Thoracic Spondylosis

Thoracic spondylosis is basically disc degeneration. There are several different types of spondylosis, so I going to try to keep this pretty generic so that I don't get them confused.

Thoracic spondylosis is a narrowing of the disc space between vertebrae. This can lead to disc herniation or bulging. This condition is associated with age, and men are usually diagnosed 10 years earlier than women. Xrays or MRI's can be performed to evaluate the severity.

The symptoms are pain in the midsection, mainly the chest and upper abdomen. It is especially demonstrated in flexion and hyperextension of the back. There may also be radiating pain in extremities depending on the location. Muscle weakness and tingling are also common.

One treatment is arthroscopic laser foremenoplasty. This is performed under low level local sedation. It is done to decompress the affected nerve root.

References:

www.eorthopod.com

www.spinaldisorders.com

Clay Shoveler's Fracture

Clay Shoveler's Fracture is a type of avulsion fracture that is usually stable. It is most commonly seen in laborers that lift weight rapidly with their arms extended, like shoveling or pulling roots. During this excessive hyperflexion the trapezius and rhomboid muscles pull on the spine at the base of the neck, and it actually tears off the bone. The most common area for this is at C6, C7 and T1.

If you are unlucky enough to be on the receiving end of this fracture, then you will feel a burning knife like pain between your shoulder blades. After X-rays determine that you have this fracture, then expect to be in a hard collar for at least 10 days until you once again have good flexion and extension of your neck and a strong callus present.

It can take days or weeks to heal. Even after most of the pain is gone, it is still common to have pain when your arms are outstretched for long periods of time. If your pain seems to last longer, then surgery can be performed to remove the tip. Otherwise, pain medicine, physical therapy, and massage is used for pain relief.

References:
http://www.medterms.com/
http://www.wheelessonline.com/
http://brighamrad.harvard.edu/Cases/bwh/images/123/Alia8Arrow.GIF
http://faculty.washington.edu/alexbert/MEDEX/Winter/ch264fg7.jpg

Carotid body tumors

Carotid body tumors (chemodectomas) are vascular tumors. They start at the paraganglionic cells on the outer layer of the carotid artery and develop where the artery bifurcates into the internal and external carotid arteries. Most often these tumors are benign, but in 5-10% of cases they are malignant. These tumors can grow pretty large before they cause symptoms like a painless pulsating mass in the neck and difficulty swallowing. Surgery is usually performed for treatment, and radiation therapy may also be used.

Carotid body tumors are usually hereditary and are more common in South America. Only about 10% of tumors are on both sides of the carotid artery. They are diagnosed through CT, MRI, and angiography.

Reference:
http://www.mskcc.org/mskcc/html/5486.cfm

www.mayoclinicproceedings.com/images/7905/790...425 x 424 - 43k

Sjogren's Syndrome

• Sjogren's ( show grins) syndrome is an autoimmune disorder that is often accompanied by a connective tissue disorder such as rheumatoid arthritis or lupus. The cause is unknown, but factors such as heredity, hormones, infection, and the nervous system can play a part. With this syndrome, the white blood cells attack the moisture producing glands, and in rare cases may even damage lungs, kidneys, and liver. If you have primary Sjogren's, then there is no direct cause, but if you have secondary Sjogren's then it may be from another disease.
  
  This syndrome is hard to diagnose because it mimics other diseases and medication side effects. However, it is more common in women, especially over the age of 40. Signs and symptoms include:



• dry eyes and mouth



• dental cavities



• fatigue



• enlarged parotid gland



• difficulty swallowing/chewing



• change in sense of taste



• hoarseness



• oral yeast infections



• skin rashes or dry skin



• vaginal dryness



• dry, non productive cough



• joint pain, swelling, and stiffness
  

There are different screening tests to diagnose Sjogrens. These include, blood test, eye test, imaging (sialogram, salivary scintigraphy, and chest xray), biopsy, urine sample, and slit lamp exam.

Complications are similar to symptoms, but in rare instance people may develop lymphoma, and peripheral nervous system disorders.

There is no cure, but you can treat the symptoms with a variety of medication. Surgery is sometimes and option. It is also important to increase fluid intake, use of moisturizers, eye drops, and nasal sprays, and have increased humidity.

