scholarly journals Tubercular Osteomyelitis of Tibia: A Case Report

2019 ◽  
Vol 2 (1) ◽  
pp. 92-94
Author(s):  
Amin Kumar Shrestha ◽  
Suman Raja Shrestha ◽  
Gopesh Kumar Thakur ◽  
Arjun Prasad Dumre
Keyword(s):  
Weight Loss ◽  
Differential Diagnosis ◽  
Osteolytic Lesion ◽  
Extrapulmonary Tuberculosis ◽  
Long Bone ◽  
Low Grade ◽  
X Rays ◽  
X Ray ◽  
Tuberculous Osteomyelitis ◽  
History Of

Tubercular osteomyelitis of long bone is extremely rare and very few cases have been reported in literature. We are presenting a case of 43 years gentlemen presented with pain and swelling over lower half of leg for 5 months. There was associated pus discharging sinus and often low-grade fever but no history of weight loss or pulmonary symptoms. X-ray chest was normal. X-rays of involved leg was suggestive of osteomyelitis. Curettage and Biopsy was done, report was suggestive of tuberculous osteomyelitis. As tuberculosis is still common in developing countries like Nepal, for any osteolytic lesion in bone, tubercular osteomyelitis should always be considered in differential diagnosis. Keywords: extrapulmonary tuberculosis; osteolytic lesion in bone; tubercular osteomyelitis.

scholarly journals PRIMARY DIAPHYSEAL TUBERCULOUS OSTEOMYELITIS OF TIBIA

2014 ◽  
Vol 21 (06) ◽  
pp. 1282-1284
Author(s):  
Ghulam Mustafa Kaim Khan ◽  
Syed Mujahid Humail ◽  
Kamran Hafeez
Keyword(s):  
Weight Loss ◽  
Developing Countries ◽  
Differential Diagnosis ◽  
Osteolytic Lesion ◽  
Long Bone ◽  
Low Grade ◽  
X Rays ◽  
X Ray ◽  
Tuberculous Osteomyelitis ◽  
History Of

Diaphyseal tubercular osteomyelitis of long bone is extremely rare and few cases have been reported in literature. We are presenting a case of 17 years old girl presented with pain and swelling over lower half of leg for 7 months. There was often low grade fever but no history of weight loss or pulmonary symptoms. X-ray chest was normal. X-rays and MRI of involved leg were suggestive of osteomyelitis. Curettage and biopsy was done, report was suggestive of tuberculous osteomyelitis. As tuberculosis is still common in developing countries, for an osteolytic lesion in bone, tuberculous osteomyelitis should be considered in differential diagnosis.

scholarly journals P045 Nothing is too 'cagey' for the rheumatologist

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Muhammad F Kazmi
Keyword(s):  
Weight Loss ◽  
Inflammatory Markers ◽  
Low Grade ◽  
Careful Monitoring ◽  
Chronic Infections ◽  
Asian Origin ◽  
Travel History ◽  
Chest Clinic ◽  
History Of ◽  
Inflammatory Changes

Abstract Background/Aims  Rheumatological conditions can present with a number of non-specific features like arthralgia, fever, fatigue, weight loss along with raised inflammatory markers and positive antibodies. Due to this, when similar symptoms are referred for input it is very important to consider other ‘mimics’. We report a case of Pigeon fancier’s lung presenting with these symptoms which was referred as likely connective tissue disease. Methods  A 52-year-old lady of South Asian origin was referred by her GP with six month history of 3kg weight loss, arthralgia, fatigue, low grade fever and persistently raised inflammatory markers (ESR ranging from 50-64 mm/hr, CRP 10-14 mg/L, normal BMI). On further questioning there was history of mouth ulcers, non-specific rash, occasional cough but no Raynaud’s or joint swelling. Blood investigations showed weakly positive ANA and RF but negative ENA, DNA, antiCCP , CK, C3,C4. C-ANCA was positive but PR3 negative. CXR was clear and tests for chronic infections including TB were negative. Due to lack of objective CTD signs, plan was to take a careful monitoring approach to see if clinical features evolved. A month later due to worsening cough, a CT chest/abdomen arranged by GP showed ground-glass changes consistent with pneumonitis and hence her rheumatology appointment was expedited to see if there was an autoimmune unifying diagnosis. She was also referred by her GP to the chest clinic in view of CT report and mild shortness of breath. Results  On further review, again there were no objective CTD signs. On direct questioning there was history of travelling before worsening chest symptoms to South Asia. Also around a year before her symptoms started she was given an African grey parrot. Based on this, serology for Avian precipitin was checked which showed strongly positive IgG antibodies to avian antigens (Budgerigar droppings and feathers, Pigeon feathers IgG Abs) confirming the diagnosis of pigeon fanciers lung. She fulfilled the diagnostic criteria and was asked to avoid the trigger. Urgent respiratory input was arranged where diagnosis was agreed with and disease was deemed sub-acute in presentation. Due to PFTs showing low transfer factor of 38%, Prednisolone was started with significant improvement within few days. Review of CT chest only showed inflammatory changes and no established fibrosis predicting excellent prognosis as delay in treatment can cause irreversible pulmonary fibrosis. Conclusion  A number of conditions can mimic rheumatological conditions which usually turn out to be either infectious or malignant in origin. This case highlights the importance of considering other differentials and along with taking a travel history also asking for other possible triggers like pets. In similar scenarios the diagnosis may be ‘cagey’ but as rheumatologists we are expected to answers questions which others can’t. Disclosure  M.F. Kazmi: None.

