#peripheral ankylosing spondylitis

[standtall-always]

Constant acute physical pain destroys you in a way nothing else can.

[does-truth-matter]

The CDC has quietly changed who should AVOID the MMR vaccine.

https://www.cdc.gov/vaccines/vpd/mmr/public/index.html

They now state that ANYONE that “Has a parent, brother or sister with a history of immune system problems” should AVOID THE MMR VACCINE!

What exactly is an 'immune system problem?" Every autoimmune disorder.

* Achalasia

* Addison’s disease

* Adult Still's disease

* Agammaglobulinemia

* Alopecia areata

* Amyloidosis

* Amyotrophic lateral sclerosis (Lou Gehrigs)

* Ankylosing spondylitis

* Anti-GBM/Anti-TBM nephritis

* Antiphospholipid syndrome

* Autoimmune angioedema

* Autoimmune dysautonomia

* Autoimmune encephalomyelitis

* Autoimmune hepatitis

* Autoimmune inner ear disease (AIED)

* Autoimmune myocarditis

* Autoimmune oophoritis

* Autoimmune orchitis

* Autoimmune pancreatitis

* Autoimmune retinopathy

* Autoimmune urticaria

* Axonal & neuronal neuropathy (AMAN)

* Baló disease

* Behcet’s disease

* Benign mucosal pemphigoid

* Bullous pemphigoid

* Castleman disease (CD)

* Celiac disease

* Chagas disease

* Chronic inflammatory demyelinating polyneuropathy (CIDP)

* Chronic recurrent multifocal osteomyelitis (CRMO)

* Churg-Strauss Syndrome (CSS) or Eosinophilic Granulomatosis (EGPA)

* Cicatricial pemphigoid

* Cogan’s syndrome

* Cold agglutinin disease

* Congenital heart block

* Coxsackie myocarditis

* CREST syndrome

* Crohn’s disease

* Dermatitis herpetiformis

* Dermatomyositis

* Devic’s disease (neuromyelitis optica)

* Discoid lupus

* Dressler’s syndrome

* Endometriosis

* Eosinophilic esophagitis (EoE)

* Eosinophilic fasciitis

* Erythema nodosum

* Essential mixed cryoglobulinemia

* Evans syndrome

* Fibromyalgia

* Fibrosing alveolitis

* Giant cell arteritis (temporal arteritis)

* Giant cell myocarditis

* Glomerulonephritis

* Goodpasture’s syndrome

* Granulomatosis with Polyangiitis

* Graves’ disease

* Guillain-Barre syndrome

* Hashimoto’s thyroiditis

* Hemolytic anemia

* Henoch-Schonlein purpura (HSP)

* Herpes gestationis or pemphigoid gestationis (PG)

* Hidradenitis Suppurativa (HS) (Acne Inversa)

* Hypogammalglobulinemia

* IgA Nephropathy

* IgG4-related sclerosing disease

* Immune thrombocytopenic purpura (ITP)

* Inclusion body myositis (IBM)

* Interstitial cystitis (IC)

* Juvenile arthritis

* Juvenile diabetes (Type 1 diabetes)

* Juvenile myositis (JM)

* Kawasaki disease

* Lambert-Eaton syndrome

* Leukocytoclastic vasculitis

* Lichen planus

* Lichen sclerosus

* Ligneous conjunctivitis

* Linear IgA disease (LAD)

* Lupus

* Lyme disease chronic

* Meniere’s disease

* Microscopic polyangiitis (MPA)

* Mixed connective tissue disease (MCTD)

* Mooren’s ulcer

* Mucha-Habermann disease

* Multifocal Motor Neuropathy (MMN) or MMNCB

* Multiple sclerosis

* Myasthenia gravis

* Myositis

* Narcolepsy

* Neonatal Lupus

* Neuromyelitis optica

* Neutropenia

* Ocular cicatricial pemphigoid

* Optic neuritis

* Palindromic rheumatism (PR)

* PANDAS

* Parkinson's disease

* Paraneoplastic cerebellar degeneration (PCD)

* Paroxysmal nocturnal hemoglobinuria (PNH)

* Parry Romberg syndrome

* Pars planitis (peripheral uveitis)

* Parsonage-Turner syndrome

* Pemphigus

* Peripheral neuropathy

* Perivenous encephalomyelitis

* Pernicious anemia (PA)

* POEMS syndrome

* Polyarteritis nodosa

* Polyglandular syndromes type I, II, III

* Polymyalgia rheumatica

* Polymyositis

* Postmyocardial infarction syndrome

* Postpericardiotomy syndrome

* Primary biliary cirrhosis

* Primary sclerosing cholangitis

* Progesterone dermatitis

* Psoriasis

* Psoriatic arthritis

* Pure red cell aplasia (PRCA)

* Pyoderma gangrenosum

* Raynaud’s phenomenon

* Reactive Arthritis

* Reflex sympathetic dystrophy

* Relapsing polychondritis

* Restless legs syndrome (RLS)

* Retroperitoneal fibrosis

* Rheumatic fever

* Rheumatoid arthritis

* Sarcoidosis

* Schmidt syndrome

* Scleritis

* Scleroderma

* Sjögren’s syndrome

* Sperm & testicular autoimmunity

* Stiff person syndrome (SPS)

* Subacute bacterial endocarditis (SBE)

* Susac’s syndrome

* Sympathetic ophthalmia (SO)

* Takayasu’s arteritis

* Temporal arteritis/Giant cell arteritis

* Thrombocytopenic purpura (TTP)

* Tolosa-Hunt syndrome (THS)

* Transverse myelitis

* Type 1 diabetes

* Ulcerative colitis (UC)

* Undifferentiated connective tissue disease (UCTD)

* Uveitis

* Vasculitis

* Vitiligo

* Vogt-Koyanagi-Harada Disease

Wonder how many doctors are paying attention?

