Compression Fracture of the Spine

Compression fractures are breaks where the bone is squished or pushed down. These are most commonly from a trauma but can also be found in elderly and other people with brittle bones and osteoporosis. The trauma is usually from a large fall of some sort. Osteoporosis is when the bone becomes weak and thinner making it more vulnerable. Some of the symptoms for a compression fracture include back neck or hip pain, loss of height, numbness, weakness, and loss of control of bowel or urine.

A compression fracture can be found by doing an X-ray, CT, or MRI. Treatment may vary depending on the severity of the fracture. In some cases, the fracture can push on or damage the spinal cord. After being diagnosed with a compression fracture, a doctor may suggest wearing a brace, using hot/cold compresses, exercising, or possibly surgery. Although these fractures could happen to anyone, the chances can be decreased by keeping bones healthy and strong. Some of these include not smoking, exercising, and eating a balanced diet.

image: http://www.emoryhealthcare.org/Images/spine_images/COMPRESSION%20FRACTURE.jpg http://www.eorthopod.com/images/ContentImages/spine/spine_thoracic/compression_fx/thoracic_compression_fx_intro01.jpg

Clay Shoveler's Fracture

The Clay Shoveler's fracture is not a frequent fracture. It is a fracture most common in the lower cervical spine and common fracture near the spinous process. It's most common spine fractures include C6, C7, and T1 and is caused by sudden exertions or extensions of the spine. For this reason, it is most common in labors who do sudden movements with weight. The name originates from clay workers who shoveled clay and had this injury. This fracture results from hyperflexion and is noted to be an injury from snow shoveling. The muscles' force it was actually pulls the bone from the spine.

This fracture is usually determined with an x-ray. Surgery is usually not required and treatment is pretty simple. Many times the patient will just have to wear a neck brace for a given period of time. Full recovery is usually expected.

Images:

http://www.gentili.net/image.asp?ID=19&imgid=clayshoveler.jpg&Fx=Clay+Shoveler%27s+Fracture

http://brighamrad.harvard.edu/Cases/bwh/images/123/Alia8Arrow.GIF

Carotid Dissection

Carotid dissection forms from tears in the arterial walls. Narrowing or complete occlusion may occur from the blood flowing between the inner and outer layers of the artery. Blood clots can form from the dissection and can lead to a stroke or traveling emboli. Carotid dissection is a significant cause for ischemic strokes in people of all ages and favors neither sex more than the other. These dissections can be classified as traumatic or spontaneous. The spontaneous are known for causing strokes in middle-aged people. The traumatic are most commonly from trauma to the head or neck.

Some common symptoms include headache, neck pain, neck swelling, focal weakness, decreased taste sensory, and many others. There are numerous causes for this dissection. Oral contraceptives, hypertension, trauma, and many others. Some studies that can be done to diagnose dissection include angiography, MRA, CTA, Doppler or Duplex. Treatment includes observation, stenting, and rehabilitation depending on the situation.

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Ranula

A ranula is a type of tumor found on the bottom of the mouth or under tongue. These tumors can be hard to find and diagnose. They may change in size and not change in color from surrounding tissue, especially on a deeper one. If the ranula is noticeable, it may appear to be blue. If the ranula becomes large enough it may disrupt swallowing, breathing, or become painful. With swelling, the tongue may become elevated. In most cases, however, there is no pain associated with ranulas. Ranulas may result from obstruction in the sublingual salivary glands or less frequently the submandibulary salivary glands.

Diagnosis of ranulas may include palpation or appearance. Treatment may include a mouth wash to help, excision (cutting or removing) of the ranula, and draining are some of the options. It is not uncommon for ranulas to reoccur and come back.

Picture: http://www.kinderchirurgie.ch/atlas/atlaskopfhals/ranula.JPG

Achondroplasia

Achondroplasia is a disease that is caused by a mutation in the gene FGFR3 fibroblast growth factor receptor 3 gene. Its meaning is "without cartilage formation." It is sometimes inherited, but usually occurs at time of conception. This mutation affects the growth of bone. People affected by this disorder are short statured and have an average height of 4foot 4 in males and 4 foot 1 in females. Appearance wise, these people tend to have disproportionate arms and legs, a large head, and a prominent forehead.

This condition can be found through DNA testing for parents with it, an ultrasound may also show it before birth. Most of the time, the features are visible from birth but it is evident on a x-ray and many times a bone study is performed. As of now, there is no treatment achondroplasia. People who have achondroplasia are more than capable of living healthy lives. Although, they do tend to have ear infections commonly and troubles with obesity. Infants may have weak muscles and a delay in walking and other motor skills.

Image: http://www.moondragon.org/obgyn/graphics/achondroplasiacomparison.jpg

Angiofibroma

An angiofibroma is a benign tumor filled with fibrous tissues. This tumor grows in the nasal cavity. It often times called juvenile nasopharyngeal angiofibroma because it is most common in adolescent males. The peak age is usually around 15. Some of the symptoms associated with this disease are nasal blockage of one side, bleeding of the nose, discomfort swallowing, headache, trouble hearing, and many others. One of the believed causes for this tumor occurring is hormones. There are many stages with this tumor.

Most of the studies that are done to diagnosis this problem are in radiology. A general x-ray may show it, but CT and MRI show them the best. Treatment may include hormonal therapy, radiotherapy, and the most common is surgery.