Pneumatosis Coli in a Dog

2008 ◽  
Vol 44 (1) ◽  
pp. 32-35 ◽  
Author(s):  
Nicholas J. Russell ◽  
Dayle Tyrrell ◽  
Peter J. Irwin ◽  
Catherine Beck
Keyword(s):  
Weight Loss ◽  
Differential Diagnosis ◽  
Clinical Signs ◽  
Colorectal Disease ◽  
Abdominal Radiography ◽  
Pneumatosis Coli ◽  
History Of ◽  
Oral Metronidazole

A 17-year-old, castrated male Maltese was presented with chronic polyphagia and a 2-week history of tenesmus, diarrhea, hematochezia, weight loss, and ribbon-like feces. Pneumatosis coli was diagnosed by abdominal radiography. Concurrent hyperadrenocorticism was suspected. The clinical signs of colorectal disease resolved within 2 days of initiating a lowresidue diet and oral metronidazole. Pneumatosis coli should be considered as a differential diagnosis for colorectal disease in dogs.

Clinical Joint Outcome after Joint Bleeds in Patients with Von Willebrand Disease Is Comparable to Moderate and Severe Hemophilia A Despite Fewer Joint Bleeds

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 3789-3789 ◽  
Author(s):  
Karin PM van Galen ◽  
Merel Timmer ◽  
Piet de Kleijn ◽  
Frank W.G. Leebeek ◽  
Roger E.G. Schutgens ◽  
...  
Keyword(s):  
Physical Examination ◽  
Research Funding ◽  
Functional Limitations ◽  
Joint Damage ◽  
Von Willebrand Disease ◽  
X Rays ◽  
X Ray ◽  
History Of ◽  
Type 3 ◽  
Von Willebrand