~shared from Jodi Wilson

[crippleprophet]

Hey Mac, I hope this finds you on a good day <3

I was wondering if you knew anything about peripheral neuropathy? I ran into it a while ago when looking up one of my numerous problems and since then have realized it could well explain many of my issues! The issue being said issues started when I was a small child and everything i'm finding with any information I can acrually parse on it is only mentioning things like Guillain-Barre Arthritis and Cancer- things either unlikely in a child of 8 or to last undiagnosed or treated for 20 years.

If you know anything or can point me in a good direction to go on a deep dive about it I'd appreciate it! I hope the rest of your day/night is gentle on you.

hey, thank you <33 this is really interesting & concerning to me because once again information about incredibly common experiences is so hard to come by – i’ve experienced peripheral neuropathy for a couple years which i’m on medication for (duloxetine, generic of cymbalta), and while i haven’t dedicated a ton of research to that specifically, i have definitely come across information when researching other conditions, and basically my understanding is it can be caused by most autoimmune diseases.

probably the first thing most people will think of from the words “peripheral neuropathy” is diabetes, which mostly happens in the feet, i believe due to lower circulation because that’s the case for most foot impairments in diabetics. neuropathy can definitely be experienced in things like (juvenile in your case) rheumatoid arthritis, ankylosing spondylitis, lupus, etc, either as a primary symptom or through secondary symptoms-the-medical-establishment-labels-fibromyalgia.

i know a lot of sick/crip spaces encourage looking into small fiber neuropathy (SFN) as well so that may be a starting point for you. an additional tactic i’d probably try if you haven’t already is like, “[something you think you might have],” for example “juvenile RA,” + “neuropathy” in PubMed & seeing where that takes you… again it’s such a common symptom that we really don’t understand enough about but that could hopefully turn up something that resonates with your experiences.

feel free to send another ask or dm me if there’s anything i can do to help! other folks feel free to chime in with suggestions if you have them. best of luck to you & i hope you find something helpful <33

[standtall-always]

I don't have cancer, I've AS (ankylosing spondylitis).

[firstmedicaldiagnosticspvtltd]

Hypertension, inflammation and IgG antibodies

Hypertension (HT) is the leading preventable cause of premature death worldwide, and about every third person suffers from hypertension (1). In the long run, high blood pressure damages important organs such as the heart, blood vessels, the brain and the kidneys. Consequential diseases such as myocardial infarction, stroke, peripheral arterial occlusive disease, retinal damage or kidney damage result from the damaged vessels caused by high blood pressure.

Inflammation is a hallmark of hypertension, and there is a mounting evidence suggesting that chronic low-grade inflammation contributes to cardiovascular disease (CVD) including HT (2–5). Endothelial dysfunction, oxidative stress, cytokines, toll-like receptors, inflammasomes, and gut microbiome interact in a complex and intricate way (6). Reducing inflammation therefore contributes to successful prevention and management of hypertension. Systemic inflammation can also be triggered by food. Proteins or protein-derived compounds that occur in food may trigger the immune response of the body. The immune system takes food proteins or derived compounds as immunogens and generates food specific IgG antibodies, which bind to food particles and then induce an inflammatory response, which may lead to various symptoms or diseases, one of which is hypertension. Continuous and repeated consumption of the same foods that trigger IgG-mediated hypersensitivity reactions may thus promote and maintain silent inflammations. IgG-mediated food hypersensitivity can therefore be a trigger in drug resistant hypertension. In a recent study with hypertensive patients it was shown that hypertension correlated with higher values for IgG and IgA, and lower values for IgM (7).

Another key study, conducted with ImuPro, compared two groups of children (obese versus normal weight children). Blood samples were tested for food-specific IgG antibodies and the inflammatory marker C-reactive protein (CRP). The obese group had two and a half times the IgG antibodies against certain foods compared with the children in the normal weight range. They also had three times the levels of CRP than the normal weight group. The excess of IgG food antigens was associated with the thickness of the intima media, a pre-atherosclerotic damage, which is an inflammation-related cause of secondary hypertension. Food-specific IgG antibodies were found to be tightly associated with low grade systemic inflammation and correlated with elevated systolic blood pressure (8). Further studies point towards the connection between CRP as the main inflammation marker and increased IgG antibodies:

Obese subjects with IgG-positive anti-Saccharomyces cerevisiae antibodies (ASCA) had both higher CRP values and body fat mass (9).

Suppression of intestinal inflammation and repair of intestinal barrier leads to decreased food induced immune responses and inflammation (10).

The serum CRP marker was correlated with foodspecific IgGs and disease activity in patients with ankylosing spondylitis (11).

In Crohn‘s disease, a high CRP value was correlated with an increased number of IgG-positive foods (12).

From the exposed, it can be assumed that food specific IgG antibodies mediate inflammatory responses, that are associated with increased CRP, a marker that exhibits a central role in the pathogenesis of hypertension (13–15).

There is evidence across a growing number of trials, showing that the elimination of IgG-reactive food results in improvements and symptom relief in a wide variety of diseases with shared inflammatory pathways (irritable bowel disease, irritable bowel syndrome and chronic diarrhoea, migraine and headache, autoimmune diseases, obesity, psychiatric disorders, asthma, allergic skin diseases, allergic rhinitis or ankylosing spondylitis). Based on these data, it can be expected that an individualized elimination diet excluding IgG-reactive foods has a beneficial effect on blood pressure in hypertensive patients.

