bone needs to be treated the soonest time possible. The patient should be immediately brought to the nearest hospital, especially if the patient is unresponsive, not moving, bleeding heavily, or not breathing.

If there is no hospital nearby, a first-aid remedy should be given. However, if there is no one nearby who knows how to administer first-aid, then it is best to keep the patient still to prevent further injury. If there is someone nearby who knows how to administer first aid, then the following measures should be given to the patient.

• Apply pressure near the wound to prevent further bleeding. When putting pressure, it is best to use a sterile bandage. If there is no sterile bandage, a perfect alterative is a clean cloth.
• Make sure that the injured site should be immobilized. Do not attempt to realign the bone, especially if you don’t have knowledge and experience doing so. If you have a medical or emergency health background, you might want to try putting a splint above and below the injury site. Make sure you put a padding into the splint to reduce the degree of discomfort.
• Swelling can be reduced by applying cold compress on the injured site. Ice cubes should be wrapped in a clean towel or a piece of cloth and apply on the skin. Do not place the ice cubes directly onto the skin.
• If the person is unresponsive and is breathing hard, then the patient should be treated for trauma. Elevate the legs of the patient and place the patient in a position where the head is a bit lower than other body parts. (1, 5, 8, and 9)

How long does it take a non-displaced fracture to heal?

The time needed for a non-displaced fracture to heal completely is dependent on various factors such as the severity and extent of injury and the type of treatment approach used by the doctor. The body’s response to a particular treatment is also another thing to be considered. Therefore, the recovery period varies from one person to another. (6, 9, and 10)

Can you prevent a non-displaced fracture?

Fractures can be prevented by not engaging in activities that could compromise your bone structure. However, accidents happen the moment you least expect it to happen. The best thing you can do is to protect your bones through the following ways:

• Exercise daily
• Eat healthy, especially foods rich in vitamin D and calcium.

When to see your doctor?

An orthopedic trauma specialist is the doctor responsible for the treatment of bone fracture. However, not all broken bones require an orthopedic trauma specialist. Research shows that a fracture of all types heal better and have a superior functional outcome when attended to by an orthopedic trauma specialist.

A non-displaced fracture bone may take several weeks or even longer to heal completely. The length of recovery period has something to do with the type of fracture, location, and severity. The recovery rate is also affected by other existing injuries or medical conditions. For the patient to recover completely from a non-displaced fracture, he/she should strictly follow the doctor’s advice. Once the healing is complete, the patient will be pain-free and will be able to move the fractured site with ease and comfort. (2, 4, 7, 9, and 10)

References

1. https://www.webmd.com
2. https://en.wikipedia.org
3. https://www.ncbi.nlm.nih.gov
4. https://www.md-health.com
5. https://www.hxbenefit.com
6. https://www.epainassist.com
7. https://www.inverse.com
8. https://my.clevelandclinic.org
9. https://childrens.bswhealth.com
10. https://www.medhealthdaily.com

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Ankylosing Spondylitis affects the spine and is a type of arthritis that inflates sacroiliac joints and facet joints resulting in spine stiffness, inflexibility and hunched forward position. Sometimes ribs get affected by inflammation and make breathing difficult.

The disease causes calcium accumulation in spine’s discs and ligaments allowing the soft frames to stiffen which fuse together with vertebral bodies and joints. This illness makes the backbone, brittle, laborious and prone to fracture. In advanced cases, swelling develops new bone on the spine leading to abnormality or disfigurement. Ankylosing Spondylitis also stiffens other parts of the body like knees, shoulders, and hips. It affects men more than women, wherein signs and symptoms begin in early adulthood.

Causes

Ankylosing Spondylitis is assumed to be inherited genetically, but maximum patients with this disease have HLA-B27 gene. However, the relationship between this gene and the disease is yet unknown. Several tests have been developed to have a better understanding. However, some additional factors like poor posture and environmental factors intensify the disease.

Symptoms

• Stiffness and Pain: Affects sacroiliac joints, but can gradually influence hips, low back and buttocks.
• Pain in tendons and ligaments: Tendonitis (swelling of tendon) stiffens and causes pain.
• Bony Fusion: Bones overgrow leading to unusual bone joining that affects the back, neck and hips troubling a person to perform regular activities.
• Cardiac Lesions: People experience severe swelling at the base of the heart, near aorta and aortic valve. The stable inflammation results in lesions. Less than 2% of patients suffer from this.
• Cauda Equina Syndrome: Patients sometimes undergo neurological deficits like balance loss, trouble speaking or bladder and bowel incontinence. It results from compression on the nerve in the rear of the spine.

Other Symptoms

• Chest Pain
• Back Pain( Specifically in morning and night)
• Appetite loss
• Morning stiffness
• Stooped shoulders or poor posture
• Low iron levels or anemia
• Weight loss
• Minimum fever level
• Decreased lung function

Symptoms of Other Body Parts

• Bowel Inflammation
• Heart Valve Swelling
• Iris Inflammation
• Headache
• Pain around the eye or eye pain
• Light sensitivity
• Blurred vision

Risk Factors

• Hereditary: People with a family history of this disease are prone to this problem.
• Age: It is unlike rheumatic or arthritic disorders and symptoms might appear in people aged between 20-40 years.
• Ethnicity: Common in Caucasian descent people than African descent or other cultures.
• Related Disease: Present or history of Crohn’s disease, psoriasis or ulcerative colitis increases the chances of developing Ankylosing Spondylitis.
• Bacteria: Microbiota are bacteria present in intestines which regulate and develop the immune system, these are believed to develop this disease.

Diagnosis

• Physical Exam: A rheumatologist will perform a thorough exam, and might ask details about the symptoms, pain, etc.
• X-Ray: It helps to know whether there is an erosion of the spine or any joints. However, corrosion is detected when the disease is in the last stage. Experts might also ask for an MRI, but sometimes the results are hard to interpret.
• Blood Test: Erythrocyte sedimentation rate is a blood test which measures the inflammation. Test for HLA-B27 is also done to evaluate if the protein is present.

Treatment

Therapy can help to minimize the pain and inhibit disability. Timely treatment can diminish symptoms and hinder complications.

Medications

NSAIDs (Nonsteroidal anti-inflammatory drugs) like naproxen and ibuprofen helps to manage pain and inflammation. These are ideal long-acting drugs for meager complications. Stronger medicines are recommended when NSAIDs do not provide sufficient relief.

Corticosteroids are usually prescriptive for a shorter duration. It is a strong inflammation fighter, and helps to alleviate symptoms and reduces damage around the area.

TNF (Tumor necrosis factor) are medicines that block causes of inflammation and decreases stiffness and joint pain. TNF inhibitors help to aid the progressed condition when NSAIDs are not effective.

In severe cases, the expert provides DMARDs, (disease-modifying antirheumatic drugs). These medicines slow down the disease and help to hinder worsening symptoms.

Surgery

In severe cases, deformity or damage of hip or knee joints takes place and replacement surgery is essential. Likely, the osteotomy is performed with lousy posture evoked by fused bones. In this procedure, surgeons realign or cut the bones in the spine to maintain the perfect shape. However, treatment depends entirely upon the severity of the condition and the intensity of its symptoms.

Natural Treatment

• Stretching: Makes bone stronger with flexible joints. It reduces pain through better body movements.
• Exercise: Motion exercises with proper strength training helps to alleviate the signs of Ankylosing Spondylitis. Activities make joint bones flexible and reduce pain. A physical therapist will help to perform the exercises safely and correctly. Deep breathing, yoga practices, swimming, are ideal.
• Posture Training: Spine stiffness results in bad posture which allows the spine bones to fuse jointly in slumping or slouching positions. But patients can reduce this risk easily by practicing good posture.
• Acupuncture: It helps to activate the natural pain relieving hormones.
• Heat & Cold Therapy: Warm shower or heating pads helps to relieve stiffness and pain in the spine or other affected areas. Ice packs can lessen swelling and pain from joints or bones.
• Massage Therapy: Helps to increase flexibility and motion range. To make the therapist aware of the tender points, inform them about the disease.

Complications

• Breathing Difficulty
• Bowel, lung or heart damage
• Eye Irritation
• Contraction of the spine
• Vertebrae might fuse together due to severe inflammation
• Inflammation in tendons and ligaments can worsen flexibility
• Inflammation can extend to shoulders, hips and nearby joints

Prevention

• Retaining a standard body weight
• Healthy diet
• Staying active
• Correct posture

Ankylosing Spondylitis Pictures

Ankylosing Process

Ankylosing Spondylitis image

Two Spinal Fractures Ank Spondylitis

Diet

• Include foods full of omega -3 fatty acids, like nuts, fish and oils
• Include different types of green vegetables and fruits
• Yogurt
• Whole grains, like faro and quinoa

Eliminate diet that is rich in sugar, fat and sodium. Processed foods like bagged, boxed, canned foods etc. contain unhealthy ingredients like Trans fats and preservatives which can worsen the inflammation. Limit alcohol intake as it interacts with medicines and makes the situation worse. It doesn’t allow the medication to work and symptoms tend to intensify.

