DOC I HAVE SEPTIC ARTHRITIS
Septic Arthritis is an infection of the joint by pyogenic bacteria.
The most common causes of Septic Arthritis is
1.Staphylococcus aureus bacteria(80%).
Other bacteria involved are:
2.Streptococci Group A & B
3.Enterobacter species
4.Haemophilus influenzae
5.Pneumococci
6.Pseudomonas
Anerobic infections may also cause Septic Arthritis.
Predisposing conditions of Septic Arthritis are:
1.injury to the joint is the most common cause.
The joint injury is exposed to local infection in the skin or environment.
Staphylococcus aureus is the most common bacteria in Septic Arthritis resulting from bone injury and infection.
2.Diabetes mellitus in adults.
3.rheumatoid arthritis
4.steroid therapy
5.Joint infection in adults are usually due to their lower resistance from
a.debilitation,
b.intravenous drug abuse,
c.infectious root-canaled teeth,
d.other disease or drugs (e.g. immunosuppressive therapy).
Symptoms of Septic Arthritis:
1.pain and swelling of the joint
Joint is hot, swollen with effusion, very tender and limited mobility
2.fever and chills
3.systemic signs of infection
Signs of Septic Arthritis:
1.Hot tender joints
2.Throbbing pain of bones in joints
3.Abscess and swelling
Diagnosis of Septic Arthritis is often based on
1.Blood ESR is raised and high polymorph leucocytes
2.Blood and joint fluid cultures are normally required to identify the specific pathogen
3.X-rays are normal at first but later show osteoporotic changes
The complications of Septic Arthritis are:
1.damage of the bones in the joint,
2.osteomyelitis
3.sepsis
Treatment of Septic Arthritis:
1.antibiotic therapy - must be started immediately even before culture results are back and continued usually as prolonged treatment lasting a matter of weeks or months until the infection is clear.
2.Splinting or immobilization of the affected joint to prevent movement
3.Aspirations of the infected joint fluids
4.Hyperbaric oxygen therapy has helped in the treatment of refractory Septic Arthritis.
5..Septic Arthritis may also need open surgical debridement to remove pus and damaged bone tissues if infection do not respond to antibiotics.
6.Physiotherapy may be required to restore joint range and muscles once the infection has cleared up.
6.Severe cases may lead to the loss of a limb.
Prognosis of Septic Arthritis depends on the rapidity of onset of treatment.
The faster the treatment the faster the cure.
Otherwise the condition may become a chronic illness requiring multiple surgical procedures.
Prevention of Septic Arthritis is to avoid infection of the skin near the joints or injury to the joints.
Treatment of underlying conditions such as diabetes is important.
Monday, October 10, 2011
Saturday, October 8, 2011
A Family Doctor's Tale - GANGLION
DOC I HAVE A GANGLION
GANGLION or ganglion cyst is a cyst found next to tendon sheath or joint.
It may occur at any part of the body but is most common on the dorsum of the hand or foot.
The cause of the ganglion is unknown but the cyst contains a mucinous material like from a tendon sheath or joint.
It has a stalk that can be traced to a tendon sheath or joint.
Ganglion cysts are seen in children but frequently disappear spontaneously in this age group in 2 to 3 years.
Symptoms of the ganglion cyst:
1.The onset is usually related to a history of trauma.
2.local pain and swelling at the dorsum of affected hand or foot
3..feeling of weakness of the affected hand or foot
4.swelling usually increase in size in relation to activity of patient.
Physical examination of the ganglion cyst:
1.hard swelling on the dorsum of hand or foot often described as a small bony swelling
2.the ganglion is freely movable on the affected hand or foot
3.the ganglion is most obvious when the hand or foot is flexed.
Treatment of the ganglion cyst:
1.Aspiration of the ganglion cyst under local anesthesia.
2.Punctuate the ganglion with a large sterile needle in many areas in the hope that the mucinous fluid may be forced out through the many needle holes
3.injection of the ganglion cyst can be done with a steroid compound
4.After the above procedures, a compression dressing is applied for 48 to 72 hours.
5.Some alternative medical advocates even suggest hitting the ganglion cyst with a wooden hammer to burst the cyst and allow the fluid to flow out under the skin.
Surgery:
1.Surgery is done only as a last resort or if symptoms persist.
Excision of the ganglion is done under local anesthesia however occasional damage to the nerve or tendon may complicate the surgery.
Prognosis:
generally good but recurrence are not uncommon.
GANGLION or ganglion cyst is a cyst found next to tendon sheath or joint.
It may occur at any part of the body but is most common on the dorsum of the hand or foot.
The cause of the ganglion is unknown but the cyst contains a mucinous material like from a tendon sheath or joint.
It has a stalk that can be traced to a tendon sheath or joint.
Ganglion cysts are seen in children but frequently disappear spontaneously in this age group in 2 to 3 years.
