Also known as: Hypochronic microcytic anemia
What is it?
Iron-deficiency anemia is a condition that occurs when there is not enough iron in the blood. Iron is a mineral the body needs to make hemoglobin, the part of the red blood cell that helps carry oxygen from the lungs to the rest of the body.
Who gets it?
Iron-deficiency anemia is the most common type of anemia in the world, affecting mostly women, young children, and older people. It is estimated that 15 percent of menstruating women are affected, and it is particularly common in women of Asian decent.
What causes it?
Any condition in which a person loses blood over a long period of time can cause iron-deficiency anemia. The most common cause in the United States is pregnancy and gastrointestinal bleeding. During pregnancy, a woman needs extra iron for her growing baby.
Bleeding and blood losses through gastrointestinal tract can be caused by colorectal cancer, hookworms, hemorrhoids, anal fissures, irritable bowel syndrome, aspirin-induced bleeding, blood clotting disorders, and diverticulosis (a condition caused by an abnormal opening from the intestine or bladder). Von Willebrand's disease, a genetic condition, can cause bleeding disorders which can cause gastrointestinal bleeding.
Other causes include menstruation, blood loss through the urine, donating blood more than five times per year, not eating healthy foods, chronic inflammation of the intestines, problems with iron absorption and surgery to remove part of the stomach.
What are the symptoms?
Many people who have iron-deficiency anemia don’t realize it. The most common symptoms are feeling tired and weak, paleness of skin, whites of eyes appear blue-like, shortness of breath, dizziness, abdominal pain and lack of appetite. These symptoms result because of the red blood cells are not functioning properly and cannot carry iron to exercising muscles. Other symptoms may include headache, feeling irritable, nails that break easily, burning and soreness on the tongue and in the mouth. Wanting to eat ice, paint, starch, or dirt (a condition called Pica) may be other signs of iron-deficiency anemia.
How is it diagnosed?
To diagnose iron-deficiency anemia, the doctor may look at the patient’s medical history and symptoms to determine what tests should be done. A blood test in combination with a test for oral iron absorption may confirm the diagnosis. The doctor may also want to check the patient’s stools or get x-rays of the bowel to determine if blood loss is a cause of the anemia.
What is the treatment?
The doctor may recommend the patient take oral iron supplements to treat iron-deficiency anemia. If poor iron absorption is a problem, the doctor may recommend therapy with injections of iron. The doctor may recommend a surgery, called an upper and/or lower GI endoscopy, to detect any malignancy. The doctor may also recommend the patient change his or her eating habits to be sure of a well-balanced diet.
Self-care tips
Iron-deficiency anemia is easily cured. Patients should follow their doctor’s recommendations and take their iron supplements and follow a well-balanced, varied diet.
Sunday, March 8, 2009
Anemia
What is it?
Anemia is condition caused by low levels of healthy red blood cells or hemoglobin (the part of the red blood cells that delivers oxygen from the lungs to the rest of the body). There are over 400 different types of anemia ranging from mild to severe. Many of them are rare.
Who gets it?
Anyone with certain underlying conditions can develop anemia. Those at risk include anyone with chronic blood loss due to cancer, gastrointestinal tumors, hemorrhoids, heavy menstrual flow, stomach ulcers, alcohol abuse, or other medical conditions.
What causes it?
Anemia is caused by chronic bleeding, a decrease in red blood cell production, or an increase in red blood cell destruction. A poor diet low in iron can cause anemia, as can some hereditary disorders and certain diseases. However, excessive bleeding due to cancer, childbirth, injury, gastrointestinal tumors, heavy menstrual flow, hemorrhoids, nosebleeds, stomach ulcers, alcohol abuse and surgery is the most common cause of anemia.
What are the symptoms?
Symptoms of anemia include weakness; fatigue; pale sallow skin; dizziness; lack of color in the palms of hands, gums and nail beds; chest pain; cravings for ice, paint or dirt; headache; inability to concentrate; inflammation of the mouth; insomnia; irregular heartbeat; lack of appetite; nails that are dry and brittle; swelling of the hands and feet; thirst; ringing in the ears and unexplained bleeding or bruising.