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Greenstick Fracture is a condition when bone bends and cracks rather than breaking. It breaks partially instead of breaking entirely into several pieces and is also termed as “partial fracture.” They are most common in infants and children particularly below the age of 10 years. This category of fracture was found by a British American, Michael Slupecki and John Insall.

Types of Greenstick Fracture

Greenstick fractures are of three types:

Greenstick Fracture of Clavicle

It occurs when the fall happens with hands outstretched or with a direct blow felt on the upper chest or shoulder. The clavicle in human body grows hard and gains complete maturity only after the age of 20 years. Hence the fracture of the clavicle is quite common in children as well as during adolescence.

Greenstick Fracture of Wrist

The fracture is common in the radius or ulna, i.e., the bones in the forearm. It is likely to occur when a child falls on a widely spread arm or palm from a certain height. In case of the radius, the fracture occurs mainly in the proximal, medial or at the distal end of the bone. It can result in the incomplete break along with an arm displacement. But if the force is caused more significantly, then it can cause complete breakage and should be treated with proper attention. An arm cast will be then required for about 4-6 weeks for complete cure.

Greenstick Fracture of Tibia

This type of greenstick fracture happens if a child lands on foot while falling from a height or experiencing a direct blow to the leg. But fracture in tibia is caused if the force is higher than the force which causes a fracture of the ulna and radius. Mainly the third and lower third part of the tibia is mostly affected.

Causes for Greenstick Fracture

As the bones remain soft during childhood, they are softer and more flexible due to high levels of calcium compared to that of adults. Technically, the cause of greenstick fracture is same as that of other types of fractures, i.e., caused by forced impact to the bones due to a fall, direct blow or a twist. Some of the common causes are:

• Falling while playing games such as hide and seek
• Physical activities like running, tumbling and skipping or while playing outdoor games
• Running over uneven and rough lands
• Tripping

Symptoms of Greenstick fracture

Children and infants cannot express their pain in words so they start to wail and their crying cannot be controlled while they feel the intense pain. They tend to guard and protect the injured area which is a prominent sign of their condition. For greenstick fracture, the signs and symptoms may vary depending on the seriousness of the fracture.

• Intense pain at the site
• Bruises or sprains with general tenderness
• Deformity or bend in and around the fractured area along with pain and swelling
• Inability to move the finger
• Pain accompanied by swelling and tenderness when moved.
• Swelling
• Twisted or bent limb
• Simple bruise or redness
• Tendency to guard the injured portion
• Continuity of the pain or feeling of stiffness in the limb after falling or an injury

Diagnosis of Greenstick Fracture

The fracture may go unnoticed resulting in inappropriate diagnosis it causes less pain.

• Thorough check of history and a physical test
• X-rays for the clear identification of the fracture & the doctor compares the injured limb with the uninjured
• Ultrasound test or even a computerized tomography
• Examination of the affected area of the limb or hands to check for tenderness or swelling or redness and any deformity or numbness
• Patient may be asked to move his hands, palms or limbs in different ways to check if any damage is present inside the tissues or nerves

Treatment for Greenstick Fracture

The primary goal is to bring the bones together to their original position and thus allow them to congregate naturally by their formation. It can be done only if the limb is immobilized so that it does not experience any pressure on the area.

• Bone might be pulled apart slightly and then again putting it into its original place. It further can straighten the bone thereby reducing it.
• In case there is a bend, the bones should be repositioned manually in proper alignment usually undergone under proper pain relieving and anesthetic medication under a proper course of medicines and sedatives should be given. Also, general anesthesia may be provided as the patient can feel some pain.
• In maximum cases, the Greenstick fracture is cured while placing it in a cast. The cast keeps the bones in proper position while they start healing and also prevent them from further injury or breaking.
• Doctors may suggest a removable splint for the child’s benefit which works equally well if the wound gets almost cured.
• It is highly advisable to avoid heavy work or activities for at least a few weeks after the splint or cast is removed. The healing time may vary according to the seriousness of the fracture, the nature of the injured bone and even the health history of the child.
• Anti-inflammatory medicines are prescribed at times to redeem the swelling.
• Unfortunately, in some cases, surgery is the only option to cure the fracture.
• In extreme cases, if one needs to be operated, then traction might be recommended post the surgery so that the fracture gets straightened.

Prevention of Greenstick Fracture

Parents must adopt a few steps for preventing Greenstick fracture in their child:

• One should supervise and keep an eye on the child while playing
• While traveling, seat belts should be put appropriately around the child
• The child must be made to wear safety gears while playing
• Adequate calcium must be in the child’s daily diet to make the bones strong

When to call a doctor?

When one experiences the following symptoms, it is recommended to consult a doctor.

• Pain in a limb which is continuing even after a day or two
• Bend in limb or joint is apparently visible
• Inability to lift heavyweight (especially from the section of the affected limb)

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What is Synovial Cyst?

It is a type of ganglion cyst that occurs due to some spinal degeneration. Fluid secretion from the adjacent joint into the nearby tissues generally causes this cyst. It can affect different joints in the human body, including:

• Spine
• Knee joint
• Hip joint
• Ankle joint
• Wrist
• Finger joint
• Shoulder joint
• Elbow joint

The cyst is also known as Myxoid Cyst and Mucous Cyst.

Clinical appearance of the Synovial Cyst often occurs along with osteoarthritic symptoms. The cyst is bluish or reddish in color and secretes a gelatinous fluid if punctured. It sometimes leads to Spinal Stenosis in lumbar spine.

[1] Synovial Cyst

Synovial Cyst Etiology

These cysts have a prevalence of less than 0.5% throughout the world. They generally occur in people with a history of back pain. People aged above 60 years are most likely to develop this condition. However, it can also be seen in people who aged around 40 years. In some very rare cases, Myxoid Cyst occurs in children.

Synovial Cyst Causes

The body produces a type of fluid that keeps the joints lubricated. Sometimes, this fluid may accumulate at one point to form this cyst. Some kind of erosion in facet joint located in the lumbar spine leads to these cysts. This process typically occurs in lumbar spine and grows at L4-L5 level in majority of cases. In some rare instances, however, it may also develop at the L3-L4 level.

The pain due to the cyst results from the blood flowing in the veins around the spinal nerves that are unable to drain when the spinal canal is closed. This leads to irritation and pain of the nerves. Sitting down reduces the pain by allowing the venous blood to drain and relieving the pressure.

Synovial Cyst Risk Factors

The factors that increase the risks of development of these cysts include:

• Osteoarthritis
• Rheumatoid Arthritis
• Acute or chronic trauma
• Joint instability
• Various overuse injuries

Individuals who take part in repetitive activities like keyboarding and playing some musical instrument have an increased risk of having Myxoid Cysts.

Synovial Cyst Symptoms

Spinal Stenosis caused by this cyst leads to pain and inflammation in the hips and lower back that progress towards the legs. Sometimes, the symptoms caused by Synovial Cyst may resemble those of Spinal Stenosis even if the condition is not present.

Generally, patients do not experience any pain while sitting as the spinal canal is opened up in the seated position which relives the pressure on the adjacent spinal nerves. However, standing up and walking closes down the spinal canal, putting pressure on the nerves and causing pain.

Synovial Cyst and Ganglion Cyst

Both these cysts are formed by the accumulation of different fluids. The Synovial Cysts are sacs filled with the fluid that is secreted for lubricating the joints while Ganglion Cysts are formed by various fluids.

Synovial Cyst Diagnosis

Radiology is used for diagnosing their presence. Magnetic Image Resonance scan or MRI scan of the spine can detect the presence of these cysts. The MRI reports display the cysts as lesions with similar signal intensity like water.

X-rays, including flexion or extension motion x-rays can be used for ruling out the possibility of any spinal instability. Checking for spinal instability is important as the joint is suffering from degeneration. In many cases, a degenerative spondylolisthesis is associated with the condition. The degenerative spondylolisthesis indicates the instability and incompetency of the joint.

Detecting any instability of the joint before performing the surgery for treating the Synovial Cyst is very important as failing to identify and cure instability during a surgery may even require a second surgery in the future.

Synovial Cyst Differential Diagnosis

The following conditions are sometimes confused with Synovial Cyst as they are characterized by similar symptoms:

• Arthritis conditions (particularly Rheumatoid Arthritis)
• Tendon rupture
• Fracture
• Tumors nodules (particularly rheumatoid nodules)
• Tumor (malignant and benign)

Physicians should ensure that patients are actually suffering from Synovial cysts and not any of the above mentioned disorders.

[2] Synovial Cyst on the inner right wrist of a 47 year old female

Synovial Cyst Treatment and Surgery

No treatment is required for these cysts unless they are causing pain and irritation. However, it is important to keep them under observation to detect any sign of deterioration. If an individual experiences just a mild irritation, he or she should restrict the activities that are mainly causing the discomfort. There are various injections and medications that help to relieve the pain within a short time. Other conventional pain relief options like physical therapy and chiropractic can also reduce the pain. One can consider the following treatment options if the pain is too severe to carry out the daily activities.