Image: http://www.medscape.com/content/2001/00/40/66/406652/art-ar3005.01.Fig6.jpg

Orbital Cellulitis

Orbital cellulitis is a condition that targets and age or sex that is characterized by swelling of the eyelid with redness and pain. This can be a result of numerous sources such as microbial infections, bacteria from sinus infection, stye, bug bites, or injury to the eye. Some of the main symptoms include an elevated fever around 102F or more, painful swelling of eyelid, decreased vision, shiny red or purple eyelids, bulging eyes, and difficult and painful eye movements.

Some of the tests that may be use to diagnosis orbital cellulitis include a complete blood count check, blood cultures, spinal tap (extreme cases), sinus x-ray, CT or MRI of sinuses & orbits, and a throat culture. Treatment is mainly just admitting the patient to the hospital and administering antibiotics in an IV. Surgery may be needed for more serious cases to be able to drain it. The best treatment is quick treatment. Some complications may be hearing loss, optic nerve damage, loss of vision, and cavernous sinus thrombosis. Prevention may be achieved in children by giving the HiB vaccine and for everyone to detect sinus and other infections early on.

Picture: http://www.drfante.com/images/orbital_cellulitis.jpg

Prolactinoma

Prolactinoma is the most common tumor of the pituitary gland. Luckily, it is a benign tumor. The pituitary gland releases the hormone prolactin, which is associated with milk production during pregnancy and breast feeding and sexual desire. The tumor causes an over production of this hormone. As the size of the tumor increases, so does the amount of prolactin. Some symptoms of this condition in women may be: loss of menstration, abnormal milk production (w/out pregnancy or breast feeding), decreased sex drive, headaches and change in vission. In men, some symptoms may include: production of milk, decreased sex drive, enlargement of breast tissues (gynecomastica), headache, and visual changes. For diagnosis, a doctor may first request blood tests to check the prolactin levels. Then, if prolactinoma is still an option a MRI would be the next or best step to visualize the tumor. A CT is also an option. The primary treatment for this condition is drugs such as bromocriptine, pergolide, and cabergoline to help reduce and balance out the levels of prolactin. If this has no affect on the tumor, or the patient does not get better, then surgery may be neccessary. Prolactinomas are more common in women than men and in people under the age of 40.

Pictures: http://search.msn.com/images/results.aspx?q=prolactinoma&FORM=BIRE#focal=b3d3a957db6b8e55c588a254c1781b57&furl=http%3A%2F%2Fwww.ent.uci.edu%2Fimages%2Fendo06.jpg

Bell's Palsy

How frightening would it be to wake up with no control of one side of your face? Bell's palsy can be weakness or paralysis of muscles that control a side of face. It may be a result of swelling of the facial nerve which would exert pressure on the nerve. This onset can be within a day or two or just a matter of hours. A person's face who is suffering from Bell's may appear droopy. Some other signs include facial stiffness, pain behind infront or inside of ear, sounds louder in that affected ear, headache, or loss of taster front of tongue. Bell's palsy can occur at any age but is most common in pregnant women, diabetics, or people with weaker immune systems. Babies can also be born with it. However, stroke, infections and tumors may also mimic the signs of Bell's palsy. A doctor may suggest an Electromyography (EMG) which measurses electrical activity in a muscle or and MRI or CT of the head.

In most cases, those that are considered mild, Bell's palsy dissapears withing a month. With more severe cases, the nerves may be permantly damaged. Most of the time, a patient will heal fine without any treatment. As of now, there is no treatment that is certain to eliminate it but may help. Some treatments may include anti-inflammatory medication, antiviral medication, or facial massage. It is very important to protect the affected side's eye with Bell's palsy. Using an eye patch and artificial tears will help protect the cornea of the eye. Although no one would want to have Bell's palsy, in most cases the it does clear up within a few weeks to a few months.

Image http://www.keepgoing.org/issue7_hijinx/images/dean1.jpg

Meningitis

Meningitis is the inflammation of the meninges surrounding the brain and spinal cord. There are different forms of Meningitis. The most common is viral; it is contracted through the nose and mouth. It tends to affect children and adults younger than 30 and is more common late summer and early fall. Another form is bacterial, it is much more severe and mimics cold like infection. Fungi, chemical irritation, drug allergies, and tumors are also causes of meningitis. Meningitis has numerous symptoms including sudden fever, altered mental status, stiff neck, severe headache, sensitivity to bright lights, seizures, and extreme fatigue. Once the symptoms are understood, there are many different exams that can be done to check for meningitis. Blood tests, chest x-ray, lumbar puncture, CT, and MRI can lead to diagnosis. In the case of a lumbar puncture, the patient's CSF is extracted and from that we measure glucose and cell count. There is some treatment for meningitis. Many cases of viral actually resolve without treatment usually withing two weeks and with no after effects. Bacterial, on the other hand, requires early treatment and even then it does not guarantee the patient will not die or suffer brain damage. Some of the after effects that may occur include memory loss, problems with coordination, reoccuring headaches, loss of balance, difficulties learning, seizures, and change in sight. Meningitis is something I have heard over and over again, especially with college students; but up until researching, it I did not really have any idea what it entailed or how serious it can be.

I found the image at http://upload.wikimedia.org/wikipedia/commons/thumb/f/fd/Streptococcus_pneumoniae_
meningitis,_gross_pathology_33_lores.jpg/402px-Streptococcus_pneumoniae_meningitis,_
gross_pathology_33_lores.jpg

Intro

Hello all. This is my blog that I will be using to post information about different pathologies and cases in CT and MRI. Check back soon for new posts!