How is it diagnosed?
To diagnose anemia, the doctor may look at the patient’s medical history and symptoms to determine what tests should be done. Anemia may be diagnosed through laboratory tests that measure the percentage of red blood cells or the amount of hemoglobin in the blood. The doctor may also use the tests to determine the type of anemia responsible for the patient’s symptoms. In addition, the doctor may order x-rays and examinations of bone marrow to identify the source of the bleeding.
What is the treatment?
Treatment of anemia is usually directed at the underlying cause. The doctor may recommend anemia due to nutritional deficiencies be treated with iron supplements, injections of vitamin B12, or other vitamin supplements. If blood loss is severe, the doctor may recommend the patient undergo transfusions of red blood cells to accelerate their production. Medication or surgery may be necessary to control menstrual flow, repair a bleeding ulcer, or remove polyps (growths or nodules) from the bowels. Cancer-related anemias may be treated with blood transfusions and/or medication.
Self-care tips
While inherited anemias cannot be prevented, avoiding excessive use of alcohol, eating a balanced diet that contains plenty of iron-rich foods, and taking a daily multivitamin can help prevent many types of anemia.
Anemia is condition caused by low levels of healthy red blood cells or hemoglobin (the part of the red blood cells that delivers oxygen from the lungs to the rest of the body). There are over 400 different types of anemia ranging from mild to severe. Many of them are rare.
Who gets it?
Anyone with certain underlying conditions can develop anemia. Those at risk include anyone with chronic blood loss due to cancer, gastrointestinal tumors, hemorrhoids, heavy menstrual flow, stomach ulcers, alcohol abuse, or other medical conditions.
What causes it?
Anemia is caused by chronic bleeding, a decrease in red blood cell production, or an increase in red blood cell destruction. A poor diet low in iron can cause anemia, as can some hereditary disorders and certain diseases. However, excessive bleeding due to cancer, childbirth, injury, gastrointestinal tumors, heavy menstrual flow, hemorrhoids, nosebleeds, stomach ulcers, alcohol abuse and surgery is the most common cause of anemia.
What are the symptoms?
Symptoms of anemia include weakness; fatigue; pale sallow skin; dizziness; lack of color in the palms of hands, gums and nail beds; chest pain; cravings for ice, paint or dirt; headache; inability to concentrate; inflammation of the mouth; insomnia; irregular heartbeat; lack of appetite; nails that are dry and brittle; swelling of the hands and feet; thirst; ringing in the ears and unexplained bleeding or bruising.
How is it diagnosed?
To diagnose anemia, the doctor may look at the patient’s medical history and symptoms to determine what tests should be done. Anemia may be diagnosed through laboratory tests that measure the percentage of red blood cells or the amount of hemoglobin in the blood. The doctor may also use the tests to determine the type of anemia responsible for the patient’s symptoms. In addition, the doctor may order x-rays and examinations of bone marrow to identify the source of the bleeding.
What is the treatment?
Treatment of anemia is usually directed at the underlying cause. The doctor may recommend anemia due to nutritional deficiencies be treated with iron supplements, injections of vitamin B12, or other vitamin supplements. If blood loss is severe, the doctor may recommend the patient undergo transfusions of red blood cells to accelerate their production. Medication or surgery may be necessary to control menstrual flow, repair a bleeding ulcer, or remove polyps (growths or nodules) from the bowels. Cancer-related anemias may be treated with blood transfusions and/or medication.
Self-care tips
While inherited anemias cannot be prevented, avoiding excessive use of alcohol, eating a balanced diet that contains plenty of iron-rich foods, and taking a daily multivitamin can help prevent many types of anemia.
Andropause
Also known as: Male Menopause
What is it?
Andropause, or male menopause, is a condition associated with declining androgen levels. It may result from primary or secondary hypogonadism or from a pathologic condition.
Who gets it?
Andropause affects about half of men older than age 50.
What causes it?
Andropause is caused by lower levels of testosterone and its consequences as men age. Recent studies show that after age 30, testosterone levels generally decrease by one to two percent per year - although this decline can vary widely.