Aspiration

Sometimes, doctors recommend draining the Synovial Cyst with a needle for relieving the pain and discomfort. Generally, neuroradiologists perform the process of aspiration. This process depends on the size and location of the cyst. The aspiration procedure is not used if the cyst is too large in size. In some instances, aspirating a lumber spine Myxoid Cyst provides only temporary relief. In these cases, a patient should seek further treatment for the condition.

Steroid Injections

This is another useful treatment option for alleviating the pain and irritation of this cyst. The steroid medication is injected into the joint where the cyst has formed. But, it is just a temporary treatment option and may not work in some cases. The maximum number of steroid injections recommended by most physicians is three per year.

Removal Surgery

Physicians may recommend a Synovial Cyst removal surgery if a patient is found to be suffering from extremely severe symptoms that cannot be treated successfully by the above treatments. Sometimes, the surgical resection involves fusing the affected joint after the initial operation because of recurrent cyst formation. This is also done when a surgeon is concerned about the spinal stability of patients. Movement of the joint can be restricted by the fusion which prevents any formation of the cyst in future. The cyst has a very low rate of recurrence after a successful surgery with or without the fusion process.

Synovial Cyst Complications

Neurological deficits like muscle weakness and numbness can cause various complications at the recovery stage of Synovial Cyst that involves the spine. Complications include poor wound healing, anesthesia and infection if surgical excision is required for treating the cyst. In some rare cases, a lumbar cyst may even require further surgery for stabilizing an unstable spine.

Synovial Cyst Prognosis

The prognosis of treatment depends on the severity of the symptoms. Aspiration and corticosteroid injection successfully cures the pain and irritation in around 35% of cases while surgical excision has a 95% success rate. In most cases, the pain and irritation subsides after a patient receives proper treatment. In case of cancerous Synovial Cyst, the outcome depends on the type of cancer and how much it has spread.

Synovial Cyst Recurrence Risk

Treating Mucous Cysts by steroid injections and aspiration process has a high recurrence risk. There is 10% risk of recurrence of the Myxoid Cysts if they are removed by surgery.

[3] Synovial Cyst on the right index finger

Synovial Cyst Prevention

There are no known ways of preventing the formation of these cysts. However, some people believe that performing specific exercises can help to keep the joints lubricated and prevent the fluid build-up.

Synovial Cyst Pictures

The Following pictures show how these cysts look like.

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Osteitis deformans, better known as Paget’s disease, is a chronic disorder characterized by disruption of normal renewal process of bones, where old or mature bone tissues are replaced by new ones. Named after Sir James Paget, the localized disease causes the ‘osteoclasts’ bone cells to absorb bones faster than normal. As a result, bone cells called ‘osteoblast’ overreact by making excess bone, resulting in softening and deformity of the affected bones.

People usually have Paget’s disease in their skull, collarbones, spine, temporal bones, and in proximal long bones of arms, hips, and thighs.

What Causes Paget’s Disease of the Bone

Although there is no conclusive evidence, researchers believe that genetic, as well as environmental factors, are responsible for its occurrence. A few studies have shown alterations in some genes including SQSTM1/p62 and RANK are associated with its development.

Some researchers think that infections caused by measles, canine distemper, and respiratory syncytial virus might contribute to this disease, although this theory has been largely debated.

[1]Micrograph showing Paget’s Disease of the bone with the characteristic jigsaw puzzle-like/mosaic pattern

Risk Factors

• Age: Older people are mostly at risk for Paget’s disease of bone.
• Origin: It commonly occurs in people from Greece, Scotland, England, and Central European countries. It is rare in Asia and Scandinavia.
• Family history: It is seen in those whose family members had suffered from the health condition in the past.
• Gender: Men are more likely to be affected than women.

Signs and Symptoms

Paget’s disease is normally asymptomatic, but sometimes symptoms may occur, with patients complaining of:

• Tingling, numbness, and pain in bones and joints
• Misshapen bones such as deformed legs, curved spines, and enlarged skull

Complications

Paget’s disease is often associated with a higher risk of:

• Arthritis caused by an increased amount of stress on joints
• Fractures due to weakening of bones
• Heart disease caused by hard-working heart muscles, which may result in high-output congestive heart failure
• Kidney stones due to an increased calcium deposits in the body
• Hearing loss, headaches, or vision loss in people with Paget’s disease of the skull
• Problems with nervous system
• Bone cancer
• Abdominal pain, constipation, loss of appetite, weakness, or fatigue caused by an elevation of calcium levels in blood due to overactive bone resorption
• Paralysis of lower body (paraplegia)

[2]An ivory vertebra due to probable Paget’s Disease

Diagnosis and Tests

An early diagnosis is essential to avoid the life-threatening complications. A physical examination of the affected areas is usually followed by blood tests and imaging tests for the detection of Paget’s disease.

Imaging Tests (Radiology)

• X-ray images of the affected bone can indicate abnormalities such as an increase in density, enlargement, and deformity in shape. In the initial stages, a hole appears in the bone due to overactive resorption. Over time, it turns into a “V” shaped area with denser bone appearing behind it.
• Bone scan, done by injecting a radioactive material into a vein, shows the areas with an unusual bone turnover as “hot spots.”
• Computerized tomography scan (CT scan) can show a detailed 3D image of the affected bone.
• Magnetic resonance imaging scan (MRI scan) uses a magnetic field along with radio waves to produce a clear image of the bones involved.

Blood Test

Paget’s disease can be confirmed with a blood test since a person with Paget’s disease usually has high levels of serum alkaline phosphatase in blood. Moreover, a complete blood count (CBC) indicating anemia points to Paget’s disease.

Bone Biopsy

A small bone marrow sample is collected after local anesthesia, to be tested in a medical lab.

Differential Diagnosis

• Osteoporosis
• Osteoarthritis

Treatment and Management

Controlling the over-activity of bone cells and minimizing progression of the symptoms are the primary objectives of treatment.

Medication

• Bisphosphonates, like alendronate, risedronate, ibandronate, zoledronic acid, etidronate, tiludronate, and pamidronate restrain bone resorption, helping in bringing down alkaline phosphatase levels to a normal state. However, bisphosphonate therapy can possibly increase the chances of severe pain in bones, joints, and muscles, and a condition of jawbone called osteonecrosis of the jaw.
• Calcitonin injections or sprays, like salmon calcitonin is prescribed in cases where bisphosphonates are not well tolerated. Administered by nasal spray or injection, calcitonin helps in regulating calcium levels in the body, and thus keeps bone resorption in check. It may have several side effects including facial flushing, and nausea.
• Nonsteroidal anti-inflammatory drugs such as acetaminophen may help lessen pain.

Surgery

When further complications such as deformities, fractures, or severe osteoarthritis develop, surgery is needed to:

• Realign deformed bones
• Remove and replace damaged hips and joints
• Reduce pressure on a compressed nerve by moving bones away from it
• Realign bones to help fractures heal

Since surgery involving the affected bones has a risk of excessive blood loss, patients are given medications that are directed towards reducing disease activity.

Alternative Treatment

Occupational therapy or physiotherapy can be useful for reducing pain and improving the range of movement.

When no symptoms occur and blood tests do not show any abnormal increase in bone-specific serum alkaline phosphatase (BSAP) level, no treatment is necessary.

[3]An ivory vertebra due to probable Paget’s Disease

Prognosis

In mild to moderate cases, Paget’s disease can improve if a patient is diagnosed and treated before the occurrence of major changes in bones. However, improvement is less likely if the person has any kind of malignant transformation including sarcomatous degeneration. The five-year survival rate for those with malignant tumor along with Paget’s disease is 5-7.5%.

Incidence and Prevalence

Recent surveys have shown that Paget’s disease of bone affects about 1-3 million people in the USA. Its prevalence is 2.3% in people belonging to the 65-74 year old age group. It occurs in 10% of individuals over 80 years old and 1-3% of population between 45 and 55 years.

It is also common in the UK, New Zealand, Australia, South Africa, France, and Germany. It affects 4.6% of elderly population in England, 2.4% in France, 3-4% in New Zealand and Australia.

Living with Paget’s Disease: Self-Management for Preventing Recurrence

Consult a medical practitioner to know ways about keeping your bones healthy. You can follow some simple steps:

• Following a diet offering 1,200 mg calcium and more than 400 IU vitamin D to keep bones strong.
• Regular exercise for maintaining skeletal health and joint mobility.
• Using walking sticks, frames, splints, or braces to support bones and joints, and prevent falling.
• Taking vitamin D and calcium supplements to improve bone health.
• Trying relaxation techniques to minimize stress on your affected bones.

ICD-9-CM and ICD-10-CM Codes

The ICD-9-CM code for Paget’s disease of bone is 731.0, and the ICD-10-CM code is M88.

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Eagle syndrome, also called Eagle’s syndrome, styloid syndrome, stylohyoid syndrome, styloid-carotid artery syndrome, and styloid-stylohyoid syndrome, refers to a health condition that causes sharp pain in the face, neck, and back of the throat. The rare condition, named after Dr. Watt Eagle, occurs due to calcified (ossified) stylohyoid ligaments (CSL) and elongated styloid processes (ESP) that exert pressure in the neck and head thereby affecting the cranial nerves.