References

Mills, K. T. et al. Global Disparities of Hypertension Prevalence and Control: A Systematic Analysis of Population-Based Studies From 90 Countries. Circulation 134, 441–50 (2016).

Nosalski, R., McGinnigle, E., Siedlinski, M. & Guzik, T. J. Novel Immune Mechanisms in Hypertension and Cardiovascular Risk. Curr. Cardiovasc. Risk

Rep. 11, (2017).

Harrison, D. G. et al. Inflammation, immunity, and hypertension. Hypertens. (Dallas, Tex. 1979) 57, 132–40 (2011).

De Miguel, C., Rudemiller, N. P., Abais, J. M. & Mattson, D. L. Inflammation and hypertension: new understandings and potential therapeutic targets. Curr. Hypertens. Rep. 17, 507 (2015).

Dinh, Q. N., Drummond, G. R., Sobey, C. G. & Chrissobolis, S. Roles of inflammation, oxidative stress, and vascular dysfunction in hypertension. Biomed Res. Int. 2014, 406960 (2014).

Barrows, I. R., Ramezani, A. & Raj, D. S. Inflammation, Immunity, and Oxidative Stress in Hypertension-Partners in Crime? Adv. Chronic Kidney Dis. 26, 122–130 (2019).

Wang, X. et al. Relationship of serum immunoglobulin levels to blood pressure and hypertension in an adult population. J. Hum. Hypertens. 32, 212–218

(2018).

Wilders-Truschnig, M. et al. IgG antibodies against food antigens are correlated with inflammation and intima media thickness in obese juveniles. Exp. Clin.

Endocrinol. Diabetes 116, 241–5 (2008).

Salamati, S., Martins, C. & Kulseng, B. Baker’s yeast (Saccharomyces cerevisiae) antigen in obese and normal weight subjects. Clin. Obes. 5, 42–7 (2015).

Xiao, N. et al. Food-specific igGs are highly increased in the sera of patients with inflammatory bowel disease and are clinically relevant to the pathogenesis. Intern. Med. 57, 2787–2798 (2018).

Niu, Q. et al. Association between food allergy and ankylosing spondylitis An observational study. Med. 98, (2019).

Kawaguchi, T. et al. Food antigen-induced immune responses in Crohn’s disease patients and experimental colitis mice. J Gastroenterol 50, 394–406

(2015).

Bautista, L. E., Vera, L. M., Arenas, I. A. & Gamarra, G. Independent associa tion between inflammatory markers (C-reactive protein, interleukin-6, and

TNF-alpha) and essential hypertension. J. Hum. Hypertens. 19, 149–54 (2005).

Nandeesha, H., Bobby, Z., Selvaraj, N. & Rajappa, M. Pre-hypertension: Is it an inflammatory state? Clin. Chim. Acta 451, 338–342 (2015).

Dodson, P. M. & Shine, B. Retinal vein occlusion: C-reactive protein and arterial hypertension. Acta Ophthalmol. 62, 123–30 (1984).

[jabishriki]

Imaging Techniques in Musculoskeletal Radiology: A Guide to Common Conditions and Effective Strategies

Musculoskeletal radiology is a specialized branch of medical imaging focused on diagnosing and managing disorders related to bones, joints, and soft tissues. It plays a crucial role in identifying various conditions, from fractures to complex diseases like arthritis. Understanding the common conditions in this field and the imaging strategies used can help practitioners and patients navigate treatment options more effectively.

Common Conditions in Musculoskeletal Radiology

Musculoskeletal radiology encompasses a wide range of conditions, many of which are common across different patient populations. One of the most frequently encountered issues is fractures. Whether due to trauma, stress, or underlying bone conditions, fractures require precise imaging to determine the extent of injury and plan appropriate treatment. Radiographs, or X-rays, are typically the first imaging modality used, providing clear visualization of bone structures.

Another common condition is osteoarthritis, a degenerative joint disease that affects millions of people worldwide. This condition is characterized by cartilage breakdown and bone structure changes, leading to pain and reduced mobility. Imaging is vital in diagnosing osteoarthritis, with X-rays being the most commonly used method. X-rays can show joint space narrowing, subchondral sclerosis, and osteophyte formation, which are hallmark signs of the disease.

Advanced Imaging Techniques for Soft Tissue Disorders

While X-rays are invaluable for assessing bone-related conditions, they are often insufficient for diagnosing soft tissue disorders. Advanced imaging techniques like magnetic resonance imaging (MRI) and Ultrasound are commonly used in these cases. MRI is particularly effective in visualizing soft tissues, such as muscles, tendons, and ligaments. It provides detailed images that help in diagnosing conditions like rotator cuff tears, ligament injuries, and muscle strains.

Ultrasound is another powerful tool in musculoskeletal radiology, especially for real-time evaluation of soft tissue conditions. It is often used to assess tendon and muscle injuries, bursitis, and nerve entrapments. Ultrasound is also helpful in guiding therapeutic injections, making it a versatile imaging modality in clinical practice. The dynamic nature of Ultrasound allows for the assessment of structures in motion, which can be particularly useful in diagnosing conditions that are position-dependent.

Role of Imaging in Diagnosing Inflammatory Conditions

Inflammatory conditions, such as rheumatoid arthritis and ankylosing spondylitis, are other critical areas where musculoskeletal radiology plays a significant role. Early and accurate diagnosis is essential for managing these chronic conditions, and imaging is a cornerstone. MRI and Ultrasound are often used to detect early signs of inflammation in joints and surrounding tissues. MRI is particularly useful for identifying synovitis, bone marrow edema, and erosions indicative of rheumatoid arthritis.