Sudden, drastic declines in testosterone levels are usually caused by hypogonadism. Classified as either primary or secondary, hypogonadism should be ruled out in patients experiencing symptoms of andropause.
What are the symptoms?
Symptoms of andropause can vary from one man to the next. Symptoms of male Andropause may include lethargy or decreased energy, decreased libido or interest in sex, erectile dysfunction with loss of erections, muscle weakness and aches, inability to sleep, hot flashes, night sweats, depression, infertility and thinning of bones or bone loss.
How is it diagnosed?
Andropause can be diagnosed by measuring the level of testosterone in the blood. Andropause occurs as a result of testosterone deficiency and a low free and bioavailable testosterone level is found in males with androgen deficiency. Total testosterone levels can be used as a screen for the Andropause but it is the decrease in the free form of testosterone that causes the symptoms.
Usually testosterone deficiency is not the most common cause of impotence; other causes include atherosclerosis, diabetes, hypertension, and use of certain medications. These factors, as well as previous genital trauma and other aspects of the patient’s medical history, are important in diagnosing andropause.
What is the treatment?
To treat andropause, the doctor may advise the patient to undergo hormone replacement therapy. Replacing testosterone can have a significant benefit particularly in older men with an improvement in well-being, improved sex drive, improved sexual function, improved muscle mass and strength and an increase in bone density. There are now several alternatives available for testosterone replacement therapy in the form of skin patches and creams that can deliver testosterone into the blood in a non-invasive way.
Men who are carefully selected for hormone replacement therapy must be monitored for signs of prostate disease, dyslipidemia, hepatotoxicity, erythrocytosis, and other side effects.
Consult your physician and ask her/him whether you should have a testosterone level determined to see if you are deficient. If you are deficient and are a candidate for testosterone replacement therapy, your physician will prescribe just the right therapy for you. Questions can be directed to the Endocrine Clinic here at Penn State Hershey Medical Center.
Self-care tips
Patients diagnosed with andropause and being treated with hormone replacement therapy should be monitored to check testosterone, lipid and hematocrit levels. That way, treatment can be adjusted according to the patient’s needs and side affects closely monitored
What is it?
Andropause, or male menopause, is a condition associated with declining androgen levels. It may result from primary or secondary hypogonadism or from a pathologic condition.
Who gets it?
Andropause affects about half of men older than age 50.
What causes it?
Andropause is caused by lower levels of testosterone and its consequences as men age. Recent studies show that after age 30, testosterone levels generally decrease by one to two percent per year - although this decline can vary widely.
Sudden, drastic declines in testosterone levels are usually caused by hypogonadism. Classified as either primary or secondary, hypogonadism should be ruled out in patients experiencing symptoms of andropause.
What are the symptoms?
Symptoms of andropause can vary from one man to the next. Symptoms of male Andropause may include lethargy or decreased energy, decreased libido or interest in sex, erectile dysfunction with loss of erections, muscle weakness and aches, inability to sleep, hot flashes, night sweats, depression, infertility and thinning of bones or bone loss.
How is it diagnosed?
Andropause can be diagnosed by measuring the level of testosterone in the blood. Andropause occurs as a result of testosterone deficiency and a low free and bioavailable testosterone level is found in males with androgen deficiency. Total testosterone levels can be used as a screen for the Andropause but it is the decrease in the free form of testosterone that causes the symptoms.
Usually testosterone deficiency is not the most common cause of impotence; other causes include atherosclerosis, diabetes, hypertension, and use of certain medications. These factors, as well as previous genital trauma and other aspects of the patient’s medical history, are important in diagnosing andropause.
What is the treatment?
To treat andropause, the doctor may advise the patient to undergo hormone replacement therapy. Replacing testosterone can have a significant benefit particularly in older men with an improvement in well-being, improved sex drive, improved sexual function, improved muscle mass and strength and an increase in bone density. There are now several alternatives available for testosterone replacement therapy in the form of skin patches and creams that can deliver testosterone into the blood in a non-invasive way.
Men who are carefully selected for hormone replacement therapy must be monitored for signs of prostate disease, dyslipidemia, hepatotoxicity, erythrocytosis, and other side effects.
