DrAlex_76 wrote:
by the way, sensations and relfex are intact in Derm / Polymyositis .
How about this case ?
A 70 yo man comes with 4 month complain of hand weakness, tingling, numbness in small fingers of both hand and mild neck pain. PE shows wasting, fasiculation and weakness of the interossei muslces. His sensation - vibration in both small hand fingers are decreased. Tricep tendons are also decreased. What is this ? What is the most like next step in management ?
May be cervical spodylosis ,
for the next step I'll go for cervial X ray which shows osteophytes .
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| ngaybinhyen
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hey guys, you are changing my topic
* cervical spondylosis = cervical disk syndrome
- Symptoms are attributed to cervical disk herniation
- Acute herniation: neck pain and arm paresthesias/pain +/- neurologic deficit
- Cervical myelopathy in older patients or younger patients with large cervical disk herniations --> spinal cord compression
- often herniation at multiple levels associated degenerative changes & spinal stenosis
+ Common causes
Degenerative changes of the cervical spine
Rheumatoid arthritis
Trauma
+ Plain X-rays of the cervical spine can be the intitial test
Loss of disk height: suggestive of, but not diagnostic of, disk herniation
Degenerative changes and osteophyte formation contributing to neural compression
+ MRI shows most structural lesions, and should be considered the study of choice
+ Myelography if the MRI cannot be performed or MRI does not show the anatomy adequately; by a specialist, and only if surgery is being considered.
+ Postmyelogram CT-scan is the best way of visualizing the abnormalities
* Rx A trial of conservative therapy is usually warranted before surgical referral
Surgical consultation should not be delayed if there is weakness or signs of myelopathy
Edited by ngaybinhyen on 09/26/08 - 11:36 PM
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| ngaybinhyen
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Topics: 23
Posts: 657
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Guys,
I'm somehow closing the topic with some silly notes
1. Ankylosing spondylitis: 3-4 times
2. Inclusion body myositis 2-3 times
3. Gout: male:female ratio b/w 2-7:1 with exception(polyarticular gout)
4. PAN male:female ratio 2.5-3:1
5. Allergic granulomatosis (Churg-Strauss syndrome) predominantly in males
6. Kawasaki disease Male:female 1.5:1.
7. Psoriatic arthritis: slight male-to-female predominance (1.3:1)
8. Postvenereal Reiter's syndrome is more common in men (20:1)
Postenteric Reiter's syndrome: men = women
9. ulcerative colitis: Males slightly more predisposed
10. Osteoarthritis: Men = women. In older people, hips more commonly affected in men
11. Degenerative tendinitis slightly more frequently in males
Calcific tendinitis: men = women
12. Interstitial lung disease = idiopathic pulmonary fibrosis, male:female 2:1
13. Goodpasture’s syndrome: Male:female ratio is 6:1 in young adults
14. Buerger's disease: striking male predominance
Correct me and add more please, guys
Edited by ngaybinhyen on 09/10/08 - 07:00 PM
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| nightflight1945
banned
Topics: 32
Posts: 920
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This is a real topic ans discussion that I'm looking for
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| ngaybinhyen
Forum Guru
Topics: 23
Posts: 657
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Hope you guys are gonna add more
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Ankylosing spondylitis is 3-4 times more frequent in men than in women 
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