Anterior Cruciate Ligament (ACL) tear

A very common injury to the knee is an ACL tear. The knee has four ligaments that help provide stability to the knee, and one of the ligaments is the ACL.
Athletes are generally more prone to having an ACL tear, although, it can happen to anyone. It's due to excessive force that is placed on the knee and sudden pivots causing excessive force.
Symptoms:
-giving of the knee
-hearing a "pop" when the injury occurs
-swelling of the knee joint
-pain
Testing for an ACL tear can include
-Lachman test
-pivot shift maneuver
other tests include x-rays and MRI to check the ligaments. Although, most people don't need a MRI to diagnose an ACL tear, it can often times be diagnosed clinically.
Treatment includes;
-generally surgery
-physical therapy.

Bankart Lesion

Bankart lesions occur when there is a tear or detachment of the labrum. When this injury occurs there is a lot of instability of the shoulder joint. This can be caused by a dislocation.
Symptoms include:
-repeat dislocation
-shoulder pain
-a catching sensation
-instabilit especially when the arm is placed behind their head.
Treatment includes:
-rest and physical therapy
-surgical repair of the labrum which is generally done arthroscopically.
Diagnosis can be made via MRI or CT with MRI being the better test.
This was very interesting to me because as I was listening to the lecture, I felt that you were describing my symptoms with the exception of the dislocation. I injured my shoulder and whenever I tried to put my arm behind my head I felt as if it was going to dislocate. This had been going on since February of this year, it is slowly getting better. Did not ever have an actual diagnosis because I did not go to the doctor.

Uterine Fibroids

Fibroids are non cancerous growths that occur in the uterus. Fibroid occur in about every 3-4 women.
Symptoms:
-pain
-leg pain
-constipation
-urinary incontinence
Testing includes:
-routine pelvic exam
-US,CT, or MRI with ultrasound being the better exam
Treatment includes:
-medication
-myomectomy
-hysterectomy

Pancreatitis

Pancreatitis is either chronic or acute, generally both the patient experiences severe pain.
Symptoms include:
acute - nausea and vomiting, rapid pulse, fever, tender abdomen.
chronic - all of the above and also including weight loss
Causes of pancreatitis include: alcohol abuse, genetic factors, abdominal trauma, increased levels of fats and calcium
Men are at more risk than women to develop pancreatitis and more often occurs in the black population.
Testing includes: blood work, CT, US
Treatment includes: alcohol control, medication for pain, dietary changes.

Aortic Dissection

When the inner layers of the aorta's wall split open it is called a dissection.
An acute dissection can cause chest pain which is sudden in nature.
It most often occurs in men between the ages of 50-55 for a proximal dissection and 60-70 years of age in a distal dissection.
Treatment:
-admission to the hospital
-meds to lower blood pressure and heart rate
-and in some cases surgery

Adding blog

I hope you see these blogs. I tried to email you two times to add my name to the blog list. So I just finally decided to go under the clinicals webblog to get to my procedures post.

Tethered Spinal Cord

Tethered spinal cord is a neurological condition in which the spinal cord is attached which limits the movement of the spinal cord within the spinal column. The spinal cord can be abnormally stretched which can cause neurological symptoms.
Symptoms in children include:
-leisons, hair patches, dimples, and fatty tumors on the lower back
-foot and spinal deformities
-low back pain
-scoliosis
-incontinence
Symptoms in undiagnosed adults include:
-motor and sensory problems
-loss of bowel control
-loss of bladder control
Imaging procedures include plain xrays, CT, and MRI, with MRI being the better imaging modality.
Treatment is generally surgical repair.

Thoracic Tumors

Although rare, spinal tumors do occur. They can be malignant or benign. They can be dangerous because of the possibility of compression of the spinal canal which could lead to paralysis.
Some benign tumors include:
-osteochondroma
-osteoblastoma
-giant cell tumors
-hemangioma
Some malignant tumors include
-plasmacytoma
-Ewing's sarcoma
-lymphoma
-chondrosarcoma
-chondroma
Diagnosis can be mad through x-rays and a CT or MRI can provide further detail. Treatment could be surgical or non surgical using bracing, chemotherapy, radiation therapy or embolyzation.