Consult your physician and ask her/him whether you should have a testosterone level determined to see if you are deficient. If you are deficient and are a candidate for testosterone replacement therapy, your physician will prescribe just the right therapy for you. Questions can be directed to the Endocrine Clinic here at Penn State Hershey Medical Center.
Self-care tips
Patients diagnosed with andropause and being treated with hormone replacement therapy should be monitored to check testosterone, lipid and hematocrit levels. That way, treatment can be adjusted according to the patient’s needs and side affects closely monitored
Androgenetic Alopecia
Also known as: Male Pattern Baldness
What is it?
Male pattern baldness is a common type of hair loss.
Who gets it?
Male pattern baldness occurs in men. While it can occur during a man’s teens, it is often part of the aging process.
What causes it?
Male pattern baldness is genetically inherited, but may also be related to slightly elevated levels of male hormones. Any type of hair loss is caused by the hair entering a resting phase, in which there is no growth. The hair then falls out.
What are the symptoms?
The hair loss seen with male pattern baldness usually starts on the top of the head, toward the back; on the sides; or near the front. After the hair falls out, there is no new regrowth. In many cases, the result is a receding hairline or bald spot. However, some men become completely bald.
How is it diagnosed?
Male pattern baldness is indicated by the pattern of hair loss and a family history of hair loss. However, if your doctor suspects any other cause, he or she may perform a biopsy, in which a small sample of the hair follicle is taken, to determine if the hair follicles are normal.
What is the treatment?
Male pattern baldness does not require treatment. However, some men opt for hair transplants or take medication to promote hair growth. Some medications are applied directly to the bald spots. Others are taken orally. While some medications have been proven effective in growing new hair and preserving existing hair, they must be used daily for the hair to stay. Your doctor can help you determine which treatment is right for you.
Self-care tips
Male pattern baldness is very common and has no effect on your general health. While there is no known way to prevent it, you can help keep the hair you have in the best shape possible by maintaining a healthy lifestyle.
What is it?
Male pattern baldness is a common type of hair loss.
Who gets it?
Male pattern baldness occurs in men. While it can occur during a man’s teens, it is often part of the aging process.
What causes it?
Male pattern baldness is genetically inherited, but may also be related to slightly elevated levels of male hormones. Any type of hair loss is caused by the hair entering a resting phase, in which there is no growth. The hair then falls out.
What are the symptoms?
The hair loss seen with male pattern baldness usually starts on the top of the head, toward the back; on the sides; or near the front. After the hair falls out, there is no new regrowth. In many cases, the result is a receding hairline or bald spot. However, some men become completely bald.
How is it diagnosed?
Male pattern baldness is indicated by the pattern of hair loss and a family history of hair loss. However, if your doctor suspects any other cause, he or she may perform a biopsy, in which a small sample of the hair follicle is taken, to determine if the hair follicles are normal.
What is the treatment?
Male pattern baldness does not require treatment. However, some men opt for hair transplants or take medication to promote hair growth. Some medications are applied directly to the bald spots. Others are taken orally. While some medications have been proven effective in growing new hair and preserving existing hair, they must be used daily for the hair to stay. Your doctor can help you determine which treatment is right for you.
Self-care tips
Male pattern baldness is very common and has no effect on your general health. While there is no known way to prevent it, you can help keep the hair you have in the best shape possible by maintaining a healthy lifestyle.
Anaphylaxis
What is it?
Anaphylaxis is a life-threatening allergic reaction to a substance that is normally harmless to most people.
Who gets it?
Anyone can suffer allergic reactions, but anaphylaxis occurs in people with an extreme sensitivity to a certain substance.
What causes it?
An allergic reaction occurs when the immune system produces antibodies and other disease fighting cells in response to an allergen. An allergen is a substance, most often an insect sting, drug, or food, that causes an allergic response. The antibodies release chemicals that actually injure the surrounding cells and cause the physical symptoms of an allergic reaction. Certain antibodies release histamines, which affect the skin, mucous membrane, mucous gland, and smooth muscle cells. Life-threatening allergic reactions can occur without any previous symptoms of allergy. Exercise or exposure to cold can trigger anaphylaxis in some people.