Ultrasound can also be used to detect inflammation, especially in peripheral joints. It is highly sensitive in identifying synovial thickening and increased blood flow, which are early markers of inflammatory arthritis. The ability to assess these conditions early in their course allows for timely intervention, which can prevent joint damage and improve long-term outcomes for patients.

Imaging Strategies for Tumors and Infections

Musculoskeletal radiology is also crucial in detecting and evaluating tumors and infections. Whether benign or malignant, bone tumors require detailed imaging for accurate diagnosis and staging. X-rays are often the first step, revealing abnormalities in bone structure that may suggest a tumor. However, advanced imaging techniques like MRI and Computed Tomography (CT) are necessary for further evaluation. MRI is particularly useful for assessing the extent of tumor invasion into surrounding soft tissues, while CT provides detailed images of bone architecture.

Infections of the musculoskeletal system, such as osteomyelitis, also require precise imaging for diagnosis and management. X-rays may show early signs of bone infection, but MRI is the preferred method due to its ability to detect early bone marrow changes. MRI can reveal the extent of the disease and help guide treatment decisions, such as the need for surgical intervention. In cases where an abscess is suspected, Ultrasound can guide aspiration and drainage, providing diagnostic and therapeutic benefits.

The Future of Musculoskeletal Imaging

Musculoskeletal radiology is continually evolving, with new imaging techniques and technologies that promise to enhance diagnostic accuracy and patient care. One such advancement is Dual-Energy CT (DECT), which can differentiate between various tissue types based on their chemical composition. This technology is particularly useful in assessing gout, as it can detect urate crystals in joints and soft tissues without requiring invasive procedures.

Artificial intelligence (AI) is also making its way into musculoskeletal imaging, offering the potential to improve the efficiency and accuracy of image interpretation. AI algorithms can assist radiologists in identifying patterns and anomalies that may be missed by the human eye, leading to earlier diagnosis and better treatment outcomes. As these technologies continue to develop, they promise to transform musculoskeletal radiology, making it even more effective in diagnosing and managing a wide range of conditions.

Musculoskeletal radiology is a dynamic and essential field in diagnosing and managing various conditions affecting bones, joints, and soft tissues. From fractures and degenerative diseases to tumors and infections, imaging techniques like X-rays, MRI, and Ultrasound are invaluable tools that guide clinical decision-making and patient care. As technology continues to advance, the future of musculoskeletal radiology looks promising, with innovations that will enhance the ability to diagnose conditions more accurately and treat them more effectively.

[dranubha-homeo-2]

Spondylitis and Homeopathy: Natural Pain Relief and Management

Spondylitis is a chronic inflammatory disease that primarily affects the spine and sacroiliac joints, which connect the lower spine to the pelvis. This condition can cause significant pain, stiffness, and eventually lead to the fusion of vertebrae, which severely impacts mobility and quality of life. Understanding the nature of spondylitis and exploring effective management strategies is crucial for those living with this condition.

Understanding Spondylitis

Spondylitis encompasses several forms, including:

Ankylosing Spondylitis (AS): The most common type, primarily affecting the spine and pelvis.

Psoriatic Arthritis (PsA): Associated with psoriasis, affecting the spine and peripheral joints.

Reactive Arthritis (ReA): Occurs after an infection in another part of the body.

Common symptoms of spondylitis include:

Persistent Back Pain: Often worse in the morning or after periods of inactivity.

Stiffness: Particularly in the lower back and hips.

Reduced Flexibility: Limited range of motion in the spine.

Fatigue: Chronic inflammation can lead to a general feeling of tiredness.

Conventional Treatment Approaches

Traditional treatments for spondylitis aim to reduce inflammation, manage pain, and maintain mobility. These typically include:

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Help reduce inflammation and relieve pain.

Disease-Modifying Antirheumatic Drugs (DMARDs): Slow the progression of the disease.

Biologic Agents: Target specific components of the immune system.

Physical Therapy: Improves flexibility and strength.

Surgery: In severe cases, to repair or replace damaged joints.

While these treatments can be effective, they often come with side effects and do not address the underlying causes of the condition.

Homeopathy: A Natural Alternative

Homeopathy is a holistic system of medicine developed in the late 18th century by Samuel Hahnemann. It is based on the principle of “like cures like,” meaning a substance that causes symptoms in a healthy person can, in small doses, treat similar symptoms in a sick person. Homeopathy uses highly diluted substances to stimulate the body’s natural healing processes.

Homeopathic Remedies for Spondylitis

Homeopathic treatment for spondylitis is individualized, focusing on the specific symptoms and overall health of the person. Commonly used remedies include:

Aesculus Hippocastanum: For lower back pain and stiffness, particularly if aggravated by walking or standing.

Bryonia Alba: For severe pain that worsens with movement and improves with rest.

Calcarea Fluorica: For chronic back pain and spinal stiffness, often used for bone and joint issues.

Rhus Toxicodendron: Effective for stiffness and pain that improves with movement and heat.

Sulphur: For chronic pain and inflammation, especially if the symptoms worsen with standing and heat.

Benefits of Homeopathy for Spondylitis

Homeopathy offers several benefits for managing spondylitis:

Holistic Approach: Addresses the physical, emotional, and mental aspects of the condition.

Individualized Treatment: Each person receives a tailored remedy based on their unique symptoms and overall health.

Minimal Side Effects: Homeopathic remedies are highly diluted, reducing the risk of side effects common with conventional medications.