Sources:

mayoclinic.com

www.orthop.washington.edu

Achondroplasia

Achondroplasia is the most common type of short limbed dwarfism. It is a disorder in bone growth. Though achondroplasia literally means " without cartilage formation," the problem is really the cartilage not forming into bone, especially in the long bones.

Achondroplasia is caused by a FGFR3 mutation. This gene provides the instructions for making a protein that is involved in the development and maintenance of bone and brain tissue. The mutations cause the gene to be overly active. A fetal ultrasound can be done to diagnose this condition, or a physical can be performed once the child is born.

This disorder is inherited through an autosomal dominant pattern, and a parent with achondroplasia has a 50% chance of their child being born with the same disorder. However, 80% of children are born to average size adult parents because of the mutation somewhere in the family genes.

People with achondroplasia are short in stature. The average male is 4'4" and the average female is 4'1". They have an average trunk size, but short arms and legs, especially upper arms and thighs, and have limited elbow movement. They also have an enlarged head and prominent forehead, sway back and bowed legs. People with achondroplasia are prone to having breathingproblems, obesity, and ear infections.


There is no cure or way to prevent for achondroplasia.

References:
http://www.healthsystem.virginia.edu/UVAHealth/peds_diabetes/achondro.cfm
http://ghr.nlm.nih.gov/condition=achondroplasia
http://www.radpod.org/2007/03/30/achondroplasia/
www.lucinafoundation.org

Orbital Blow Out Fractures

An orbital blow out fracture is when the "eye socket" is fractured. The most common injury is done to the floor of the socket, but the wall and roof may also be affected. Blow out fractures are usually a result of blunt force trauma to the eye. The orbital rim is so strong that the impact is usually transferred to the floor of the orbit, which then "blows out." A CT is usually done to better see the fracture. A blow out fracture is evident because it most commonly goes down into the maxillary sinus.

A person with a blow out fracture will experience pain and tenderness around the eye, swelling, and in some cases double vision. If there is double vision, the extra ocular muscles that move the eye may be trapped in the fracture, or it could be due to the swelling and hemorrhaging around the eye. Surgery may be performed within a few days or up to 1-2 weeks is there is muscle entrapment or double vision. During that time, it is recommended that a person not blow their nose. Oral antibiotics may also be given to reduce the chance for infection.

Information was found at http://www.eyemdlink.com/
Picture was found at http://www.learningradiology.com/

Coat's Disease

As seen in my other blogs, I think that I have a knack for choosing pathologies that deal with children or seem to affect pregnant mothers. It is completely coincidental. And yet, I have still managed to randomly pick another that falls within this criteria.

Coat's disease (Exudative Retinitis) is a disorder that affects the retina of the eye. It usually starts as an abnormal growth spurt in the capillaries that supply blood to the retina. It is a progressive disease and is usually found in children, especially boys, within the first ten years of life. In some cases, it is found in young adults. There is no known cause.

Symptoms are vision loss, primarily central vision, but peripheral vision may also be affected. It can lead to mild or total blindness. However, only one eye is usually affected.

These abnormal blood vessels may dilate, malform, or leak, which may cause the retina to swell.

The leaking blood vessels may be treated with laser surgery or cryotherapy. In severe cases, if the retina becomes detached, a virectomy may be performed to replace the vitreous with a gas bubble that can help restore vision. In some cases, the disease may stop progression on its own.

Diagnosis of Coat's disease can be accomplished by looking at the back of the eye, as well as performing fluorescein angiography by injecting contrast to see the blood circulation in the back of the eye. MRI, CT and Ultrasound are also useful.

" Coat’s disease. Color Doppler USG (a) shows a large retinal detachment with hypoechoic subretinal exudates. CT (b) shows diffuse increase in the intraocular density"

Sources:

http://www.rnib.org.uk/xpedio/groups/public/documents/PublicWebsite/public_rnib003642.hcsp

http://www.palmettoretina.com/learn/conditions/coats_disease.html

Image Source:

http://www.ijo.in/viewimage.asp?img=IndianJOphthalmol_2006_54_4_227_27946_29.jpg