What are the symptoms?
Symptoms of anaphylaxis occur quickly and progress rapidly. They can include sudden anxiety and weakness, itching, swelling, hives, cramps, diarrhea, vomiting, difficulty breathing, tightness in the chest, very low blood pressure, loss of consciousness, and shock. Anaphylactic shock can occur within minutes and result in death. A patient in anaphylactic shock needs immediate medical treatment.
How is it diagnosed?
Anaphylaxis is diagnosed based upon its rapidly progressing symptoms. Your doctor may order blood and skin tests to identify specific allergens.
What is the treatment?
People who have anaphylactic reactions should, of course, avoid the allergens that trigger this response. Anaphylactic shock is treated with an injection of epinephrine, a hormone that stimulates the heart and relaxes the airways. This may be combined with an injection of an antihistamine, which counteracts the histamine produced by the immune cells during an allergic reaction. Those who are known to have severe allergies should carry a self-injection kit, including antihistamine tablets, for emergency treatment. However, they should still seek medical care after any type of anaphylactic reaction. Patients with anaphylactic reactions may need to receive supplementary oxygen and intravenous (IV) fluids. In severe cases, a breathing tube may need to be inserted to open the airways. People who are severely allergic may undergo a desensitization program, in which a series of injections of the allergen are given in increasingly larger doses until the body shows that it can be tolerated. This type of program must be administered by an allergy specialist and it may take anywhere from 15 to 20 weeks to develop an immunity. These are followed up with monthly booster shots.
Self-care tips
The only way to prevent anaphylaxis is to avoid known allergens. Some of the most common include bee stings, fish and shellfish, penicillin, latex, certain vaccines, nuts and seeds, and certain food additives. If you have a history of anaphylaxis, you should wear a medical ID bracelet containing information on your allergies.
Anaphylaxis is a life-threatening allergic reaction to a substance that is normally harmless to most people.
Who gets it?
Anyone can suffer allergic reactions, but anaphylaxis occurs in people with an extreme sensitivity to a certain substance.
What causes it?
An allergic reaction occurs when the immune system produces antibodies and other disease fighting cells in response to an allergen. An allergen is a substance, most often an insect sting, drug, or food, that causes an allergic response. The antibodies release chemicals that actually injure the surrounding cells and cause the physical symptoms of an allergic reaction. Certain antibodies release histamines, which affect the skin, mucous membrane, mucous gland, and smooth muscle cells. Life-threatening allergic reactions can occur without any previous symptoms of allergy. Exercise or exposure to cold can trigger anaphylaxis in some people.
What are the symptoms?
Symptoms of anaphylaxis occur quickly and progress rapidly. They can include sudden anxiety and weakness, itching, swelling, hives, cramps, diarrhea, vomiting, difficulty breathing, tightness in the chest, very low blood pressure, loss of consciousness, and shock. Anaphylactic shock can occur within minutes and result in death. A patient in anaphylactic shock needs immediate medical treatment.
How is it diagnosed?
Anaphylaxis is diagnosed based upon its rapidly progressing symptoms. Your doctor may order blood and skin tests to identify specific allergens.
What is the treatment?
People who have anaphylactic reactions should, of course, avoid the allergens that trigger this response. Anaphylactic shock is treated with an injection of epinephrine, a hormone that stimulates the heart and relaxes the airways. This may be combined with an injection of an antihistamine, which counteracts the histamine produced by the immune cells during an allergic reaction. Those who are known to have severe allergies should carry a self-injection kit, including antihistamine tablets, for emergency treatment. However, they should still seek medical care after any type of anaphylactic reaction. Patients with anaphylactic reactions may need to receive supplementary oxygen and intravenous (IV) fluids. In severe cases, a breathing tube may need to be inserted to open the airways. People who are severely allergic may undergo a desensitization program, in which a series of injections of the allergen are given in increasingly larger doses until the body shows that it can be tolerated. This type of program must be administered by an allergy specialist and it may take anywhere from 15 to 20 weeks to develop an immunity. These are followed up with monthly booster shots.