Long-Term Relief: Focuses on stimulating the body’s healing mechanisms, potentially offering long-lasting relief.

Integrating Homeopathy with Conventional Treatment

For those already undergoing conventional treatment for spondylitis, homeopathy can be integrated as a complementary approach. It is important to consult with both a homeopathic practitioner and a conventional healthcare provider to ensure a coordinated and safe treatment plan.

Dr. Anubbha’s Homeopathy Clinic: The Best Choice for Spondylitis Treatment

Dr. Anubbha’s Homeopathy Clinic in Hyderabad is renowned for providing the best homeopathic treatment for spondylitis. Dr. Anubbha is a highly experienced and skilled best homeopathic doctor, dedicated to helping patients find relief from their symptoms naturally.

At Dr. Anubbha’s Homeopathy Clinic, patients receive comprehensive care tailored to their unique needs. The clinic’s approach focuses on:

Personalized treatment plans

Holistic care addressing the root cause of symptoms

Long-term relief and improved quality of life

Conclusion

Spondylitis is a challenging condition that can significantly impact a person’s quality of life. While conventional treatments are effective for many, homeopathy offers a natural, holistic alternative that can provide relief from pain and stiffness, improve mobility, and enhance overall well-being. By focusing on individualized care and stimulating the body’s natural healing processes, homeopathy can play a valuable role in the management of spondylitis. Dr. Anubbha’s Homeopathy Clinic stands out in providing comprehensive and accessible care, including online homeopathy consultations, ensuring patients receive the best possible treatment tailored to their unique needs.

[automaticgentlementiger]

ortho hospital in virugambakkam

Orthopedics Hospital and musculoskeletal disorders treatment

Orthopedics is the branch of medicine that treats injuries and diseases of the body's musculoskeletal system. The musculoskeletal system comprises of bones, ligaments, joints, muscles, tendons, and nerves. It is responsible for various movements performed by the body. Some orthopedic surgeons specialize in caring for athletes.

Why Us

𝐒𝐀𝐑𝐀𝐕𝐀𝐍𝐀𝐇𝐎𝐒𝐏𝐈𝐓𝐀𝐋,the best ortho hospital in Virugambakkam treats various musculoskeletal disorders and performs joint replacements. From diagnosis and treatment to recovery and wellness, the hospital has a combination of experienced surgeons and rheumatologists who provide the highest quality care to thousands of patients. Hundreds of patients every day.

The hospital is equipped with some of best orthopaedic specialists led by internationally acclaimed orthopedic specialist and surgeon Dr. R Saravanan.They are highly skilled and specialized in treating different types of Orthopaedic conditions. The treatment and care extend to orthopaedic conditions like injuries, diseases of the bones, joints, muscles, tendons, and ligaments.

Here, there is a comprehensive care team that is inclusive of orthopaedic physicians, orthopaedic surgeons, physical therapists, rehabilitation specialists, other advanced care providers, and support staff.The various conditions for which the treatments offered include Osteoarthritis, Rheumatoid Arthritis, Knee Replacement, Hip Replacement, ACL Repair, Ligament Repair, Shoulder Injuries, tendinitis, avascular necrosis, ankylosing spondylitis, cervical spondylosis, etc. The hospital is committed to improving patient outcomes and quality of life. For this, they use-

Use advanced technologies

World-class quality standards

Pioneering new treatments

Use the best talent

The hospital is fully equipped with advanced diagnostic tools and procedures such as X-ray, MRI, CT scan, bone scan, disc arthrography, Doppler ultrasound, peripheral bone density testing, and more. It uses arthroscopic techniques and minimally invasive joint surgery depending on the nature of the orthopedic condition.

Arthroscopy

Arthroscopy is a type of keyhole surgery used to visualize, diagnose, and repair joint damage within a joint. This procedure is mostly used on body parts such as knees, wrists, elbows, ankles, and shoulders. Arthroscopy is used to diagnose many joint problems, including:

Unexplained joint pain

Joint stiffness

Swelling in the joint

Joint fibrosis - when excess scar tissue caused by previous injuries interferes with the normal functioning of the joint

Bone spurs - abnormal bone growths that cause repeated pain.

Synovitis – where the lining of the joint is inflamed.

Joints can get out of position or "jump" at certain times

Book your appointment at the best Ortho Hospital in Virugambakkam.

[lupine-publishers-juns]

Lupine Publishers | A Rare Case of Penile Schwannomatosis Presenting with Painful Nocturnal Penile Tumescence

Abstract

Background: Penile schwannoma is a rare tumor. They commonly present as an asymptomatic, painless and slow growing mass. Other presentations include sexual dysfunction, most commonly dyspareunia, followed by erectile dysfunction, abnormal penile curvature or pain with ejaculation. Case presentation: A 26-year-old male presented atypically with painful nocturnal penile tumescence, along with multiple nodules over the dorsal penis. Excision of multiple penile tumors under general anaesthesia was performed and histopathologic examination revealed benign schwannoma. Conclusion: Our hypothesis is that the schwannoma lies along the axis of the dorsal penile nerve, and compression of this nerve occurs during his erection causing pain. However, there are limited presentations of painful erections in penile schwannomas, and we hope that future studies can help confirm this theory.