Symptoms of the ganglion cyst:
1.The onset is usually related to a history of trauma.
2.local pain and swelling at the dorsum of affected hand or foot
3..feeling of weakness of the affected hand or foot
4.swelling usually increase in size in relation to activity of patient.
Physical examination of the ganglion cyst:
1.hard swelling on the dorsum of hand or foot often described as a small bony swelling
2.the ganglion is freely movable on the affected hand or foot
3.the ganglion is most obvious when the hand or foot is flexed.
Treatment of the ganglion cyst:
1.Aspiration of the ganglion cyst under local anesthesia.
2.Punctuate the ganglion with a large sterile needle in many areas in the hope that the mucinous fluid may be forced out through the many needle holes
3.injection of the ganglion cyst can be done with a steroid compound
4.After the above procedures, a compression dressing is applied for 48 to 72 hours.
5.Some alternative medical advocates even suggest hitting the ganglion cyst with a wooden hammer to burst the cyst and allow the fluid to flow out under the skin.
Surgery:
1.Surgery is done only as a last resort or if symptoms persist.
Excision of the ganglion is done under local anesthesia however occasional damage to the nerve or tendon may complicate the surgery.
Prognosis:
generally good but recurrence are not uncommon.
Thursday, October 6, 2011
A Family Doctor's Tale - ARTICULAR CARTILAGE INJURY
DOC I HAVE ARTICULAR CARTILAGE INJURY
Articular Cartilage Injury is a common disorder of the knee caused by damage of the surface of the cartilage covering of the knee.
It can also occur from wear and tear through repeated friction of the cartilage resulting in chronic wear and tear or direcr trauma.
The carticular cartilage acts to allow frictionless movement of the bone against another and performs also as a shock absorber during weight bearing activities.
The causes of Articular Cartilage Injury are:
Several conditions has been blamed:
1.Repetitive movements of the knee-soccer players who use repetitive movements are at higher risk of Articular Cartilage Injury as well as meniscus tears.
2.Chronic wear and tear- with age the blood supply to the knee is reduced resulting in degeneration of the the articular cartilage of the knee.
3.trauma - injury to the articular cartilage such as a fall or direct hit to the knee
4.Obesity cause more weight bearing effect on the articular cartilage
The symptoms and signs of Articular Cartilage Injury are:
Symptoms:
1.Recurrent Pain in the knee
2.Swelling of the knee
3.Difficulty in bending or straightening the knee
4.audible clicks on knee movement
5.difficulty in walking because of the pain
Diagnosis:
1.history of a fall or injury followed by limitation of movement of the knee
2.MRI will show if there is articular cartilage damage
The Treatment of Articular Cartilage Injury is:
Conservative treatment:
1.rest,elevation and ice compress treatment of the knee upon injury
2.Pain killers such as NSAID(non-steroidal anti-inflammatory drugs) for pain relief and reducing inflammation
3.Muscle relaxant to relax muscles
4.crutches can reduce the weight off the affected limb
5.Physiotherapy such as traction, shortwave diathermy help to increase knee muscle strength and improve flexibility of movement of the knee
Surgery is usually indicated in Articular Cartilage Injury if the condition does not improve with conservative treatment.
1.A keyhole or arthroscopic microfracture repair is done to fill the defect in the cartilage with stem cells
2.Osteochondral graft transfer techniques where plugs of cartilage together with the bone foundation are taken from a less critical of the knee and transplanted to cover the defect in the cartilage.
3.Autologous cartilage implantation techniques where cartilage cells harvested from the knee , grown and multiplied in the laboratory are tranfered back into the joint to cover the defect.
Physiotherapy starts the day after surgery.
Prognosis depends on the severity of the cartilage injury
In most cases Articular Cartilage Injury may recover with conservative methods.
Some cases however may require surgical treatment
Prognosis is good after surgical treatment.
Prevention is to avoid weight bearing, reduce obesity and muscle strengthening exercises.
Articular Cartilage Injury is a common disorder of the knee caused by damage of the surface of the cartilage covering of the knee.
It can also occur from wear and tear through repeated friction of the cartilage resulting in chronic wear and tear or direcr trauma.
The carticular cartilage acts to allow frictionless movement of the bone against another and performs also as a shock absorber during weight bearing activities.
The causes of Articular Cartilage Injury are:
Several conditions has been blamed:
1.Repetitive movements of the knee-soccer players who use repetitive movements are at higher risk of Articular Cartilage Injury as well as meniscus tears.
2.Chronic wear and tear- with age the blood supply to the knee is reduced resulting in degeneration of the the articular cartilage of the knee.