What causes Eagle Syndrome

Although the causes of ESP and CSL are not well understood, chronic renal failure and abnormal calcium-phosphorous metabolism might be associated with their occurrences.

Eagle syndrome can be categorized into two types depending on whether it is occurring due to an ESP or CSL:

• Classic Eagle syndrome: It commonly occurs after tonsillectomy due to cranial nerve compression, resulting in inflammation and ossification of the stylohyoid ligament, with symptoms usually appearing on one side of the head and neck (unilateral). But can affect both sides (bilateral) on rare occasions.
• Vascular Eagle syndrome: Elongation of styloid processes, caused by their angulation in the middle or at the end, leads to an impingement of carotid artery wherein turning the head might compress it or tear the blood vessel.

[1] Proc styloideus – Eagle syndrome

Signs and Symptoms

Classic Eagle Syndrome

• Sharp pain in the face and neck, radiating to ears, jaw, base of the tongue, throat, or chest
• Difficulty in swallowing (dysphagia)
• Change in voice
• A lumpy feeling in the throat
• Earache (otalgia) or ringing noise in the ear (tinnitus)
• Hypersalivation
• Vertigo or dizziness

Vascular Eagle Syndrome

• Loss of consciousness due to a fall in blood pressure (syncope)
• Sympathetic plexus irritation, where irritation of certain network of veins and nerves close to the neck and head leads to feeling of discomfort in the eyes and abdominal pain

Complications

• Carotid dissection
• Restriction in blood flow to tissues
• Transient ischemic attack or “mini stroke,” which may increase the risks of a life-threatening stroke in the future

Diagnosis and Tests

On careful physical examination, palpation of the tip of styloid processes triggers pain and makes the symptoms worse, which is not possible if the styloid processes are of normal length (approximately 2.5 cm). Application of a local anesthetic to the tonsillar sinus can help with the diagnosis as lessening of the pain following the injection may suggest eagle syndrome.

Imaging Tests

• Cervical spine radiology (X-rays)
• CT scanning with three-dimensional (3D) reconstruction of the neck and skull base

Differential Diagnosis

• Glossopharyngeal neuralgia
• Laryngopharyngeal dysesthesia
• Esophageal diverticula
• Sluder syndrome
• Migraine-type headaches
• Hyoid bursitis
• Trigeminal neuralgia
• Toothache or temporomandibular disorders
• Glossodynia
• Cervical arthritis
• Otitis
• Impacted/unerupted molar teeth
• Temporal arteritis
• Faulty dental prostheses
• Cervical mass
• Carotid artery dissection
• Possible tumors
• Salivary gland disease
• Sphenopalatine neuralgia
• Fibromyalgia syndrome

Treatment and Management

Initial treatment involves conservative methods like use of oral medications and local anesthetics.

Ossifikationen im Ligamentum stylohyoideom beidseits – Eagle Syndrom CT

Medical Therapy

The following medications may be used for treating or lessening the symptoms of Eagle Syndrome:

• Antidepressants (amitriptyline, tianeptine) and anticonvulsants (gabapentin, pregabalin) affect neurotransmitters and lessen nerve stimulation, thereby providing relief from pain.
• Analgesics (acetaminophen, tramadol) are used for reducing pain.
• Local infiltrative administration of steroids or anesthetics like lidocaine induces numbness in the area.

Surgery

When patients do not respond to medications, surgical procedures such as styloidectomy are carried out to remove the elongated part of the styloid.

Intraoral (transpharyngeal) Approach: The elongated styloid process is detected through external examination so it can be cut out through a small incision in the muscles. It is a short, minimally invasive surgery that does not lead to any permanent scarring. But, this approach is associated with a risk of blood vessel injuries and deep neck space infections as it does not give a clear representation of the internal organs during surgery.

Patients need to take only soft foods 4 to 6 hours after the operation, while they are usually discharged within 8 to 24 hours.

Extraoral Approach: It involves making an incision around the upper third of the edge of the sternocleidomastoid neck muscle, and hyoid bone. The cervical fascia and platysma muscle are cut to reach the neurovascular bundle in the neck and digastric jaw muscles, after which the styloid process is examined. Styloidectomy is done once the muscle insertions and layers of broad tendons (aponeurosis) are set apart from the styloid.

External surgical excision has a success rate of 93.4%, where most patients are discharged within 36 hours of the surgery. However, the recovery time for the extraoral technique is longer than the intraoral approach.

[3] Verknoechertes Lig stylohyoideum – CT 3D – Eagle syndrome

Follow-up Treatment

Patients are recommended to have analgesics and antibiotics for a week after surgery. Follow-up care for at least a year is crucial for recovering from styloidectomy. During this period the patient is physically examined and tested every 3 months.

Other Methods of Management

• Homeopathic medications
• Therapeutic exercises and physical therapy to relax muscles and reduce pain
• Chiropractic treatment by a licensed practitioner

Prognosis

The medical and surgical treatment methods together have a success rate of approximately 80%. However, effectiveness of a certain treatment depends on the presence of any other associated condition or causative factor.

Incidence and Prevalence

An ESP may occur in 4% of the population, out of which only 4-10.3% of the people exhibit pain and other symptoms. Therefore, the actual incidence of Eagle Syndrome is 0.16%, with the ratio between affected females and males being 3:1. People between 30 and 50 years of age are more likely to have this condition.

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Compartment Syndrome Definition

Compartment Syndrome is an acute disease characterized by increased pressure inside a muscle compartment which can result in damage to the muscles and nerves and also cause problems in the flow of blood.

Compartment Syndrome ICD9 Code

The ICD9 codes for this disorder are 729.7 and 958.9.

Compartment Syndrome Incidence

The exact incidence of this condition is not known. However, the disease is supposed to be quite common in nature especially in athletes, aged people and those suffering from fractures.

Compartment Syndrome Symptoms

The condition gives rise to acute pain that refuses to subside even after taking analgesics (pain-relievers) or keeping the affected region elevated from other areas of the body. In more acute cases, the signs and symptoms may involve the following:

Picture 1 – Compartment Syndrome

• Paleness of skin
• Weakness
• Acute, worsening pain
• Tingling and numbness
• Reduced sensation

Compartment Syndrome Types

The condition has been categorized into two major types, which are:

Acute Compartment Syndrome

Regarded as a medical emergency, it is generally caused by an acute injury. In the absence of medical treatment, it can cause permanent damage to the muscles.

Chronic Compartment Syndrome

This is not generally a medical emergency. Also referred to as Exertional Compartment Syndrome, it is caused most frequently as a result of exertion during athletic activities.

Compartment Syndrome Causes

The causes for this condition differ on the basis of the type of the disorder that an individual suffers from.

Causes for Acute Compartment Syndrome

It usually arises after an acute injury, such as a broken bone or a car accident. In rare cases, it arises after a comparatively minor injury.

This type of Compartment Syndrome may also develop due to certain conditions, such as:

Crush injuries

Crushing injuries or traumas are one of the main factors responsible for this syndrome.

Fractures

Fractures, or breaks in the bones, are possibly the most common injury that can result in this syndrome. A fracture of the arm or leg is typically found to be the cause of this condition.

A badly bruised muscle

Such types of traumas can occur due to sudden blows to the leg, as may happen in cases of a fall from motorcycle or a collision of the foot with the helmet of a player.

Use of anabolic steroids

Intake of steroids is regarded as a possible factor in the development of this syndrome.

Use of tight bandages

Use of tight bandages and casts may also give rise to this problem. If the signs and symptoms of this syndrome arise, any bandage that is possibly constricting a nerve or muscle should be loosened or removed. A doctor should be contacted on an immediate basis if a cast is found to be the cause of this syndrome.

Re-established flow of blood after obstructed circulation, which may arise after surgical repair of a damaged blood vessel that has been obstructed for several hours. A blood vessel may also get blocked during sleep. Lying in a prolonged duration in a position that obstructs a blood vessel and then waking up or moving can result in this syndrome. The majority of healthy individuals would naturally move when flow of blood to a limb is obstructed at the time of sleeping. The occurrence of Compartment Syndrome in this way generally occurs in individuals with compromised nervous systems. This may occur after acute intoxication with drugs or alcohol.

Other possible causes for this syndrome include the following:

• Snake bites
• Strenuous exercise
• Burns
• Bleeding from an injured blood vessel
• Penetrating traumas such as gunshot wounds or stab wounds
• Intravenous medications, generally administered through a drip into a vein, which unknowingly leak within the arm surrounding the vein.

Causes of Chronic (Exertional) Compartment Syndrome

The inflammation and pain associated with this form of the syndrome arises as a consequence of exercise. Athletes participating in sporting activities like swimming, biking or running that require repetitive motions are more susceptible to chronic cases of this syndrome. Discontinuation of exercise generally helps bring relief to sufferers. The condition is not usually dangerous in nature.

Compartment Syndrome Risk Factors

The risk of development of this condition is increased in certain individuals. The risk-prone population includes:

Neourologically compromised individuals

As aforementioned, those suffering from neurological problems can suffer from circulatory obstructions while sleeping which can lead to Compartment Syndrome.

Athletes

Athletes and sportsperson are highly susceptible to all kinds of injuries, including the ones that can give rise to this syndrome.

