scholarly journals Lytic Lesions of Vertebrae Without Involvement of Intervertebral Disc- An Atypical Presentation of Spinal Tuberculosis

2016 ◽  
Vol 27 (2) ◽  
pp. 81-85
Author(s):  
Homayra Tahseen Hossain ◽  
Quazi Tarikul Islam ◽  
Munshi MB Md Shoaib Adnan ◽  
Muntasir Ibne Mobin ◽  
HAM Nazmul Ahasan ◽  
...  
Keyword(s):  
Back Pain ◽  
Malignant Disease ◽  
Spinal Tuberculosis ◽  
The Elderly ◽  
Intervertebral Discs ◽  
Low Grade ◽  
Metastatic Lesions ◽  
Lytic Lesions ◽  
Proper Diagnosis ◽  
Neurological Features

Tuberculosis is very common in our country. It can involve many organs and have broad spectrum of image presentation. It may resemble malignant diseases, especially in the elderly and thus confuse the judgement of the clinician. We report a case of a 58 year old gentleman presenting with chronic cough, low grade fever, weight loss for 16 months; features of progressive marrow failure for 8 months and severe low back pain without any neurological features for 2 months. The CT scan of spine revealed lytic lesions of vertebrae sparing the intervertebral discs, thus resembling metastatic lesions of bone. We approached this case as malignant disease initially, but found it to be a disseminated tuberculosis infection involving lungs, bone marrow and spine after a series of investigations. Though disseminated TB is not uncommon in our country, the purpose of presenting this case is to give emphasis that, clinicians should consider Pott’s disease (spinal tuberculosis) in the differential diagnosis of patients with back pain and destructive vertebral lesions. Proper diagnosis and anti-tuberculous treatment with or without surgery will result in cure of the patientBangladesh J Medicine Jul 2016; 27(2) : 81-85

A Rare Case of Spinal Leprosy Mimicking Spinal Tuberculosis

2019 ◽  
pp. 33
Author(s):  
K Thuraikumar ◽  
V Naveen ◽  
Mustaqim A ◽  
Arieff AA ◽  
K Shri ◽  
...  
Keyword(s):  
Back Pain ◽  
Soft Tissue ◽  
Histopathological Examination ◽  
Posterior Instrumentation ◽  
Spinal Tuberculosis ◽  
Previous History ◽  
Skin Lesions ◽  
Titanium Implants ◽  
Paravertebral Abscess ◽  
History Of

Introduction: Spinal tuberculosis is the most common manifestation of extrapulmonar y tuberculosis. A combination of leprosy and tuberculosis is a rare entity.Case report: A 44-year-old male patient working as a laborer presented to our hospital with complaints of severe back pain and swelling over the back, difficulty in walking, associated with constitutional symptoms. On admission, he was febrile and had leukocytosis. Initial spine X-ray showed end plate destruction and increase in soft tissue shadow at the level of T8-T9. CT spine revealed thoracic paravertebral collection extending from T7 to T9 levels, suggest ive of tuberculous spondylitis with cold abscess. Patient refused a transpedicular biopsy and was started on anti-tubercular therapy. Two weeks after commencement of treatment, he developed worsening back pain and weakness of the lower extremities. MRI spine showed a paravertebral abscess and posterior soft tissue edema involving level of T7 to T11. Patient underwent a posterior decompression, debridement and posterior instrumentation. He was discharged well, there was improvement of his lower limb power. Upon clinic review, he complained of multiple hyperpigmented, painless, nonpruritic skin lesions over the trunk and back. No previous history of eczema, psoriasis and Tinea corporis. Given the history of allergy, initial impression was hypersensitivity reaction towards the titanium implants, and he was started on anti-histamines. However, there was no improvements seen. Histopathological examination of skin lesions revealed presence of granuloma within the dermis layer, composed of epitheloid, histiocytes, lymphocytes and plasma cells. Wade-Fite stain for Mycobacterium leprae is positive. Slit skin smear shows multibacillary leprosy. Patient was started on multidrug therapy (rifampicin, clofazimine and dapsone) for 1 year. He has recovered well.International Journal of Human and Health Sciences Supplementary Issue: 2019 Page: 33

scholarly journals Glioma with Leptomeningeal Spread Mimics Chronic Meningoencephalitis in a Young Adult