Abstract Background Recurrent joint bleeds are the main cause of joint deterioration (hemophilic arthropathy) in patients with hemophilia. To what extent arthropathy occurs following joint bleeds in patients with Von Willebrand disease (VWD) compared to hemophilia has never been studied. Objectives The primary objective was to compare joint outcome by physical examination between adults with VWD and moderate and severe hemophilia A (HA). The main secondary objectives were to compare joint bleed frequency, radiological joint damage and self-reported functional limitations between VWD and moderate and severe HA. Methods We selected adult patients with VWD (VWF activity <30%) and moderate or severe HA, who had a medical history of treatment for joint bleeds, for this post hoc analysis. To compare joint outcome we used the Hemophilia Joint Health Score (HJHS range 0-124, obtained by physical examination), X-ray Pettersson scores of ankles, knees and elbows (PS range 0-13 per joint) and Hemophilia Activities List scores, a patient administered questionnaire measuring functional limitations (HAL range 0-100). Univariate analyses were performed using Mann Whitney U and Chi2. For multivariate analysis we used negative binomial regression analysis (HJHS) and logistic regression (dichotomized PS>3 and HAL<95) adjusted for age. We performed a subgroup analysis of the patients with type 3 VWD. Results We included 48 patients with VWD, 39 with moderate and 59 with severe HA. The mean age was 45, 38 and 26 years, respectively. Fewer patients with VWD than HA had a lifetime history of more than 5 joint bleeds (56% VWD vs. 77% moderate HA vs. 98% severe HA, p<0.001). Joint dysfunction at physical examination was comparable between the patients with VWD and moderate HA (median HJHS 5 vs. 5.5, p=0.65) but slightly better in VWD compared to severe HA (median HJHS 5 vs. 9, p=0.02). Apparent joint damage on X rays (PS>3 of one or more joints) occurred in 12/46 patients with VWD compared to 27/40 patients with severe HA (26% vs. 68%: OR 0.09; 95%CI 0.03-0.34, p<0.001). In moderate HA insufficient X rays were available for analyses. Functional limitations according to the HAL were comparable between patients with VWD and moderate and severe HA (VWD median HAL total score 88 vs. 95 in both moderate and severe HA, p=0.35). The subgroup analysis of joint dysfunction in patients with type 3 VWD (n=19, median age 40) showed clinical changes comparable to severe HA (median HJHS 14 vs. 9, p=0.83). We found a trend towards less radiological joint damage in type 3 VWD compared to severe HA (PS>3: 47% vs. 68%, OR 0.28; 95%CI 0.07-1.12, p=0.07). However, patients with type 3 VWD reported more functional limitations compared to those with moderate or severe HA (median HAL total score 77 vs. 95, p=0.01; adjusted for age OR 0.38; 95%CI 0.1-1.2, p=0.10). Conclusions Despite fewer joint bleeds, joint function according to the HJHS was comparable between adult patients with VWD and moderate HA with a history of treatment for joint bleeds. Apparent X ray joint damage occurred less often in patients with VWD compared to those with severe HA. The HJHS of patients with type 3 VWD was comparable to those with severe HA, but the patients with type 3 VWD reported more functional limitations, partly explained by their higher age. Knowledge of similarities and differences in joint outcome between VWD and hemophilia can be helpful to improve the awareness and treatment of joint bleeds in VWD to prevent arthropathy and functional limitations. Disclosures van Galen: Bayer: Research Funding; CSL Behring: Research Funding; Baxter: Research Funding. Leebeek:CSL Behring: Research Funding; Baxter: Research Funding. Schutgens:Sanquin: Research Funding; CSL Behring: Research Funding. Fischer:Baxalta/Baxter: Consultancy, Research Funding, Speakers Bureau; Pfizer: Consultancy, Research Funding, Speakers Bureau; CSL Behring: Consultancy, Speakers Bureau; NovoNordisk: Consultancy, Research Funding, Speakers Bureau; Octapharma: Speakers Bureau; Baxter: Consultancy, Research Funding, Speakers Bureau; Wyeth: Research Funding; Biogen: Consultancy; Biotest: Consultancy, Speakers Bureau; Bayer: Consultancy, Research Funding, Speakers Bureau; Freeline: Consultancy. Mauser-Bunschoten:CSL Behring: Research Funding; Bayer: Research Funding; Baxter: Research Funding; Griffols: Research Funding; Novo Nordisk: Research Funding; Pfizer: Research Funding; Biovitrum: Research Funding; Saquin: Research Funding.

The Discovery of X-Rays: a Probable Case of Second Order Observation

2018 ◽  
Vol 19 (4) ◽  
pp. 403
Author(s):  
Marco Aurélio Clemente Gonçalves ◽  
Mariele Regina Pinheiro Gonçalves ◽  
Pablo Eduardo Ortiz
Keyword(s):  
History Of Science ◽  
Second Order ◽  
Point Of View ◽  
X Rays ◽  
Historical Reconstruction ◽  
X Ray ◽  
Probable Case ◽  
The Status ◽  
History Of