Old individuals

Aged people, particularly those who suffer from one or more fractures, are also more prone to this syndrome. Those having fractures in the arm or leg are especially at greater risk of having this problem.

Compartment Syndrome Diagnosis

The diagnosis of this syndrome initially begins with a physical examination of sufferers. A physical examination is conducted to detect the presence or absence of the following problems:

• Inflammation in the affected region
• Painful sensations on squeezing the affected region
• Sensations of acute pain while moving the affected area

The diagnostic method differs according to the type of the condition that one suffers from.

Diagnosis for Acute Compartment Syndrome

Patients concerned about Acute Compartment Syndrome should immediately go to an emergency room to get themselves checked, as this is a medical emergency. Physicians tend to detect this form of the syndrome by measuring the compartment pressure in order to assess whether or not patients are suffering from the acute variety of the disorder.

Diagnosis for Chronic (Exertional) Compartment Syndrome

In order to diagnose this type, a doctor must rule out the presence of other disorders that can also cause pain in the lower leg. Physicians should conduct tests like applying pressure on the tendons to make sure sufferers do not have Tendonitis. They may order carrying out an X-ray to ensure that the shinbone (tibia) has not suffered a stress fracture.

In an attempt to confirm Chronic Compartment Syndrome, a doctor is likely to measure the pressure within the compartment before and after a workout (or any other activity that gives rise to painful sensations in patients). The measurement is done by using a needle affixed to a pressure meter that is placed into the affected area of the body. Patients are confirmed of having the chronic variety of the syndrome if pressures remain high after working out.

Compartment Syndrome Differential Diagnosis

The differential diagnosis for this syndrome involves isolating its signs from similar symptoms produced by other disorders. The differential diagnosis differs on the basis of the form of the disorder that an individual is suffering from.

Acute Compartment Syndrome Differential Diagnosis

It includes excluding its signs from those of disorders like:

• Cellulitis
• Cnidaria Envenomation
• Peripheral Vascular Injuries
• Deep Venous Thrombosis
• Gas Gangrene in Emergency Medicine
• Rhabdomyolysis in Emergency Medicine
• Emergent Management of Necrotizing Fasciitis
• Physical Medicine and Rehabilitation for Stress Fractures

Chronic Compartment Syndrome Differential Diagnosis

It involves isolating its signs from those of disorders like:

• Tumor
• Tenosynovitis
• Myopathies
• Spinal Stenosis
• Hypothyroid Myopathy
• Deep Venous Thrombosis
• Lumbosacral Radiculopathy
• Nerve Entrapment Syndromes

Physicians should ensure that patients are actually suffering from Compartment Syndrome and not any of the disorders mentioned above.

Compartment Syndrome Treatment

The treatment plan for this disorder is based on the form of the syndrome that individuals suffer from, i.e, acute or chronic.

Treatment for Acute Compartment Syndrome

There is no effective non-operative treatment for acute forms of this disorder which are regarded as surgical emergencies. Fasciotomy is the surgical treatment choice for this condition. In this method, surgeons make an incision and cuts open the skin as well as the fascia that forms a covering over the affected compartment.

In some cases, the inflammation can be acute enough for the skin opening to be closed immediately. When inflammation subsides, the incision can be surgically repaired. A skin graft is used in some cases.

Treatment for Chronic Compartment Syndrome

This form of the syndrome can be cured through surgical as well as non-surgical means.

Non-surgical treatment

This includes anti-inflammatory medications, physical therapy and orthotics (inserts for shoes), which have questionable results. The symptoms may subside by avoiding the activity that can cause the disorder. Cross-training with low-impact activities may yield some benefit. Certain athletes suffer from a worsening of symptoms on some kinds of surfaces (such as artificial turf or concrete). In such cases, they can obtain relief from symptoms by switching surfaces.

Surgical treatment

It may be an option if conservative measures fail to yield benefit. Surgical option is similar to that used for curing Acute Compartment Syndrome and involves opening the fascia to allow space to injured muscles for swelling.

Compartment Syndrome Prognosis

The overall prognosis depends on the injury that results in the development of this syndrome. The outcome of the disease also depends on how quickly it is diagnosed and treated. If the disorder is treated quickly, it is possible for nerves and muscles to attain a complete recovery. In case of prompt treatment, physicians can restore blood supply to the affected muscles before damage occurs permanently. Permanent injury to nerve and loss of muscular function can occur if the diagnosis is delayed. This is particularly common in cases where an injured person is heavily sedated or has lost consciousness and cannot complain of pain. Permanent injury to nerve may occur 12 – 24 hours after compression.

According to some experts, compartment syndrome in the arm or leg should be cured within as little span of time as possible (preferably within 6 hours) in order to prevent muscle necrosis (or death of muscles).

Compartment Syndrome Complications

The possible complications of this syndrome include the following:

Picture 2 – Compartment Syndrome Image

• Infection
• Permanent damage to nerve
• Loss of affected limb due to requirement of amputation, in rare cases
• Permanent muscle damage and reduced function of the affected limb
• Permanent scarring, as a result of conducting the fasciotomy procedure on the affected limb
• Kidney failure, due to death of muscles and possible damage to the kidneys (as various chemicals are released by the muscle)
• Death, in rare cases

Compartment Syndrome Prevention

There is no way to prevent this disorder. If you are suffering from an injury and having acute painful sensations or inflammation in your affected area that fail to improve despite use of analgesic medicines, get in touch with a medical care provider as early as possible. This can ensure quick recovery for you as well as help prevent any complications that may ensue in future.

References:

http://en.wikipedia.org/wiki/Compartment_syndrome

http://www.wisegeek.com/what-is-compartment-syndrome.htm

http://orthoinfo.aaos.org/topic.cfm?topic=a00204

http://www.nhs.uk/Conditions/compartment-syndrome/Pages/Introduction.aspx

The post Compartment Syndrome appeared first on Prime Health Channel.

Spondylitis Definition

Spondylitis is an arthritic condition that affects the spine directly. It is one of the common causes of pain in the neck and back area and typically occurs due to a swelling of the facet joints located between the vertebrae.

Spondylitis is sometimes also referred to as Ankylosing Spondylitis although the term actually refers to a subtype of the condition. The disorder should not be confused with Spondylolysis, Spondylosis or Spondylolisthesis.

Spondylitis ICD9 Code

The ICD9 Code for this disorder is 721.90.

Spondylitis Types

The condition has been classified into a number of types. The major types of Spondylitis include:

Cervical Spondylitis

It refers to a painful condition of the neck that affects the cervical spine. The pain may spread to other regions of the body, such as the collar bone, posterior area of the neck, shoulder joints and both sides of the shoulder. This form of the disorder limits the motion of the neck and the muscles become weak leading to loss of range of motion in the arms.

Lumbar Spondylitis

It is a painful condition of the lumbar region.

Spondylitis Deformans

This is an autoimmune disorder that involves the sacroiliac joints and the spine. Due to this reason, it is a form of Spondylarthritis. It is also known as Ankylosing Spondylitis. The condition affects a number of areas of the body, such as:

• Hip joints
• Shoulders
• Sacroiliac joints
• Vertebral column

In this type, the spines generally turn extremely stiff. The rigidity may also be observed in other areas like the hips, neck, knees, shoulders, jaw and heels.

What is Undifferentiated Spondylitis?

It is a term used by certain doctors to describe back pain originating without any apparent causes and which seems to be related with degenerative changes on imaging exams like CT or MRI scans.

The condition is not related with an underlying Spondyloarthropathy.

Spondylitis Causes

The majority of scientists and medical researchers are of the opinion that this is a hereditary disorder. A specific gene known as HLA-B27 has been found to be associated directly to the disorder. Although there is definitely an association between Spondylitis and this gene, many individuals with HLA-B27 never develop the disorder. Due to this reason, scientists suspect that there are also some other factors involved with this disease.

Spondylitis and Associated Conditions

The conditions associated with this disorder include the following:

Psoriatic arthritis

It arises in certain people affected with a chronic skin condition by the name Psoriasis. Around one out of 20 individuals suffering from Psoriasis ted to develop arthritic symptoms along with the skin condition. Generally, people with psoriasis are found to be more prone to arthritis than members of the general population. The cause of psoriatic arthritis is unknown. However, genetic factors are supposed to play a role in the development of the disease.

Reiter’s syndrome

It is an inflammatory complication of some prior case of infection affecting any other area of the body. Its symptoms include:

• Reactive arthritis
• Skin lesions
• Urethritis, or inflammation of the urethra
• Conjunctivitis, or inflammation of the eye

The disease is most common in men who are less than 40 years of age.

Spondylitis Risk Factors

Apart from a genetic association, a few other factors are supposed to raise the risk of getting this disorder in an individual. These include:

Being male

Men are more susceptible to this condition than women, particularly between 20 and 30 years of age. This may be ascribed to the fact that men are usually more actively involved in sports than women during this age and are hence prone to injuries that may progress to Spondylitis.

Being Native American

Native Americans are also found to be slightly more susceptible to Ankylosing Spondylitis as compared to people of other racial origin.

