Orthopedic Care and Consultation
Untreated rheumatoid arthritis can lead to severe deformities. Following xrays are of a 43 years old woman who was a known case of rheumatoid arthritis and had taken on and off treatment.
She presented with deformed hands and pain in bilateral hips. The problem had persisted for past 10 years.
Bilateral Deformed Hands In Rheumatoid Arthritis
The xrays of the hip revealed bilateral arthritic changes. [Read more...]
Popularity: 5% [?]
This xray belongs to 58 year old women who weighed 120 khs and had severe pain in both the knees for last 10 years. patient was unable to walk beyond 10 steps even with support.
She also had respiratory and cardiac ailments.
The xray in picture shows severely destroyed knees with varus deformity in both sides along with subluxation of the knee joints on both sides.
The patient had been advised total knee replacement [TKR] two years back but she refused. This time she had come with a request to get operated for total knee replacement but her physician told her about the risk involved due to her medical illness.
The patient again refused.
Popularity: 4% [?]
Arthrodesis is also known as artificial ankylosis or syndesis. It is an operation designed to produce bony ankylosis of a diseased joint often done in joints or bones near the joint affected by infection, tumors, trauma, and paralytic conditions.
It is also used in certain cases of painful osteoarthritis and rheumatoid arthritis as a pain relieving measure.
It is important to understand the difference between ankylosis and arthrodesis. Ankylosis refers to a stiff joint irrespective of the cause for stiffness. Arthrodesis always means that the joint has been fused surgically.
The main disadvantage of arthrodesis is that it sacrifices the movement of joint. Thus the function of the limb is definitely compromised. For example, in the lower limb, energy requirements for ambulation are increased. [Read more...]
Popularity: 2% [?]
Chondrocalcinosis is another name for Calcium pyrophosphate dihydrate disease, a rheumatologic disorder with varied clinical manifestations due to precipitation of calcium pyrophosphate dihydrate crystals in the connective tissues.
Its alternative names specify clinical or radiographic findings.
Pseudogout refers to the clinically evident acute synovitis with red, tender, and swollen joints that may resemble arthritis of gout.
Chondrocalcinosis, refers to the radiographic evidence of calcification in hyaline and/or fibrocartilage.
It is also called Pyrophosphate arthropathy. The knee joint is the most commonly affected.
Popularity: 5% [?]
A bone spur is a bony growth formed on normal bone. In medical language, it is termed as osteophyte. A bone spur is an extra bone and can cause symptoms due to pressure on adjacent tissues.
Spurs can be commonly found in
How Does A Spur Form?
A bone spur is response by the body to some sort of external stimulus. This repair response may lead to formation of extra bone called spur. [Read more...]
Popularity: 2% [?]
Avascular necrosis (AVN) of head of femur occurs when blood supply to the head is jeopardized. That may occur when blood vessels are injured or the pressure within the bone rises enough to cause narrowing of blood vessels resulting in ischaemia of the bone.
The various known causes of avascular necrosis of hip are
There are percentage of people in whom the cause cannot be determined and are labeled as idiopathic AVN.
Popularity: 4% [?]
Synovial fluid is a thick, stringy fluid found in the cavities of synovial joints. It reduces friction between the articular cartilage and other tissues in joints by lubricating and cushioning them during movement.
During movement, the synovial fluid held in the cartilage is squeezed out mechanically to maintain a layer of fluid on the cartilage surface. Normal synovium contains synovial lining cells that are 1-3 cells deep. Synovium lines all intracapsular structures except the contact areas of articular cartilage. [Read more...]
Popularity: 7% [?]
Osteoarthritis of knee is very common problem in Asian region. The disease typically starts in medial compartment of the knee and then progresses to all the compartments.
OA bilateral knee
The xray belongs to a lady of 49 years old whose main complaint was pain on climbing stairs. An xray doen revealed bilateral medial compartment involvement.
The patient is being managed on conservative treatment.
Popularity: 6% [?]
Cartilage is the layer covering a joint. Its main function is to produce smooth articulations among the joint surfaces. Type of cartilage in synovial joint is hyaline cartilage. Hyaline cartilage is a hard, translucent material rich in Type II collagen and proteoglycan.
To reduce the friction, the cartilage is lubricated by various mechanisms.
Synovial joints serve as mechanical bearings with low coefficients of friction. Their three major sources of lubrication are:
Hydrodynamic lubrication
Loading of the articular cartilage causes compression that forces water out of the cartilage. This fluid forms an aqueous layer that separates and protects the opposing surfaces.
Boundary layer lubrication
A small glycoprotein called lubricin, which is produced by synovial lining cells, binds to articular cartilage where it retains a protective layer of water molecules.
Hyaluronic acid
It i s produced by synovial lining cells and lubricates the contact surface between synovium and cartilage. [Read more...]
Popularity: 3% [?]
Anakinra is an interleukin-1 (IL-1) receptor antagonist and is common;y used for treatment of rheumatoid arthritis. Anakinra blocks the biologic activity of naturally occurring IL-1 by competitively inhibiting the binding of IL-1 to the Interleukin-1 type receptor.
IL-1 is produced in response to inflammatory stimuli and mediates various physiologic responses, including inflammatory and immunologic reactions. IL-1 stimulates bone resorption and induces tissue damage like cartilage degradation as a result of loss of proteoglycans.
The anakinra molecule is a recombinant, non-glycosylated version of human IL-1 receptor antagonist prepared from cultures of genetically modified Escherichia coli using recombinant DNA technology.
The drug is used as biological response modifier. [Read more...]
Popularity: 2% [?]
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