The discovery of x-rays, one of the most beautiful experiments ever carried out, generates numerous controversies and these, in turn, can trigger a series of counterproductive information regarding not only the History of Science but also the teaching  activity. The aim of this article is to resolve these controversies concerning what ocurred and highlight the important role of the German physicist Wilhelm Conrad Röntgen, highlighting not only his genius but, especially in this case in particular, his condition of second-order observer. It is not uncommon to find information in various media refering to this discovery under the claim that it was the result of a fortuitous event, and this denotes a profound lack of knowledge about the facts or a disrespect for the renowned discoverer. Such allegations about the event depreciate the extraordinary discovery that impacts humanity, from the deed  to the present. Thus, through a brief historical reconstruction, it was tried to present here what had happened judiciously. With this respect, the brilliant scientist is given the status of a second-rate observer, from the philosophical point of view. This condition resonates with the diachronic aspect of the History of Science, according to the perspective presented here, and it is also supported by the time taken by the discoverer from the beginning of his research until the end of it. Keywords: X-Ray. Second-Order Observer. History of Science. ResumoO descobrimento dos raios-x, um dos mais belos experimentos já realizados, gera inúmeras controvérsias e essas, por sua vez, podem desencadear uma série de informações contraproducentes no tangente não só a História da Ciência como também à atividade de ensino. O presente artigo tem como objetivo dirimir tais polêmicas com respeito ao ocorrido e destacar o importante papel do físico alemão Wilhelm Conrad Röntgen, destacando não só sua genialidade, mas sobretudo, neste caso em particular, a sua condição de observador de segunda ordem. Não é raro encontrar em diversos meios de comunicação informações com respeito a referida descoberta sob a alegação de que a mesma fora fruto de um caso fortuito e isso denota profundo desconhecimento sobre os fatos, ou então, desrespeito com o renomado descobridor. Tais alegações sobre o sucedido depreciam a descoberta extraordinária que impacta a humanidade, desde o feito até a atualidade. Assim, através de breve reconstrução histórica, buscou-se aqui apresentar o ocorrido criteriosamente. Com este respeito passa-se a atribuir ao brilhante cientista a condição de observador de segunda ordem, do ponto de vista filosófico. Tal condição encontra ressonância no aspecto diacrônico da História da Ciência, segundo a perspectiva aqui apresentada e está amparada, também, pelo tempo empreendido pelo descobridor desde o início de sua pesquisa até a finalização da mesma. Palavras-chave: Raios-x. Observador de Segunda Ordem. História da Ciência.

The Bakerian Lecture 1978 - Cosmic exploration by X-rays

1979 ◽  
Vol 366 (1724) ◽  
pp. 1-21 ◽  
Keyword(s):  
The United States ◽  
National Committee ◽  
Radio Sources ◽  
Cosmic Radio ◽  
The Sun ◽  
X Rays ◽  
X Ray ◽  
Recent Developments ◽  
History Of ◽  
The Subject

Bakerian Lectures dealing with astronomical topics have occurred roughly every ten years during this century. They have therefore something of the character of reports on progress and one need read no further back than Hoyle’s ‘Review of recent developments in cosmology’ (Hoyle 1968) and Ryle’s ‘The nature of the cosmic radio sources’ (Ryle 1958) to discover the background against which are to be seen the dramatic changes of the ensuing period. It stretches from the conception of X-ray astronomy through its birth, with the discovery of the first non-solar source (Giacconi et al . 1962), to its maturity with the availability of satellites to provide long exposures. Nor is it any accident that the root κóσμoς is prominent in the titles of recent lectures for while those of Jeans, Eddington, Milne and Blacket were concerned with our Galaxy, the drama is now truly cosmic. Cosmic X-ray astronomy grew out of the study of the Sun and for this reason its founding father is Herbert Friedman. Giacconi describes well the early history of the subject (Giacconi & Gursky 1974) and tells how, in June 1962, having been interested in the idea by Rossi in September 1959, he and his colleagues detected flux coming neither from the Sun nor from the Moon. Friedman had discussed as early as 1956 ‘how his group obtained puzzling results, which might have been due to celestial X-ray fluxes’, and reported this at the I. A. U. meeting in Moscow in 1958. Stimulated by our solar studies with the Skylark rocket, similar thinking was taking place under the auspices of this Society. Mention of this was made at a conference in the United States in June 1961 (Boyd 1962) but a meeting of the Astronomy Working Group of the British National Committee on Space Research (N. C. S. P./34, 1959 a ) had discussed, in May 1959, the possibility, of mounting ‘Directive X-ray counters’ on the proposed U. K. -I satellite. The minute read ‘Current theories suggested that there may be objects in the sky with strong X-ray emission although inconspicuous visually. A search for these is a matter of great interest and importance.’ It is noteworthy that Hoyle, who had discussed Friedman’s speculations with him, was present at the meeting.

scholarly journals Urachal Adenocarcinoma: A Case Report with Key Imaging Findings and Radiologic-Pathologic Correlation

2018 ◽  
Vol 2018 ◽  
pp. 1-5 ◽  
Author(s):  
Willian Schmitt ◽  
Marta Baptista ◽  
Marco Ferreira ◽  
António Gomes ◽  
Ana Germano
Keyword(s):  
Weight Loss ◽  
Differential Diagnosis ◽  
Clinical History ◽  
Imaging Findings ◽  
Lesion Location ◽  
Patient Demographics ◽  
Pathologic Correlation ◽  
Associated Symptoms ◽  
History Of ◽  
Urachal Adenocarcinoma