Having certain inflammatory conditions

The presence of some inflammatory disorders like Ulcerative colitis, Psoriasis or Crohn’s disease heightens the risk of Spondylitis. The disease affects around 5% people with Psoriatic arthritis.

Spondylitis Incidence

The exact incidence of this disease is unknown as it is often a feature of a group of disorders. In the United States, 0.21% of people over 15 years of age are affected by this disorder. The condition is assessed to be prevalent in 197 out of every 10,000 individuals in the U.S.

Spondylitis Symptoms

This arthritic condition has a direct effect on the spine of its sufferers. It gives rise to general discomfort and chronic pain in the lower and upper back of affected individuals. Sufferers also frequently experience an overall sensation of stiffness in the back. In the course of time, patients may lose some amount of mobility.

The disease always begins with the spine. Over a period of time, however, it can spread to various organ systems through the body and give rise to a variety of different symptoms. In the initial stages, a patient is likely to experience stiffness and pain – specifically in the lower section of the spinal column that is close to the buttocks. In the later stages, the pain may be felt in the upper parts of the spine as well as in other joints in the body (such as the hips). When the condition progresses to an advanced stage, sufferers may discover that their spine has become inflexible. They may begin to suffer from chronic fatigue or start losing weight.

As is the case with other types of arthritis, this is an inflammatory disorder. The inflammation caused by this condition can make the immune system react as if some type of injury has occurred. A new bone may begin to grow in the spine and eventually result in an overall immobilization of the spinal column. This condition is referred to as Spinal fusion. Although not very common, Spinal fusion can occur if Spondylitis is left without being treated.

The disorder often goes undetected until it develops completely and results in pain. The pain is generally concentrated around the cervical area of the spine, lower spine and shoulder with stinging pain that is moving downwards.

Spondylitis Diagnosis

The diagnosis of this disorder involves:

Consideration of medical history

The medical history of patients should be taken into account. Sufferers may complain about joint pain, fatigue, morning sickness, neck pain, hip pain and back pain. Some patients may complain about other bodily problems like night sweats and weight loss. Symptoms of inflammatory bowel disorder or skin disease (Psoriasis) may precede or follow the start of Spondylitis problems in the back. Doctors may ask patients about a history of recent or past ailments as well as a family history of Spondyloarthropathies.

Physical exam

Patients may be physically examined, which may reveal problems like muscular spasms, inflammation, tenderness in the joints, or reduced movement in the spinal column. It is only in rare cases that vision is affected although ocular inflammation may be present. Psoriatic involvement of the skin may be obvious.

Medical tests

In order to determine signs of possible infection and the degree of inflammation, physicians put the majority of affected individuals through the following tests:

• Blood cultures
• Spinal x-rays
• Hemoglobin
• Hematocrit
• C-reactive protein (CRP)
• Erythrocyte sedimentation rate (ESR)

Doctors may conduct an HLA-B27 assay and a serological test for rheumatoid factor (RF) in order to exckude the possibility of presence of Rheumatoid arthritis. The HLA-B27 antigen is often detected in people suffering from the following problems:

• Reiter’s syndrome
• Ankylosing spondylitis
• Psoriatic arthropathy
• Enteropathic arthropathy (arthritis associated with ulcerative colitis and Crohn’s disease)

Other tests that are conducted are associated to the specific cause of the spondylitis. These may include:

• Tuberculin skin testing (PPD)
• Biopsy for culture and sensitivity to exclude presence of tuberculosis, brucellosis and infectious arthritis (septic arthritis)
• CT scans, to determine changes in soft tissue in and around the joints
• MRI scans, for diagnosis and follow-up assessment (in a few cases)

Diagnoses depend on clinical findings of arthritis as well as other conditions. The clinical features needed to establish a diagnosis of this disorder involve a typical pattern of:

• Radiographic sacroiliitis
• Peripheral arthritis
• Absence of rheumatoid factor
• Association with HLA-B27
• Extra-articular features such as Uveitis

Spondylitis Differential Diagnosis

The differential diagnoses of Spondylitis include ensuring that the symptoms experienced by patients are not the result of any of the following disorders:

• Osteoarthritis
• Spinal fracture
• Rheumatoid arthritis
• Herniated intervertebral disc
• Muscle abscess
• Metastatic bone tumor

Spondylitis Treatment

The treatment for this condition aims at the following:

• Relieving joint pain
• Maintaining mobility
• Delaying or preventing deformities

A range of prescription medications and Nonsteroidal anti-inflammatory drugs (NSAIDs) like Aspirin are used to decrease pain and inflammatory symptoms related with the disease. In severe cases of ankylosing spondylitis, patients may require surgery. Operative procedures may help improve gross lumbar flexion deformity, chin-on-chest deformity and other defects. Any underlying disorder or concomitant infection will be simultaneously cured.

Spondylitis Complications

The complications associated with this condition are mainly those of underlying disorders like:

• Psoriasis
• Reiter’s syndrome
• Inflammatory bowel disease

Deformities may arise due to progressive cases of the disease. In patients of Ankylosing spondylitis, the following problems may occur:

• Loss of lumbar lordosis (Abnormal flattening of the lower spine)
• Kyphosis, or exaggeration of the curve of the thoracic spine (middle spine). Physicians may be able to cure this  deformity

Spondylitis Prognosis

The outcome tends to be variable for cases of Spondylitis that are related with problems like:

• Psoriasis
• Inflammatory bowel disease
• Reiter’s syndrome

Spontaneous remission, as well as exacerbation, is common. However, the outcome is generally favorable. In a few sufferers, the disorder may progress to complete immobility of the affected joints. This problem is known as Ankylosis. However, the course of the disorder is unpredictable as relapses may occur at any phase. Spondylitis can be aggravated due to the presence of infection or active chronic inflammatory disorders like Psoriatic arthritis or Crohn’s disease.

Spondylitis – Recovery and Return to Work

Usually, rheumatologic disorders such as these are frequently cured with the aid of medications along with physical therapy. The management can be done with the aid of general aerobic conditioning and exercises that improve strength and flexibility of affected regions. It is important to teach proper lifting techniques to patients and educate them about body mechanics to make them fit for going back to work.

Stretching or flexibility exercises may be taught to promote the range of motion in the spinal column. In order to help patients prevent poor posture, exercises may be introduced to strengthen the muscles in the abdominal and the lower back region. Even if patients suffer from mild symptoms of Spondylitis, activities like swimming and walking may be recommended. These can be done without putting the spine under great stress. It is advised that sufferers take up workout programs slowly and build up speed gradually as well as increase the duration of exercises over time to elevate tolerance and mobility without worsening the condition.

Some individuals, who have jobs that need standing, lifting or bending for long hours, may need to shift to more sedentary duties. If the condition heals with residual deformity, patients may no longer be able to carry out heavy duties. They may need to be trained again in a different domain. A prolonged leave may be necessary in some cases. If that is not possible, a change of job nature may be required.

Spondylitis Pictures

The following images would let you know how this condition affects the spine of affected individuals.

Picture 1 – Spondylitis

Picture 2 – Spondylitis Image

If you suspect yourself to be having this disorder, do not delay treatment. Seek medical attention on an early basis and get yourself tested by a professional healthcare provider. Early diagnosis and treatment will help you recover from this disease on an early basis and ensure good health for you.

References:

http://www.mdguidelines.com/spondylitis

http://www.wisegeek.com/what-is-spondylitis.htm

http://www.yogawiz.com/askquestion/1784/what-is-spondylitis.html

http://en.wikipedia.org/wiki/Spondylitis

The post Spondylitis appeared first on Prime Health Channel.

What is Scleroderma?

It refers to a chronic, progressive condition of the connective tissue. The name of this disease has been derived from two Greek terms – “skleros” meaning “hard” and “derma” standing for “skin.” Put simply, it is a disorder characterized by hardening and tightening of the skin and connective tissues of sufferers.

The condition is also known by the name Systemic sclerosis.

Scleroderma Types

There are two forms of this disorder:

Localized Scleroderma

It is classified mainly into two varieties:

Morphea Scleroderma

The condition is marked by thick, oval patches on the skin that have a purple border and a white middle. They arise only in a few regions on the body or may be more widespread.

Linear Scleroderma

It is more common in kids and is marked by the development of streaks or bands of hardened skin on the forehead or on one or both legs or arms.

Systemic Scleroderma

Also known as Systemic sclerosis, it not only affects the skin but also the internal organs and blood vessels. One of its variants are known as CREST syndrome or Limited Scleroderma.

Scleroderma Incidence

The condition has been estimated to have an incidence of 19 cases in every one million individuals. The prevalence has been estimated to be 240 cases per million. The prevalence has increased as a result of earlier diagnosis, improved diagnostic methods and longer rates of survival.

As misdiagnosis is common in this disorder, it is difficult to determine the exact rates of prevalence and incidence. Among US women in the 35-65 years age group, the prevalence of this disease has been determined to be as high as 400 cases in every one million.

Scleroderma Causes

The disorder occurs due to an accumulation or overproduction of collagen in the tissues of the body. Collagen is a form of fibrous protein that constitutes the connective tissues and even the skin of the body.