Keywords: Penile; schwannoma; painful tumescence; sexual dysfunction

Background

Schwannomas are a form of peripheral nerve tumors made up of neoplastic Schwann cells that typically occur as solitary, encapsulated masses. They can occur throughout the body, but more commonly arise on the head, neck, or flexor surfaces of limbs [1,2]. The tumors are sporadically associated with genetic syndromes such as schwannomatosis and neurofibromatosis or may be the result of therapeutic irradiation [3]. Schwannomas have a low annual incidence of 0.6 per 100,000 people [4]. These are rare and only 27 cases have been reported in literature since it was first described in 1968 [5]. Penile schwannomas are typically asymptomatic, painless and slow growing. Possible presentations include sexual dysfunction, most commonly dyspareunia, followed by erectile dysfunction, abnormal penile curvature, or pain with ejaculation. Our patient presented with painful nocturnal penile tumescence, which is not a well-known presentation of penile schwannomas. There is limited published literature on such cases and hence little is known about this condition (Figures 1&2).

Case Presentation

A 26-year-old man with a history of ankylosing spondylitis (HLA B27 gene) and previous circumcision first presented with a oneyear history of recurrent painful nocturnal erections. He had prior consultations with various urologists and did not respond to oral analgesia. The frequency of painful nocturnal erections increased from once per week, to thrice per week over the past year. Each episode of painful nocturnal tumescence lasted approximately five minutes and the patient was often awaken from sleep by the severe pain, which affected his sleep and quality of life (Figure 3). There was no history of priapism, sexual transmitted disease, or genital trauma. There were no persons with known neurofibromatosis in his family. On examination, four lumps could be palpated over the dorsum of the stretched penis. Two were superficial nodules on the distal shaft, with one deep nodule each at the mid shaft and base of the penis. The nodules were 0.5cm or less in diameter and firm in nature. The mid shaft nodule was tender on palpation and correlated with the site of painful nocturnal erections. The penis was otherwise unremarkable and there was neither penile curvature on erection nor any palpable lymph nodes in the femoral or inguinal areas. Nodules or café-au-lait spots were not present in the rest of the body (Figure 4). Over a five-year follow-up, patient developed worsening symptoms with the painful erections occurring twice every night from one episode a week. Physical examination and interval ultrasound imaging demonstrated an increase in the number of nodules from four to five with further growth of the existing nodules. Most noticeably, the right intracavernosal nodule increased from 4 mm to 7 mm in diameter. The patient decided for surgical excision of multiple penile nodules (Figures 5&6).

Investigations

Laboratory findings included normal blood cell counts, chemistries and urinalysis. Initial ultrasound penis showed multiple rounded heterogeneously echogenic nodules in the subcutaneous region of the dorsal penile shaft. The nodules show minimal central and peripheral vascularity. A small cystic lesion with internal echoes is also noted in the corpus cavernosum. The patient initially declined surgical intervention and opted for annual ultrasound imaging (Figure 7). Magnetic resonance imaging (MRI) of the penis performed prior to surgery showed multiple enhancing sub-centimetre nodules in the penile shaft, most of which were superficial. There was a nodule in the right corpus cavernosum, and another in the dorsal midline which disrupts the wall of both corpora cavernosa.

Treatment

Patient underwent excision of multiple penile tumors under general anaesthesia. A circumferential incision was made at the previous circumcision site. The penis was then degloved to its base and the layers dissected down to Buck’s fascia. There were five superficial tumors adherent to the tunica albuginea (two at right distal shaft, two at midshaft, one at base of penis). A deep-seated tumor was located at the right corporal mid shaft. The tumors measured approximately 1-1.5cm in diameter (Figure 8). The cut surface of the tumors was homogenously yellowish with noted feeding vessels. All tumors were excised, and histology was sent from all locations.

Outcome and Follow-Up

All specimens show similar morphology. The circumscribed and thinly encapsulated nodules were made up of Schwann cells arranged as a mixture of more cellular Antoni A and less cellular Antoni B areas. The more cellular Antoni A areas consists of Schwann cells arranged as short fascicles or parallel rows of nuclear pallisading (Verocay bodies). The less cellular Antoni B areas show a looser myxoid stroma. The nodules are associated with thickened and oedematous nerve fibres, and occasional more plexiform Schwannian areas are seen involving the nerve fibres (Figures 9&10). No high-grade nuclear atypia, increased mitosis or tumour necrosis is seen. On immunostaining, the lesion shows diffuse staining with S-100, which is indicative of Schwannoma. In the follow up consultations over a year after surgery, there was no further nightly painful erections and patient was able to sleep well. On examination there is a small nodularity at mid shaft which is likely due to scar tissue formation. However, the patient did experience difficulty maintaining erection due to discomfort over the surgical site. This was managed well with Viagra 25mg, with an improvement in International Index of Erectile Function score from 8/25 to 19/25. Patient declined genetic testing as he was not keen on childbearing.

