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Bone and Spine

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Infections

Drug Resistant Tuberculosis – Types and Treatment

By Dr Arun Pal Singh

drug resistant tuberculosis

A person is said to have drug-resistant tuberculosis if the tuberculous bacteria that the person is infected with, will not respond to, and are resistant to, at least one of the main antitubercular drugs. Drug-resistant tuberculosis occurs when bacteria become resistant to the drugs used to treat TB. This means that the drug can no […]

Filed Under: Infections

Hydatid Disease of Bone

By Dr Arun Pal Singh

Hydatid Cyst of Bone

Hydatid disease of bone is very rare and is often misdiagnosed because of non-specific presentation and radiology. As its management is quite different from other conditions involving the bone, it is important to consider the differential of Hydatid disease of the bone in lucent bone lesions, especially where the echinococcosis is prevalent. Hydatid Disease or […]

Filed Under: Infections

Osteomyelitis Presentation and Treatment

By Dr Arun Pal Singh

Osteomylities of Tibia With Bowed Tibia

Osteomyelitis literally means inflammation of bone and its marrow regardless of whether it is due to pyogenic organisms, tuberculosis, syphilis, a specific virus, or the presence of a foreign. However, its more accepted meaning is the infection by pyogenic bacteria or less commonly to the other organisms. The infection involves the marrow spaces, the Haversian […]

Filed Under: Infections

Tuberculosis of Shoulder Joint

By Dr Arun Pal Singh

Different forms of tuberculosis of shoulder

Tuberculosis of shoulder is rare. It constitutes about 1-2 % of skeletal tuberculosis.[1] It is found more in adults as compared to children. Concomitant lung TB is found more commonly than other skeletal TB. Relevant Surgical Anatomy of Shoulder Joint The shoulder joint is a  ball and socket synovial joint. The humeral head is large […]

Filed Under: Infections

Tuberculosis of Foot

By Dr Arun Pal Singh

Tuberculosis of foot, calcaneum osteolytic variety

Tuberculosis of foot is rare and constitutes less than 10% of cases of osteoarticular tuberculosis. Calcaneum is the most common bone involved followed by subtalar joint and midtarsal joints. Pathophysiology Bonewise, the order of involvement in decreasing order is calcaneum, talus, first metatarsal, navicular, first and second cuneiforms cuboid and others. The infection first lodges […]

Filed Under: Infections

Tuberculosis of Ankle

By Dr Arun Pal Singh

tuberculosis of ankle joint

Tuberculosis of ankle joint is relatively uncommon. The incidence of ankle tuberculosis is less than 5 percent of all osteoarticular tuberculosis. Pathophysiology The mycobacteriaereachs the ankle joint viathe bloodstream. The initial focus may start in the synovium, especially in children, or as an erosion in the distal end of tibia, malleoli or talus. Rarely tuberculosis […]

Filed Under: Infections

Tuberculosis of Knee Joint – Diagnosis and Treatment

By Dr Arun Pal Singh

Xray and MRI of tuberculosis of knee joint. Multiple foci are shown with arrows.

Tuberculosis of knee joint is third common osteoarticular tuberculosis after spine and hip. Knee tuberculosis or commonly called TB knee accounts for nearly 10 percent of all skeletal tuberculosis. Relevant Anatomy of Knee Joint The knee joint is the largest joint in the body. It is a superficial joint and because of its large size […]

Filed Under: Infections

Tuberculosis of Hip – Presentation and Treatment

By Dr Arun Pal Singh

Tuberculosis of Hip

Tuberculous of the hip joint is common with a frequency of involvement next only to spinal tuberculosis. Hip tuberculosis accounts for 15% percent of all cases of osteo-articular tuberculosis and 1-3 % of all tuberculosis cases. Anatomy of the Hip Joint The hip joint is a ball and socket synovial joint. Fibrocartilaginous labrum attached to […]

Filed Under: Infections

Prosthetic Joint Infection

By Dr Arun Pal Singh

Spacer for Prosthetic Joint Infection

Prosthetic joint infection is a devastating complication of joint replacement surgery and occurs in1–3% of patients. Prosthetic joint infection can occur due to direct inoculation at the time of surgery or hematogenous spread of organisms to the prosthesis at a later time. One of the peculiarities of these infections is that the organism on attachment […]

Filed Under: Infections

Septic Arthritis or Infectious Arthritis

By Dr Arun Pal Singh

Septic Arthritis Knee where joint aspiration is done

Septic arthritis is a term used when the joint space is infected with microorganisms which can be bacteria, viruses, mycobacteria, and fungi. Septic arthritis also includes prosthetic joint infections. Septic arthritis is also called infectious arthritis. Joints are quite resistant to infection but there are some risk factors that increase the risk increased infection. These […]

Filed Under: Infections

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articular cartilage zones

Articular Cartilage Structure and Function

Articular cartilage is the layer covering the joint surfaces. Its main function is to produce smooth articulations between the joint surfaces. Articular cartilage is the highly specialized connective tissue of diarthrodial joints. Articular cartilage lacks blood vessels, lymphatics, and nerves. Asa result it has limited healing and repairing mechanisms. In most joints, adult human articular […]

Xray of Kohler Disease showing flattening of navicular bone

Kohler Disease or Navicular Osteochondrosis

Kohler disease is osteochondrosis of the navicular bone, first described by Kohler in 1908. In this condition also called navicular osteochondrosis, there is avascular necrosis navicular bone. Alban Kohler was a German radiologist who first described this condition. Exact occurrence of Kohler disease is not known. The disorder is more frequent in children aged 5-10 […]

neurogenic claudication

Neurogenic Claudication – Risks, Pathophysiology and Treatment

Neurogenic claudication, also called pseudoclaudication, is a common symptom of lumbar spinal stenosis due to causing impingement or inflammation of the spinal nerves Claudication refers to an impairment in walking or pain, discomfort, numbness, or tiredness in the legs that occurs during walking or standing and is relieved by rest. The word claudication comes from the Latin claudicare meaning ‘to limp’. Thus, it is […]

female athlete triad

Female Athlete Triad or Relative Energy Deficiency in Sport

The female athlete triad is a combination of menstrual dysfunction, low energy availability with or without an eating disorder, and decreased bone mineral density often seen in young women in competitive sports. The new term for this entity is Relative energy deficiency in sport [RED-S]. Classically female athlete triad was defined as consisting of disordered […]

Brachial Plexus Injury

Brachial Plexus Injury – Causes, Presentation and Treatment

Brachial plexus injuries can occur in neonates following birth trauma [Erb’s paralysis and Klumpke’s paralysis], compression of brachial plexus by surrounding structures [thoracic outlet syndrome] and due to inflammation of the nerve [Turner parsonage syndrome or brachial neuritis] and direct or indirect injury by trauma [called traumatic brachial plexus injury]. Traumatic brachial plexus is the […]

c7 vertebra

Vertebra Prominens or Seventh Cervical Vertebra [C7]

Vertebra prominens is the common name for 7th cervical vertebra or C7, the largest and most inferior vertebra of the cervical region of the spine. It is named because it has a large spinous process that protrudes posteriorly and can be felt prominently on palpation. Vertebra prominens is easily recognized on palpation of the back of […]

Congenital Absence of Tibia

Congenital Absence of Tibia

Absence of tibia is a rare birth defect characterized by a deficiency of the tibia while the other bones of the lower leg relatively intact. The deficiency may occur in one or both legs.  The right side is more commonly affected [72%]. Bilateral occurrence is found in about 30%. The absence of tibia could be […]

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