Doctors are not sure about the exact factors that are responsible for the abnormal production of collagen. However, they suspect the immune system of the body as a possible cause. Many of them have the opinion that the condition arises when the immune system of the body turns against the body due to unknown reasons, leading to overproduction of collagen and inflammation.

Scleroderma Symptoms

The symptoms of this disorder tend to vary in nature, depending on the organ systems that have been affected. Its detection can be difficult as some of its symptoms in the initial stages are common in the general population and are not always related to the disorder.

The most prevalent signs of this disease include:

Gastroesophageal reflux disease (GERD)

Patients have suffer from acid reflux, which may damage the esophageal section close to the stomach. They may also have problems in absorbing nutrients if the intestinal muscles fail to properly move food particles through the intestines.

Raynaud’s phenomenon

It is characterized by an exaggerated response to emotional distress or cold temperatures, which squeezes the small blood vessels in the hands and feet – leading to pain, numbness or changes of color in the fingers or toes.

Changes in skin

The changes may involve inflammation of the fingers and the hands. Other problems might include tightening of the skin around the face, mouth or hands. The skin, due to its tightness, may appear shiny. The motion of the affected region may be limited.

Scleroderma Diagnosis

The diagnosis of this disorder may involve the following tests:

Blood tests

Blood exams can reveal an increase in the amount of antibodies produced by the immune system in the bloodstream.

Skin analysis

Physicians generally evaluate the condition of the skin in as many as 17 particular regions to assess the level of skin involvement. This can indicate the possibility of life-threatening changes in the internal organs.

Biopsy of tissue

A small sample of tissue may be removed from the affected skin area and analyzed in the laboratory to determine the presence or absence of abnormalities.

On the basis of the results of the initial assessment, physicians may also recommend carrying out other diagnostic procedures to detect any gastrointestinal complications or complications in the heart, lung or kidney that may accompany Scleroderma.

Scleroderma Differential Diagnosis

The differential diagnosis of this disorder involves telling its symptoms apart from those of other conditions, that give rise to similar problems, such as:

• Eosinophilic fasciitis
• Graft versus host disease
• Pulmonary hypertension
• Reflex sympathetic dystrophy
• Rheumatoid arthritis
• Scleromyxedema
• Mycosis fungoides
• Porphyria cutanea tarda
• Idiopathic Pulmonary fibrosis
• Amyloidosis
• Eosinophilia-myalgia syndrome
• Primary biliary cirrhosis
• Lupus (systemic lupus erythematosus)

Physicians should ensure the absence of these abovementioned conditions before confirming the presence of Scleroderma.

Scleroderma Treatment

The condition does not have any specific cure as there is no medication that can stop the excessive production of collagen. However, the localized form of Scleroderma sometimes goes away on its own. Various medicines can help manage the symptoms of the disorder or help prevent the complications associated with it.

The treatment of this condition involves the use of:

Drugs

These involve medications for dilating the blood vessels of sufferers. Medicines used to control blood pressure and dilate the blood vessels may help prevent complications related to the kidney and lungs. Doctors also use immune-suppressant drugs in some cases. These drugs, such as those used after organ transplants, reduce the functionalities of the immune system and may decrease the symptoms of Scleroderma.

Therapy

Therapeutic procedures involve cosmetic procedures occupational or physical therapy. Therapists can help sufferers manage the painful sensations and improve their mobility and strength. They can also help patients perform important daily tasks and give sufferers a sense of independence in carrying out their functions. Therapy also includes cosmetic procedures. Exposure to ultraviolet light can help improve the appearance of skin lesions related with this condition. Laser surgery may also help remove these lesions or at least hide them.

Surgery

Surgical techniques for this disorder include:

Lung transplant

This method is carried out in people who suffer from Pulmonary hypertension or high blood pressure in the arteries to their lungs.

Amputation

It may be needed if gangrene occurs in finger ulcers caused due to acute cases of Raynaud’s disease.

Scleroderma Risk Factors

Various factors seem to elevate the risk of development of some types of this condition. These include:

Being female

Women are found to be more susceptible to this disorder than men. Females are four times likelier to get this disorder as compared to males.

Exposure to certain substances

The development of this disorder has also been associated to an exposure to various substances, which include:

• Some type of drugs used in chemotherapy
• Certain industrial solvents, like paint thinners
• Silica dust, that is common in rock quarries and coal mines

Belonging to certain races

People of certain racial origin are more prone to this disorder as compared to others. They include Native Americans and African Americans. Choctaw Native Americans residing in Oklahoma are at least 20 times or at greater risk of developing this disorder as compared to the general population. Odd though it may appear, the Choctaws residing in the Mississippi region are not at an elevated risk. African-Americans suffering from the disorder are more likely to have lung complications.

Scleroderma Complications

The disorder may give rise to a number of complications that can range from mild to severe in intensity. Some of these may even turn fatal for sufferers.

The problems include:

• Lung complications, such as Pulmonary fibrosis and Pulmonary hypertension
• Circulatory complications, marked by tissue damage, skin sores, gangrene and even amputation
• Kidney complications, such as renal crisis (characterized by sudden rise in blood pressure and rapid kidney failure)
• Digestive complications, like swallowing difficulties, constipation episodes alternating with diarrhea and acid reflux
• Dental complications, like changes in gum tissue, destruction of tooth enamel and loosening or even falling of teeth
• Sexual complications, like reduced sexual lubrication and constriction of vaginal aperture (for women) and erectile dysfunction (in men)
• Cardiac complications, such as scarring of heart tissues, arrhythmias, congestive heart failure and Pericarditis

Scleroderma Prognosis

In the majority of people suffering from localized Scleroderma, the condition is found to be self-limited. There are varying degrees of hand debilitation in sufferers.

The condition generally progresses over a span of several years. The 10 year survival-rates are around 60-70% in people with limited systemic involvement. The rates are around 20% in those with more diffused involvement.

There may be certain periods when the condition of sufferers is stable. In occasional circumstances, the signs may enter remission all through or in localized regions of the body. The disorder can become life-threatening in cases where they involve the kidneys or the lungs. In the absence of treatment, the condition may turn fatal within a span of a few years.

The factors that indicate a more acute outcome for the disease involves:

• Extensive involvement of skin with fast progression
• Being young when diagnosed with the disease
• Presence of anemia
• Higher Erythrocyte Sedimentation Rate (ESR)
• Renal involvement
• Pulmonary involvement
• Being of African origin

Scleroderma Prevention

As its causes are unknown, it is not possible to avoid the development of this disorder. However, its complications can be avoided by seeking medical treatment on an early basis. The later complications can be avoided with the aid of:

• Rehabilitation exercises, to improve motion and strength
• Hydrotherapy and paraffin baths, to relieve symptoms and increase mobility
• Counseling, to manage depression arising due to restriction of activities

Scleroderma Foundation

The Scleroderma Foundation is a national organization for extending support and guidance to individuals affected by this disorder and their friends and family members. The organization also conducts researches associated with the disease.

You may contact the Foundation at:

Scleroderma Foundation – National Office

300 Rosewood Drive, Suite 105

Danvers, MA 01923

Ph: (978) 463-5843

Toll-free Information Line: (800) 722-HOPE (4673) – (8:30 a.m. to 5 p.m. Eastern, Monday through Friday)

Fax: (978) 463-5809

Scleroderma Pictures

The following images show how this disorder affects the appearance of the skin of people affected by Scleroderma.

Picture 1 – Scleroderma

Picture 2 – Scleroderma Image

If you are suspecting the symptoms of Scleroderma in yourself or any of your family members, get in touch with a professional medical care provider and get yourself tested as early as possible. This would help you get the condition diagnosed and treated on an early basis, and ensure a faster recovery.

References:

http://www.mayoclinic.com/health/scleroderma/DS00362

http://www.nlm.nih.gov/medlineplus/scleroderma.html

http://www.umm.edu/patiented/articles/what_symptoms_of_scleroderma_000088_2.htm

http://www.mdguidelines.com/scleroderma

The post Scleroderma appeared first on Prime Health Channel.

It is a condition characterized by cellular death or necrosis of the bone components that occurs due to interrupted blood supply. In absence of proper blood flow, there is death of the bone tissue which leads to collapsing of the bone. If the condition involves bones of a particular joint, it frequently causes destruction of joint articular surfaces.

Although the condition can develop in any bone of the body, it mostly affects the ends of the femur, i.e. the bone that extends from knee joint to hip joint. The other common areas include upper arm bone, shoulders, knees, ankles, scaphoid (wrist) and talus.

Avascular necrosis is known by several other names, such as:

• AVN
• Osteonecrosis
• Aseptic necrosis
• Bone infarction
• Ischemic necrosis
• Ischemic bone necrosis

Avascular Necrosis Epidemiology

AVN affects both men and women equally. However, in cases which are related to systemic lupus erythematosus, the condition mostly affects women. Although it can develop in any age, most cases are found to affect individuals aged between 30 and 50 years. Nearly 10000 to 20000 people are diagnosed with AVN of femur head every year in US alone. In children, AVN of the femoral head is referred to as Legg-Calvé-Perthes syndrome.