Discussion

Schwannomas rarely present with penile pain. There have been postulations made regarding the correlation of symptoms to neuroanatomy. A literature review done by Huang et al. concluded that patients with penile root schwannomas are more prone to symptoms with discomfort or sexual dysfunction (4 of 6) compared with patients with penile shaft schwannoma (7 of 16) or glans schwannoma (2 of 7) [6]. Based on anatomy, penile schwannomas at the mid shaft or glans should originate from the dorsal nerve of the penis, which is the deepest division of the pudendal nerve. The pudendal nerve does pass through the penile root, but there is no clear branching or tracking of the nerve origin of the tumor [7]. Pain may occur in the region of the tumor and any nerve the tumor originates from, but pain may not be specific enough to discern the particular involved nerve. Neurologic deficits of sensory and motor function correspond to the nerve in which the tumor originates or which it is compressing, and as such will often be most useful in localizing the tumor [8,9]. This patient presented with painful nocturnal erections corresponding to the mid shaft schwannoma. Our hypothesis is that the mid shaft schwannoma lies along the axis of the dorsal penile nerve and pain could arise when the nerve is compressed by the schwannoma during full erection. During nocturnal tumescence, the cavernosus arteries dilate, leading to engorgement of the corpora cavernosa and increase of intracorporal pressure. This pushes the schwannoma towards the dorsal penile nerve leading to nerve irritation, compression and pain. Penile schwannomas normally occur at the dorsal penile shaft. However, there have been documented cases where the tumor has infiltrated the glans and prepuce [10]. In such cases, we have to consider other possible diagnoses including benign soft-tissue lesions such as lipoma, fibroma, leiomyoma, Peyronie’s disease, injection-related fibrosis, and rarely malignant sarcomas. Clinical history taking and clinical examination are important, but imaging can aid in narrowing the differentials by locating the plane of the lesion and delineating the mass. Ultrasound examination can demonstrate hypoechoic lesions, and doppler ultrasound can detect hypervascularity. CT scan is rarely used, and mostly performed to exclude metastasis. Schwannomas demonstrate typical MRI features of T1 isointensity to hypointensity, T2 hyperintensity, and postcontrast enhancement. Heterogeneous signal intensity and postcontrast enhancement are suggestive of internal hemorrhage and myxoid/cystic changes [11]. Otherwise, excision biopsy of the tumor would be the gold standard for final diagnosis. Treatment of penile schwannomas is symptomatic, focused primarily on pain management. Complete surgical excision is the recommended treatment for penile schwannomas, with low recurrence rates [1- 10]. This patient recovered well with no signs of recurrence one year postoperatively. Schwannomas of the penis are usually benign, but four malignant variants have been reported in literature. No cases of benign penile schwannoma have been reported to be associated with hereditary diseases [12]. Schwannomatosis is the third major form of neurofibromatosis, and is characterized by a predisposition for schwannomas, in the absence of schwannomas on both vestibular nerves. Its diagnosis is based on a criterion [13]. Most patients present in adulthood with multiple schwannomas and pain, and approximately 20 percent of patients have a family history of schwannomas or schwannomatosis [14]. So far, there have been no confirmed causes of penile schwannoma with schwannomatosis. There is no strong evidence about the correlation between schwannoma and erectile dysfunction [15]. This patient’s postoperative erectile dysfunction is likely due to pain surrounding the surgical wound site. Also, there were no surgical complications other than possible scar tissue formation on the penile shaft.

Conclusion

Schwannomas of the penis are extremely rare and typically present as a solitary, asymptomatic, painless and slow-growing tumor. The rarity in this case is that our patient presented with painful nighttime erections. Based on the penile neuroanatomy, penile schwannomas at the mid shaft should originate from the dorsal nerve of the penis. Our hypothesis is that the schwannoma lies along the axis of the dorsal penile nerve and compression of this nerve occurs during his erection causing pain. However, there are limited presentations of painful erections in penile schwannomas, and we hope that future studies can help confirm this theory.

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For more  Journal of Urology & Nephrology Studies  articles please click here: https://lupinepublishers.com/urology-nephrology-journal/index.php

[sbgridconsortium]

Investigating shared molecular motifs in autoimmunity

Human leucocyte antigen B*27 (HLA-B*27) exhibits a strong association with autoimmune conditions including ankylosing spondylitis and acute anterior uveitis. While ankylosing spondylitis is characterized by chronic inflammation of the spine, sacroiliac, and in some cases, peripheral joints, acute anterior uveitis cases exhibit episodic inflammation of the iris and ciliary body of the eye. However, the mechanism linking HLA-B*27 to ankylosing spondylitis and acute anterior uveitis remained unclear.

Based on the association between HLA-B*27 and reactive arthritis which can follow the onset of bacterial infection, it was hypothesized that the presentation of pathogenic microbial peptides to CD8+ T cells could enable anti-self reactivity. SBGrid member Christopher Garcia and other researchers sought to investigate this potential link. They isolated T cell receptors with unknown specificity expressing a disease-associated public β-chain variable region–complementary-determining region 3β (BV9–CDR3β) from individuals with ankylosing spondylitis or acute anterior uveitis. Interestingly, populations of T cells expressing these T cell receptors were expanded in the joint and eye and exhibited consistent α-chain variable region chain pairing. Through yeast display, the researchers identified shared self-peptides and microbial peptides that activated the isolated T cell receptors. By analyzing the structures of the T cell receptors, they found that the observed cross-reactivity was based on a shared binding motif present in both self-antigens and microbial antigens engaging the BV9–CDR3β T cell receptor.

Above: Structure of TCR-antigen complex with bacterial YEIH epitope AS8.4 on HLA*B27. CC BY SBGrid.

The authors’ findings have important implications for the understanding of ankylosing spondylitis and acute anterior uveitis pathophysiology.

Read more about this work in Nature.

[standtall-always]

And all the other things you want, have the need to do but that you are just not able to. For God knows how long

crumpling under the weight of two unanswered texts

[edexme]

Ankylosing spondylitis

Ankylosing spondylitis (Bechterew’s disease) is a rheumatic disease. There is an inflammation of joint capsules. The inflammation is accompanied by a gradual stiffening of the inflamed joint. Usually, it involves the joints of the back. But the knees, hips, and pelvis can also be affected. The Latin name for the disease is ankylosing spondylitis. The disease generally starts between the ages of…

[crippleprophet]

Wait holy shit

AS describes exactly the pain I have

oh boy okay as i’ve mentioned i’ve got an extensive document on AS symptoms & mythbusting coming soon but i’ve been wanting to do a quick summary of “wtf is that?” for a while and this is the perfect opportunity! most stats in this post from this 2022 summary article (link) but note that their gender stats are questionable as recent studies show equal prevalence regardless of ‘sex’. so!