2021 ◽  
pp. 179-183
Author(s):  
Ann-Kristin Becker ◽  
Marta Leonora Frank ◽  
Michael Friese ◽  
Joachim Röther
Keyword(s):  
Brain Tumor ◽  
Back Pain ◽  
Young Adult ◽  
Lower Back Pain ◽  
Low Grade Glioma ◽  
Low Grade ◽  
Who Grade ◽  
Leptomeningeal Spread ◽  
Lower Back ◽  
Uncommon Case

The most malignant type of intrinsic brain tumor is glioblastoma (WHO grade IV). Primary leptomeningeal spread is rare and leads to a variety of differential considerations, as there is no typical clinical or imaging pattern. Here we present a rare and uncommon case of a primary leptomeningeal glioblastoma in combination with a low-grade glioma in a 21-year-old male, initially presenting with only headache and lower back pain. The presented case illustrates the challenging differential considerations and the severe course of leptomeningeal glioblastomas.

scholarly journals Associations between low back pain, urinary incontinence, and abdominal muscle recruitment as assessed via ultrasonography in the elderly

2015 ◽  
Vol 19 (1) ◽  
pp. 70-76 ◽  
Author(s):  
Vânia F. Figueiredo ◽  
Juleimar S. C. Amorim ◽  
Aline M. Pereira ◽  
Paulo H. Ferreira ◽  
Leani S. M. Pereira
Keyword(s):  
Urinary Incontinence ◽  
Low Back Pain ◽  
Back Pain ◽  
The Elderly ◽  
Abdominal Muscle ◽  
Low Back ◽  
Muscle Recruitment

scholarly journals Low Back Pain: The Potential Contribution of Supraspinal Motor Control and Proprioception

2018 ◽  
Vol 25 (6) ◽  
pp. 583-596 ◽  
Author(s):  
Michael Lukas Meier ◽  
Andrea Vrana ◽  
Petra Schweinhardt
Keyword(s):  
Low Back Pain ◽  
Motor Control ◽  
Back Pain ◽  
Control Strategies ◽  
Intervertebral Discs ◽  
Cortical Reorganization ◽  
Potential Contribution ◽  
Low Back ◽  
Output Side

Motor control, which relies on constant communication between motor and sensory systems, is crucial for spine posture, stability and movement. Adaptions of motor control occur in low back pain (LBP) while different motor adaption strategies exist across individuals, probably to reduce LBP and risk of injury. However, in some individuals with LBP, adapted motor control strategies might have long-term consequences, such as increased spinal loading that has been linked with degeneration of intervertebral discs and other tissues, potentially maintaining recurrent or chronic LBP. Factors contributing to motor control adaptations in LBP have been extensively studied on the motor output side, but less attention has been paid to changes in sensory input, specifically proprioception. Furthermore, motor cortex reorganization has been linked with chronic and recurrent LBP, but underlying factors are poorly understood. Here, we review current research on behavioral and neural effects of motor control adaptions in LBP. We conclude that back pain-induced disrupted or reduced proprioceptive signaling likely plays a pivotal role in driving long-term changes in the top-down control of the motor system via motor and sensory cortical reorganization. In the outlook of this review, we explore whether motor control adaptations are also important for other (musculoskeletal) pain conditions.

scholarly journals Onset of hydronephrosis and lower urinary tract symptoms in a previously healthy young man: Phyllodes tumour of the prostate as a potential diagnosis.

2014 ◽  
Vol 8 (7-8) ◽  
pp. 561 ◽  
Author(s):  
Matteo Ferrari ◽  
Umberto Capitanio ◽  
Nathalie Rizzo ◽  
Massimo Freschi ◽  
Francesco Montorsi ◽  
...  
Keyword(s):  
Urinary Tract ◽  
Malignant Disease ◽  
Specific Antigen ◽  
Low Grade ◽  
Total Prostate Specific Antigen ◽  
Urinary Tract Symptoms ◽  
Phyllodes Tumour ◽  
Transvesical Approach ◽  
Tomography Scan ◽  
Lower Urinary

We report the case of a 50-year-old healthy man with early onset of micturition symptoms associated with an elevated total prostate-specific antigen. On physical examination, we found an enlarged prostate; a first-line ultrasound of the urinary tract revealed local disease which covered the entire small pelvis. A computed tomography scan confirmed the presence of a 12.5 × 11.0 × 9.5-cm multicystic prostatic mass, compressing the bladder and pelvic ureters, associated with right hydronephrosis. Renal function was preserved and prostatic biopsies was negative for malignant disease. The mass was completely removed through transvesical approach and histological analysis diagnosed a low-grade phyllodes tumour of the prostate. The patient was free of local recurrence and metastasis 36 months after surgery.