Avascular Necrosis Causes and Risk Factors

There can be a number of causes and risk factors for AVN. These include:

• Gout
• Dialysis
• Diabetes
• Vasculitis
• Alcoholism
• Deep diving
• Post trauma
• Osteoporosis
• Hypertension
• Osteoarthritis
• HIV infections
• Chemotherapy
• Atherosclerosis
• Bisphosphonates
• Sickle cell anemia
• Arterial embolism
• Radiation therapy
• Gaucher’s Disease
• Arterial thrombosis
• Rheumatoid arthritis
• Bone or joint injuries
• Vascular compression
• Autoimmune diseases
• Excessive usage of steroids
• Damage caused by radiation
• Systemic lupus erythematosus
• Caisson disease or decompression sickness
• Pancreatitis or inflammations of the pancreas
• Organ transplantation procedures (mainly kidney transplantation)

Sometimes no definite causes can be traced that lead to the development of AVN; such instances are said to be idiopathic. Prolonged and repeated exposure to high pressures has also been linked to the development of this disorder, although the relationship between the two is not clearly understood.

Avascular Necrosis Symptoms

AVN is usually asymptomatic during the earlier stages. However, with the gradual progression of the disorder, most patients complain of joint pains. At the initial stages, the pain is felt only when weight is put on an affected joint. Later on, patients experience pain even when they are sitting or resting. Onset of pain is gradual and can be only mild or severe. If the bone and its surrounding joint surface disintegrate, there can be a sharp rise in pain. This increased pain may make it difficult for the individual to move the affected joint, thereby leading to limited movement of the area. Disabling osteoarthritis might develop when the affected area is the hip. Groin pain can accompany an affected hip which is felt mainly during walking. If the lower extremity gets affected, a patient might limp while walking. As the ball collapses with the progression of avascular necrosis of the hip, the pain can persist after weight-bearing or rotation with walking. Some individuals experience the symptoms of AVN bilaterally, such as in both the hips and knees.

Avascular Necrosis Diagnosis

The diagnosis of AVN is mostly carried out by orthopedic doctors. In cases where the affected areas are the jaws, the condition is normally evaluated and treated by the dental and the maxillofacial surgeons. At first, a doctor conducts a thorough medical checkup and asks a patient about his or her medical history. He then recommends carrying out a number of diagnostic tests. During the earlier stages, the diagnostic modalities mostly used for Osteonecrosis include MRI scans and bone scintigraphy. The other tests recommended for diagnosing AVN include:

• X Rays
• Biopsies
• Bone scans
• Computer Tomography (CT) Scans
• Functional evaluation of the bones

X-ray images of the condition taken during the earlier stages generally appear normal. During the later stages, however, the images appear relatively more radio-opaque as the nearby bone is being resorbed secondary to the reactive hyperemia. Increased radiographic opacity is not shown by the affected bone itself as the dead bone cannot go through bone resorption, a process that is generally carried out by the living osteoclasts. Late radiographic images show a radiolucency area after the collapse of the subchondral bone and the ringed areas of radiodensity that result from saponification and the calcification of the marrow fat after medullary infarcts.

Avascular Necrosis Differential Diagnosis

A number of joint and bone conditions exhibit signs and symptoms similar to that of AVN. Hence while determining the diagnosis for this disorder, appropriate care should be taken to differentiate it from such similar-appearing conditions. The differential diagnoses for AVN include ensuring the absence of the following conditions:

• Groin Injury
• Hip Fracture
• Osteoporosis
• Stress fracture
• Hip Dislocation
• Femoral Neck Fracture
• Hip Overuse Syndrome
• Osteochondritis dissecans
• Paget’s disease of the bone
• Femoral Neck Stress Fracture

Avascular Necrosis Treatment

Appropriate treatment is necessary for AVN patients, without which the joints might break down. In order to find out which treatment method suits an individual best, a doctor has to keep in mind the following considerations:

• The age of a patient
• The location of the disorder or the affected areas
• The stage of progression at which the disease is currently in
• The underlying causes responsible for the development of osteonecrosis

Nonsurgical Treatments

Generally, the doctors start with simple, nonsurgical remedies to manage the condition. These might include medications or certain other procedures. Unfortunately, although these procedures are able to reduce the pain temporarily, they cannot give rise to any lasting improvement.

Medications

A doctor might prescribe medications to reduce the rate of progression of the disorder, ease the pain and get rid of inflammations, which may include:

• Non-steroidal anti-inflammatory drugs (NSAIDs), like naproxen (Aleve) and ibuprofen (Motrin, Advil, or others)
• Osteoporosis drugs like alendronate (Binosto, Fosamax)
• · Cholesterol-lowering drugs like statins and fibrates, that can help to reduce cholesterol or fats (lipids) from the blood and reduce the propensity for vessel blockages
• Blood thinners like warfarin (Coumadin, Jantoven), which can help patients who experience blood clotting problems

Reducing weight bearing

If the condition is diagnosed early, a physician might recommend reducing additional pressure from an affected joint. This can be accomplished by limiting strenuous activities or the usage of crutches. In certain cases, reduction in weight bearing might slow down the damage caused by AVN and allow natural healing. This treatment procedure can be combined with medications to avoid or delay any surgical procedure for some patients.

Regular exercising

Following a low-stress exercise program can help to keep the affected joints mobile and eventually increase range of motion in these areas.

Electrical stimulation

Electrical stimulation can be used to facilitate bone growth, and is known to produce good results when used prior to femoral head collapse.

Surgical Treatments

A number of surgical procedures are used to cure AVN. As most patients do not start exhibiting symptoms before the condition is fairly advanced, surgery is the main form of treatment in most cases.

Core decompression

This procedure involves removal of the inner cylinder or inner layer of the bone that helps to reduce the pressure within the affected bone, increasing the blood flow and allowing the formation of more blood vessels. Core decompression is ideal for people who are still in their earlier stages of avascular necrosis, prior to the collapsing of the joint. This method of treatment can reduce the pain and slow the rate of progression of joint and bone destruction.

Bone reshaping or Osteotomy

This form of treatment involves reshaping of the bone to minimize stress on an affected area. It involves the removal of a wedge of a bone just above or below a weight-holding joint to reduce the pressure from the damaged bone. Osteotomy or bone reshaping might help in postponing joint replacement. It might take a long time for the patient to recover, during which the individual is advised not to be a part of any stressful activities. The procedure is mostly used for patients having early-stage osteonecrosis on a very small portion of the affected bone.

Bone graft or transplant

Bone grafting involves transplantation of a healthy bone from one part of the body to another. It is frequently used to provide support to a joint after a core decompression procedure. In various cases, the surgeon will employ a vascular graft that includes a vein and an artery for increasing the blood supply to an affected area. Rest for a period of several months is necessary for an AVN patient to attain complete recovery.

Arthroplasty or Total Joint Replacement

Arthroplasty or Total Joint Replacement is used to treat the late-stage patients of osteonecrosis whose joints have already destroyed. In this procedure, artificial parts made of plastic or metal are used to replace the affected joint. Total joint replacement is sometimes referred to as femoral head resurfacing. It is frequently recommended for individuals for whom the other efforts to save the joint did not yield satisfactory results. Various replacement options are available, and a patient should discuss his or her specific needs with the doctor.

Avascular Necrosis Complications

If ignored or untreated, AVN worsens with time. The bone eventually becomes weakened enough and collapse. Severe arthritis can occur if the bone’s smooth shape is lost. In any case, a patient may suffer from permanent decreased mobility and require complete joint replacement.

Avascular Necrosis Prognosis

The outcome for this condition depends on the area of the bone that is affected, largeness or smallness of the area involved, and how well the rebuilding of the bone occurs. Bone rebuilding is a normal process of the body and continual breakdown and rebuilding of bones take place at all times. This procedure maintains the strength of the skeleton and balance of minerals. However, AVN patients experience rapid break down of the bone tissues which are not followed by quick repair. Patients may enjoy full recovery after treatment or experience permanent damage of the joints with progression of the disease.

Avascular Necrosis Prevention

Although it is difficult to say whether reducing the risk factors can ensure total protection from the development of AVN, following certain health tips can definitely guarantee an overall good health.

• Limited consumption of alcohol – One of the major factors responsible for the development of osteonecrosis is heavy drinking. Reducing alcohol consumption can minimize the risks of development of this disorder.
• Lowering the cholesterol levels – Small portions of lipids or fats can block the blood supply to the bones. Hence, blood cholesterol levels should be kept low.
• Monitoring usage of steroids – Doctors should be informed about any usage of steroids whether in the past or in the present. High doses of steroids, when taken repeatedly, can greatly increase the propensity for bone damage.

Avascular Necrosis Pictures

These images will give you a clearer idea of the condition of the bones and joints affected by this disorder.

Picture 1 – Avascular necrosis

Picture 2 – Avascular necrosis Image

With proper treatment and rest, it is possible for Avascular necrosis patients to have a good prognosis.

References:

http://www.mayoclinic.com/health/avascular-necrosis/DS00650

http://www.niams.nih.gov/health_info/osteonecrosis/

http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0004519/

http://emedicine.medscape.com/article/86568-overview

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