3.trauma - injury to the articular cartilage such as a fall or direct hit to the knee
4.Obesity cause more weight bearing effect on the articular cartilage
The symptoms and signs of Articular Cartilage Injury are:
Symptoms:
1.Recurrent Pain in the knee
2.Swelling of the knee
3.Difficulty in bending or straightening the knee
4.audible clicks on knee movement
5.difficulty in walking because of the pain
Diagnosis:
1.history of a fall or injury followed by limitation of movement of the knee
2.MRI will show if there is articular cartilage damage
The Treatment of Articular Cartilage Injury is:
Conservative treatment:
1.rest,elevation and ice compress treatment of the knee upon injury
2.Pain killers such as NSAID(non-steroidal anti-inflammatory drugs) for pain relief and reducing inflammation
3.Muscle relaxant to relax muscles
4.crutches can reduce the weight off the affected limb
5.Physiotherapy such as traction, shortwave diathermy help to increase knee muscle strength and improve flexibility of movement of the knee
Surgery is usually indicated in Articular Cartilage Injury if the condition does not improve with conservative treatment.
1.A keyhole or arthroscopic microfracture repair is done to fill the defect in the cartilage with stem cells
2.Osteochondral graft transfer techniques where plugs of cartilage together with the bone foundation are taken from a less critical of the knee and transplanted to cover the defect in the cartilage.
3.Autologous cartilage implantation techniques where cartilage cells harvested from the knee , grown and multiplied in the laboratory are tranfered back into the joint to cover the defect.
Physiotherapy starts the day after surgery.
Prognosis depends on the severity of the cartilage injury
In most cases Articular Cartilage Injury may recover with conservative methods.
Some cases however may require surgical treatment
Prognosis is good after surgical treatment.
Prevention is to avoid weight bearing, reduce obesity and muscle strengthening exercises.
Tuesday, October 4, 2011
A Family Doctor's Tale - FLAT FOOT
DOC I HAVE FLAT FOOT
Flat Foot is a common disorder of the foot characterized by the depression or loss of the medial longitudinal arch of the foot.
It is usually associated with valgus of the foot or eversion of the heel and abduction of the forefoot.
It is also associated with a tight Achilles tendon.
The cause of Flat Foot is :
1.hereditary and associated with hypermobilty of the other joints
2.a rupture of the posterior tibial tendon
Symptoms:
1.Pain in the foot especially when standing for a prolonged period
2.easy fatigabilty of the foot.
3.Certain weight bearing exercises like jogging or brisk walking makes the pain worse
Signs:
1.absence of the medial arch is present
2.hypermobility of the foot is apparent
3.mild genu valgum (knock knee) or internal tibial torsion is also present.
4.Xrays of the foot usually show a loss of the normal arch and plantar flexion of the talus.
Complications:
1.mild deformity of the foot
2.strain on the back (lumbar spine) with prolonged standing
3.heel cord contractures
Conservative treatment:
1.no treatment is usually necessary if mild
2.shoe correction may help temporarily
3.Exercises to stretch and loosen tigh heel cords
4.Pain killers such as NSAID(non-steroidal anti-inflammatory drugs) for pain
5.Muscle relaxant to relax muscles especially the back
Surgery:
Surgery is usually not indicated in Flat Foot.
Rarely surgery is to tighten the muscles supporting the medial arch of the foot only for severe cases with symptoms of pain and to prevent complcations.
Prognosis:
There is no cure for flat foot but surgery may help in severe cases to prevent complcations.
Prevention:
avoid prolonged standing
use shoes with medial arch correction pads
Flat Foot is a common disorder of the foot characterized by the depression or loss of the medial longitudinal arch of the foot.
It is usually associated with valgus of the foot or eversion of the heel and abduction of the forefoot.
It is also associated with a tight Achilles tendon.
The cause of Flat Foot is :
1.hereditary and associated with hypermobilty of the other joints
2.a rupture of the posterior tibial tendon
Symptoms:
1.Pain in the foot especially when standing for a prolonged period
2.easy fatigabilty of the foot.
3.Certain weight bearing exercises like jogging or brisk walking makes the pain worse
Signs:
1.absence of the medial arch is present
2.hypermobility of the foot is apparent
3.mild genu valgum (knock knee) or internal tibial torsion is also present.
4.Xrays of the foot usually show a loss of the normal arch and plantar flexion of the talus.
Complications:
1.mild deformity of the foot
2.strain on the back (lumbar spine) with prolonged standing
3.heel cord contractures
Conservative treatment:
1.no treatment is usually necessary if mild
2.shoe correction may help temporarily
3.Exercises to stretch and loosen tigh heel cords
4.Pain killers such as NSAID(non-steroidal anti-inflammatory drugs) for pain
5.Muscle relaxant to relax muscles especially the back
Surgery:
Surgery is usually not indicated in Flat Foot.
Rarely surgery is to tighten the muscles supporting the medial arch of the foot only for severe cases with symptoms of pain and to prevent complcations.
Prognosis:
There is no cure for flat foot but surgery may help in severe cases to prevent complcations.
Prevention:
avoid prolonged standing
use shoes with medial arch correction pads
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