scholarly journals Intervertebral disc vacuum phenomenon is associated with Modic changes in the adjacent endplate: implications for discogenic back pain

2020 ◽  
Author(s):  
Junhui Liu ◽  
Yufeng Xiang ◽  
Zhi Shan ◽  
Shunwu Fan ◽  
Fengdong Zhao
Keyword(s):  
Back Pain ◽  
Lumbar Disc ◽  
Intervertebral Discs ◽  
Modic Changes ◽  
Type I ◽  
Type Ii ◽  
Vacuum Phenomenon ◽  
Lower Lumbar Spine ◽  
Lumbar Degenerative Diseases ◽  
Lower Lumbar

Abstract Background Back pain often arises from degenerative changes in lumbar intervertebral discs and their adjacent endplates. A painful endplate is not easy to identify in patients, but could possibly be revealed by inflammatory-like ‘Modic’ changes and by a ‘vacuum phenomenon’ within the disc. We hypothesize that Modic changes and a VP often co-exist in those lumbar levels most closely associated with back pain Methods We scanned 1023 consecutive inpatients of the Department of Orthopaedics from 2015 August to 2018 August, all patients suffered from lumbar degenerative diseases, whether the patients had back pain or not were evaluated, and the prevalence and location of vacuum phenomenon(VP) and Modic changes were compared at each spinal level. Results 5115 discs were studied from 1023 patients. The number of discs showed to have a VP was 430 using CT, of the 430 discs with a CT-diagnosed VP, 116 were L4-5, and 171 were L5-S1. 522 of the 5115 discs exhibited Modic changes, with prevalence of type I, type II and type III Modic changes being 1.6%, 8.2% and 0.4% respectively. Modic changes usually occurred adjacent to L4-5 discs or L5-S1 discs. The prevalence of back pain was higher in the VP group than no-VP group, VP were significantly associated with Modic changes Type II at L4/5 and at L5/S1. Conclusion VP are closely associated with back pain and Modic changes in the lower lumbar spine. Further investigations may be warranted when radiographs or CT identify a VP in a lumbar disc.

scholarly journals Neurotropic B vitamins: analgesic and anti-inflammatory effects

2020 ◽  
Vol 1 (2) ◽  
pp. 40-44
Author(s):  
Anton A. Beliaev ◽  
◽  
Olga V. Kotova ◽  
Elena S. Akarachkova ◽  
◽  
...  
Keyword(s):  
Back Pain ◽  
Dietary Habits ◽  
Chronic Back Pain ◽  
Musculoskeletal Diseases ◽  
Significant Risk ◽  
B Vitamins ◽  
Poor Sleep ◽  
Low Grade ◽  
Positive Effects ◽  
Anti Inflammatory

Patients with musculoskeletal diseases (MSDs) constitute a heavy burden on the society. Therefore, there is a constant search for safe and efficient methods for treatment of such conditions, in which inflammation underlies the pathogenetic process. Chronic back pain is associated with physical inactivity and other lifestyle factors, such as tobacco consumption, poor dietary habits, overweight, poor sleep quality, and uncontrollable stress. For example, obesity is associated with low-grade chronic systemic inflammation, and is, therefore, a significant risk factor for occurrence and chronicity of back pain. The patient's lifestyle may contribute to MSDs, including chronic MSDs associated with inflammation and decreased functional capacity, both independently or in combination with other risk factors. The most common drugs used for treatment of MSDs are the non-steroidal anti-inflammatory drugs (NSAIDs). However, taking into account the possible NSAID-induced adverse events, the physicians are constantly thinking about ways to reduce the risks. В vitamins (B1, B6 and B12) possess analgesic and anti-inflammatory effects, which are discussed in the paper. When used in combination with NSAIDs, particularly in combination of diclofenac with vitamins B1, B6 and B12, the B vitamins possess some other positive effects contributing to restoration of mobility, pain relief and functional recovery in patients with low back pain. Such combination (diclofenac + vitamins B1, B6 and B12) is represented on the Russian market by Neurodiclovit, the successful use of which is discussed in the case report.

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