wtf is AS?

ankylosing spondylitis is a systemic autoimmune disorder characterized by inflammatory back pain. it’s estimated to be 1.5 times as common as rheumatoid arthritis and over 6 times as common as lupus (SLE) but is incredibly underdiagnosed, which is why i’m super loud about it!

key symptoms of inflammatory back pain:

most frequent onset in early 20s but can be juvenile or later. articles say onset is prior to age 40 but seeing as i’m deeply skeptical of all things medical establishment i wouldn’t rule later onset out

either no history of mechanical trauma or unrelated (for example, i have a herniated disk but had AS symptoms for years before then)

pain gets worse with rest and better with movement - most sources say “exercise” but in the experience of me and other folks with AS i’ve talked to that’s debatable at best. my pain gets worse after remaining in the same position and better with rotating, stretching, etc; sitting upright is most painful for me, but on typical days i need to alternate laying down and standing / walking briefly

morning stiffness and back pain that wakes you up at night

alternating buttock (butt) pain

articles say inflammatory back pain improves with NSAIDs but i’ve never met any chronically ill person whose pain has been made manageable with NSAIDs

AS can also include (usually asymmetrical) joint pain in other locations (especially large joints like the hips, shoulders, neck, and knees - juvenile AS commonly starts with pain in one or both knees prior to spine involvement), fatigue, peripheral neuropathy, and enthesitis (inflammation of tendon insertion points, especially plantar fasciitis).

testing and diagnosis:

CRP and ESR for inflammation. 40-50% of people with AS do not have elevated inflammatory blood markers.

HLA-B27 gene marker. less common in people with non-radiographic AS (doesn’t show up on an x-ray) and more common in white people. only 6-10% of people who are HLA-B27 positive develop AS and plenty (10-30%) of people with AS are negative for HLA-B27 - myself included!

x-ray and MRI for spine inflammation. both of mine were negative; the absence of clinically visible inflammation does not rule out AS. there is a growing body of literature and education about non-radiographic AS; my rheumatologist put me on 20mg prednisone for a week while waiting on my bloodwork and scan results and when that helped my back pain immensely, said “yep it’s definitely inflammatory then” and that this is the standard of diagnosis/care rheumatological associations are advocating for

i wish you the absolute best of luck in finding an explanation and treatment for your pain 💕 if you (or anyone reading this who suspects they have AS!) have any questions feel free to reply, send me an ask, or dm me!

[lizzie-gains]

I see a doctor on Friday. The one who started my sister's process towards diagnosis.

So far it's felt like the doctors up here think I'm a hypochondriac. I've brought them my peripheral pins and needles, my chronic, never ceasing pain plus pain flare ups, and even the fact that my sister has been diagnosed with something hereditary, with very similar symptoms to me. But they do like one test and it looks fine, and then they tell me to just see what happens. They thought MS at first but even then it took me pushing and asking to finally get a brain MRI after the second major neuropathy flare up, so it didn't happen until the flare up had finished.

I'm a little nervous, honestly. I hope I can get a diagnosis of something, because that means treatment. But all of the possible diagnoses, including the most likely ankylosing spondylitis, are currently uncurable things I'd rather not have.

[tramadolweb01]

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Diagnosis and Treatment

The diagnosis is basically based on the medical history and the physical exam. Sometimes the doctor may advice to for blood tests or imaging tests for the confirmation. And sometimes the doctor may further recommend you for MRI. Several medicines are helpful in relieving pain as well as inflammation. When the joint swelling is not widespread injections of corticosteroids drug directly into the membrane or joint might give immediate relief. Tramadol is also very helpful in relieving you from pain efficiently. Purchase Tramadol online overnight delivery at cheap rates from our authentic drug store every time.

Spondyloarthriits

Spondyloarthrits is a term which is used for a number of conditions which may cause swelling or pain typically around the joints in the spine. In this condition the inflammation of the small pieces of connective tissue (known as entheses) occurs. They are littletoughcords that connects the ligaments or tendons to the bone. Order Tramadol Online and take it at your doorstep when you actually want to get rid of the pain.

It is a vast term used for inflammatory diseases that includes joints and entheses. The most common among it is ankylosing spondylitis. Few others include psoriatic arthritis, reactive arthritis as well as enteropathic arthritis which are linked to inflammatory bowel disease. Spondyloarthritis mainly affects the spine. Few forms may affect the spine. Some other may affect the peripheral joint those in feet, hands, legs and arms. Purchase Tramadol Online and take away the best drugs from us every time.

Spondyloarthritis Causes

Scientists have identified approximately thirty genes which may cause ankylosing spondylitis. The most important is known as HLA-B27. Mainly all white people with ankylosing spondylitis are carries of this gene. The people with HLA-B27 are likely to have enteropathic arthritis; moreover other causes are not clear. Scientists also believe that other causes are unclear. Scientist believes it may be related bacteria which enters the damaged bowel.

Spondyloarthritis Symptoms

It has two main symptom patterns, for most of the people the predominant symptom is typically low back pain. If it is not controlled spinal movement can progress and this leads to the fusion of spinal movement may progress resulting in fusion of vertebrates and limiting the spine’s mobility. The main symptom is swelling in arms as well as legs. It is referred to as peripheral spondyloarthritis. Purchase Tramadol online legally from our online pill store.

The joint inflammation goes and comes and is also accompanied by fatigue. The problem which occurs besides spondyloarhtritis also including osteoarthritis are redness of the eye, pain, inflammation of aortic heart valve, skin disease psoriasis and intestinal inflammation.