Have a couple cases where cannot fully extend elbow and in considerable pain posteriorly on olecreanon rim. Attempts to exercise it to extension just cause pain. Loose bodies and spurs can cause trouble but are often not visible on xrays. This is called posterior olecranon impingement.
There appears to be an association of chiari (“a hindbrain malformation characterized by downward anatomical extension of the cerebellar tonsils below the foramen magnum, and is thought to result from a developmentally small posterior fossa.”) and FM. This however, is manifest on positional scans (in extension or flexion). To add to the number of MORON studies I have already seen, a study is done in static neutral position and finds nothing. This just adds to my contention that MRI’s are useless (particularly when humans are involved).
In 70 year olds, incidence of major asymptomatic supraspinatus tears is 7.8% in elderly controls, and 15.8 in elderly diabetics
One would think minimally invasive prostatectomy would have fewer side effects – in the postop period they do, but not in the long term…
Where there was a positive margin after prostate cancer surgery, time until PSA starts rising depends on how many margins, and what per cent of the prostate was cancerous. Tables have been plotted for such.
In 91% of severe persistent groin pains, adductor tenotomy was found beneficial
Recent review encourages a positive optimism about dementia prevention. They point out that hip fracture rates have dropped 25% from 1995 to 2005, and age-adjusted stroke rates have dropped 25% in both USA and Australian studies as well. Dementia rates could do the same. – What did they find helps? – Treating hypertension, stop smoking, and increasing exercise showed best results.
Recent analysis had put hip fracture rates with bisphosphonate osteoporosis meds at 1/1000 per year. This is way too common – I have a suggested treatment.
I have patients argue that the reduction of upper back pain would be an indication for breast reduction. What needs to be factored in, is the 11-49% chronic scar pain following surgery – and how to deal with that.
Study found plantar fasciits was associated with leg length discrepancy and in the longer leg.
When partial tear became full, or when full tears spread by >5 mm – it was more likely to become symptomatic. It was suggested that “Further research is warranted to investigate the role of prophylactic treatment of asymptomatic shoulders to avoid the development of pain and loss of shoulder function.” – ie when does one repair these asymptomatic tears – early or when they hurt?
Case was presented where deep breathing was found to abort TN episodes with hope that others would try it and maybe report if it was effective.
Fibromyalgia rates are much higher in Hashimoto’s thyroiditis (HT) – about 31% and not higher in cases with subclinical hypothyroidism. This suggests a subgroup might be autoimmune.
About 1-5% of FM might actually be an alpha-1-antitrypsin deficiency. This condition causes run away inflammation that causes COPD but responds to AAT replacement therapy. Cases are presented.
DHEA and androgen levels are higher in PCO yet FM rates are 32.5% in PCO versus 7.7 in the general population.
Missing a Hook of Hamate Fracture presents a medico-legal nightmare somewhat like missing a scaphoid fracture. It is often a “unbalanced loaded” racket sports related injury or direct blow. Pain may not be severe and plain xrays are often normal. Early casting immobilization for 6-8 weeks is essential. Missing a fracture can lead to persistent pain from non-union, ulnar nerve injury in Guyon canal, and late rupture of little profundus/superficialis tendon. A New test has been devised for detection.
There are two versions of Trigeminal Neuralgia – one version that just has episodic sharp pains, and another that has that and also a continuous pain component. Those with a continuous component do poorly.
Hand Osteoarthritis with progressive deformities, pain and erosions on xray is not your typical osteoarthritis. It is coined “inflammatory osteoarthritis” and can lead to increased disability. Drugs like IM methylprednisolone, Hydroxychloroquine, Infliximab, and Anakinra all help.
Recent study looking into factors involved in chronic pain in the elderly found subjects with central obesity were twice as likely to have pain problems. Various factors contribute.
Article referred in press describes how radiofrequency to 3/5 of Genicular nerves could induce over 50% improvement in 59% of cases over the 3 months followup.
Two Canadian studies have been done on Nabilone – One at University of Manitoba showing it improves pain, and a recent one from McGill showing it helps sleep.
Beefing up my contention that suprascapular nerve blocks have therapeutic shoulder effects, is a new article finding it works as well as steroid injections into shoulder – without having to use steroids.
Only 38% of Doctors can diagnose a posterior MI (heart attack) because traditional leads do not pick it up. I have on occasion seen someone with vague chest pains but a previous history of heart disease. If ECG is normal and patient looks stable, it is easy to not consider this an acute condition. That might be wrong.
Skin surface CES therapy is usually 2 milliamp therapy with anode over motor cortex strip (C3) (on skin) with a cathode lead on forehead. In SCI patients it resulted in significant pain relief (P<0.03 versus sham). They found the effect was “large” but did not meet the 30% improvement required for substantive improvement.
13 MS cases with chronic pain versus 10 without pain did not show any associations with plaque in certain areas of the brain