Urachal pathologies are rare and can mimic numerous abdominal and pelvic diseases. Differential diagnosis of urachal anomalies can be narrowed down by proper assessment of lesion location, morphology, imaging findings, patient demographics, and clinical history. We report a case of a 60-year-old male, with a history of unintentional weight loss without associated symptoms, who was diagnosed with locally invasive urachal adenocarcinoma. With this article, we pretend to emphasize urachal adenocarcinoma clinical features along with its key imaging findings with radiologic-pathologic correlation.

scholarly journals Conundrums of hypothyroidism

2018 ◽  
Vol 4 (3) ◽  
pp. 447
Author(s):  
Vidya D. Kharkar ◽  
Snahasish Naskar
Keyword(s):  
Atopic Dermatitis ◽  
Differential Diagnosis ◽  
Connective Tissue Disorder ◽  
Primary Hypothyroidism ◽  
Low Grade ◽  
Once Daily ◽  
Calcium Supplements ◽  
Low T3 ◽  
History Of ◽  
Laboratory Investigations

<p class="abstract">A 46 year old female came with complaints of dryness of skin and severe hair loss since 2-3 years. There was history of intermittent low grade fever, swelling all over body since 1 year; patient also complained of tingling numbness over bilateral legs and forearms along with difficulty in swallowing food. On further probing, history of difficulty in lifting arms above the head, constipation, generalised fatigue and drowsiness could be elicited. Patient also noticed raised skin coloured asymptomatic lesions over buttocks. On examination loss of eyebrows and alopecia in frontal and parietal scalp was seen. There was prominent follicular ostia and atrophy on scalp and body. Depressed keratotic papules with a generalized doughy feel of skin was appreciated all over body. A differential diagnosis of connective tissue disorder, widespread alopecia areata, folliculotropic mycosis fungoides, hypothyroidism and atopic dermatitis was made. Laboratory investigations revealed a low T3, T4 with a significantly raised TSH suggestive of a primary hypothyroidism. On histopathology mucin deposition in papillary and mid dermis was seen along with non-scarring pattern of alopecia. A diagnosis of hypothyroidism was made and patient was started on Tab. levothyroxin 75 micrograms once daily for 4 months along with hematinics, multivitamins and calcium supplements. Regular and frequent application of emollients was advised to the patient.</p>

A CASE OF SPINAL TUBERCULOSIS MISEVALUATED AS INTESTINAL OBSTRUCTION

2021 ◽  
pp. 32-33
Author(s):  
Chepuri Sagar
Keyword(s):  
Intestinal Obstruction ◽  
Spinal Tuberculosis ◽  
Low Grade ◽  
X Ray ◽  
Pott’S Disease ◽  
Pain Abdomen ◽  
Chief Complaints ◽  
History Of ◽  
Extra Pulmonary ◽  
Tuberculosis Of Spine

Tuberculosis of spine (Pott's disease) is a frequently encountered extra pulmonary form of tuberculosis and is the most dangerous form . We report a case of spinal tuberculosis which present with clinical features of intestinal obstruction. A 45 1 year old male patient came to general surgery out patient department with chief complaints of pain abdomen since two weeks, constipation since two weeks and distension of abdomen since 10 days. History of fever present since 2 months low grade on and off. Case was evaluated with X ray erect abdomen, colonoscopy, CT abdomen which showing features of tuberculosis of spine. Patients of tuberculosis of spine can be asymptomatic and sometimes diagnosis is made incidentally during the course of evaluation for other symptoms

X-Ray Diffraction – The Magic Wand

2020 ◽  
Vol 42 (3) ◽  
pp. 317-317
Author(s):  
Iqra Zubair Awan Iqra Zubair Awan
Keyword(s):  
Materials Science ◽  
Review Paper ◽  
Medical Community ◽  
X Rays ◽  
X Ray Diffraction ◽  
Medical Sciences ◽  
X Ray ◽  
Magic Wand ◽  
History Of ◽  
Engineering Materials

This review paper covers one of the most important discoveries of the last century, viz. X-ray diffraction. It has made enormous contribution to chemistry, physics, engineering, materials science, crystallography and above all medical sciences. The review covers the history of X-rays detection and production, its uses/ applications. The scientific and medical community will forever be indebted to Rand#246;ntgen for this invaluable discovery and to those who perfected its application.

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