HERNIATED DISK

Although most herniations occur in the lumbar region they can also occur in the cervical region. Signs of herniation include weakness or numbness in an extremity and pain. Risk factors to herniation include: age, smoking, weight, diabetic and occupaional strain. Diagnosing tests can range from MRI, CT, myelogram, xrays. Although not life treatening it can cause a lot of pain , loss of movement, and loss of sensation. Treatment for herniation can range from modified activity, physical therapy, hot or cold compresses, medication for pain, rest and in some cases surgery.

GOITER

When the thyroid gland is enlarged it is called a goiter, if goiters get to large they may interfere with breathing and swallowing.
Women more often than men develop goiters.
A symptom of a goiter is an enlargement of the neck.
Diagnosing a goiter can be made from different tests such as a hormone blood test, MRI, CT, Ultrasound or thyroid scan.
Treatment can range from observation, medications surgery, and in come cases radioactive iodine.
Goiters are not life threating.

ANEURYSM

Aneurysms are a ballooning or widening of a vessel, normally it occurs in the circle of Willis. Aneurysms are generally an acquired problem and possibly genetic in nature. Some health conditions are associated with aneurysms are:
- Marfan Syndrome
- polycystic kidney disease
- neurofibromatosis
- high blood pressure
- tobacco use
- alcohol consumption
Some symptoms of a ruptured aneurysm are:
- severe headache
- stiff neck
- vomiting
- nausea
- altered mental status
Diagnostic test that can be performed are as follows:
- MRI
- CT
- Lumbar puncture
- cerebral angiogram

Sinusitis

Swelling or inflammation of the tissues of the sinus is called sinusitis.
Sinusitis occurs when the sinuses become fluid filled and germs can grow causing an infection. There are several types of sinusitis depending on the duration ranging from acute to chronic. Anyone is at risk for developing sinusitis.
Syptoms inlcude
*pain or presure in the face
*nasal congestion
*fever
*cough
*bad breath
*headaches
Treatment can range from moist warm air and over the counter decongestants and in some cases antibiotics can be perscribed, generally this is no longer the case. In rare instances sinus surgery may be necessary to drain the infection from the sinus cavity.
CT is the better imaging modality for diagnosing sinusitis.

Optic Neuritis

When the optic nerve gets inflammed it's called optic neuritis. It can be brought on by in infection (viral) or from an auto immune disease.
Symptoms of optic neuritis includes:
-vision loss
-most experience pain while moving the eye
The first symptom that may occur in about 20 percent of people who are going to get Multiple Sclerosis is optic neuritis.
MRI is the better screening tool to use to diagnose optic neuritis.
Generally optic neuritis resolves itself, but steroids may be used for treatment of the inflamation.
In about two to six months people return to their normal vision.

Images obtained from:
http://www.emedicine.com/oph/topic186.htm

Empty Sellar Syndrome

Empty sellar syndrome is when the pituitary gland, chich sits in the sella turcica has shrunk or has been flattened.
Symptoms of Empty Sellar Syndrome are
-possible elevated prolactin levels
-headache
-vision problems
MRI and CT both can be used as a diagnostic test for Empty Sellar Syndrome.
There are usually no adverse health effects and a normal life expectancy is expected with this disorder.

image from
http://www.gfmer.ch/selected_images_v2/detail_list.php?cat1=23&cat3=208&stype=d

Mastoiditis

Mastoiditis generally results from an infection of the middle ear that moves into the mastoid bone area.
Children get mastoidits more often than adults.
To treat mastoiditis generally antibiotics are given. In some cases surgery will be performed so the mastoid can be drained, although, not common.