Self-care tips
The only way to prevent anaphylaxis is to avoid known allergens. Some of the most common include bee stings, fish and shellfish, penicillin, latex, certain vaccines, nuts and seeds, and certain food additives. If you have a history of anaphylaxis, you should wear a medical ID bracelet containing information on your allergies.
Anterior Cruciate Ligament (ACL) Injury
What is it?
Anterior cruciate ligament (ACL) injury is the most common knee injuring, resulting from a stretch or tear in the ligament. Ligaments are strong bands of tissue that connect one bone to another. The ACL is one of the major ligaments in the knee, connecting the thigh bone (femur) to the shin bone (tibia). It helps to keep the knee stable and protects the femur from sliding or turning on the tibia.
Who gets it?
While anyone can injure an ACL, it is unusual in childhood. The incidence of ACL injury peaks in adults during their middle years.
What causes it?
ACL injuries most often result from sports where the foot is planted on the ground while the leg is being twisted, such as in football, soccer, basketball and skiing. The ACL may also become injured when the knee is straightened further than it normal (hyperextended). It can also occur when the thigh bone is forcefully pushed across the shin bone, such as with a sudden stop while running or a sudden transfer of weight such as in skiing.
A chronic ACL injury is often the result of an injury in which the patient either did not consult a doctor after initial injury, the diagnosis was missed, or nonoperate care of an ACL injury was unsuccessful.
What are the symptoms?
Often the patient will hear a popping sound when the ACL injury occurs and will not be able to continue the activity. Swelling of the knee within the first several hours of injury will usually follow. In the case of a chronic ACL injury, the patient will sometimes experience increasing instability of the knee during twisting and pivoting movements and muscle weakness.
How is it diagnosed?
A doctor may suspect an ACL injury after noticing the knee is loose and swelling is present upon initial examination. To confirm diagnosis, the doctor may draw blood from the knee for testing and order x-rays to be taken to see if there is an injury to the bones in the knee. An MRI test may be done to show the condition of the ACL.
The doctor may also examine the ligament, lateral ligament and posterior cruciate ligament for injury, and may make a comparison of the injured and uninjured knee to make sure that another injury is not overlooked.
In a chronic ACL injury, the longer the injury has been present the more likely it is to have an abnormal appearance on MRI examination. The doctor should also determine if there is an associated instability from other tears.
What is the Treatment?
Initial treatment for an ACL injury may including icing the knee, keeping the knee elevated whenever possible and administering anti-inflammatory medications.
Long-term treatment for ACL injuries may vary for each patient. Activity level, age, job demands, and general medical condition may be factors in the decision to recommend reconstruction. If the knee "gives way" during daily activities, this is a strong indication for surgery to prevent injuries from falls.
Since a torn ACL will not heal by itself, reconstructions by using ligaments or tendons from another part of the body (graft) are used. During ACL reconstruction, holes are drilled in the femur and tibia, and the torn ACL is removed. The graft is passed through the drill holes to replace the ACL, and is anchored in place using screws or staples. The hope is that stabilized knees will allow patients to return to pre-injury activity level and prevent further damage to the knee.
New surgical equipment has made this operation easier to perform and more precise, so that more surgeons are able to perform it. Patients with a chronic ACL injury and recurrent giving way of the knee are also candidates for ACL reconstruction.
Self-care tips
With successful ACL reconstruction, the patient may expect to return to vigorous sporting activities and degenerative changes will be prevented. Current rehabilitation after ACL reconstruction includes achieving full motion very quickly after reconstructive surgery. Exercises such as the leg press, bicycling and stair-climbing machines are usually recommended during rehabilitation.
Anterior cruciate ligament (ACL) injury is the most common knee injuring, resulting from a stretch or tear in the ligament. Ligaments are strong bands of tissue that connect one bone to another. The ACL is one of the major ligaments in the knee, connecting the thigh bone (femur) to the shin bone (tibia). It helps to keep the knee stable and protects the femur from sliding or turning on the tibia.
Who gets it?
While anyone can injure an ACL, it is unusual in childhood. The incidence of ACL injury peaks in adults during their middle years.
What causes it?
ACL injuries most often result from sports where the foot is planted on the ground while the leg is being twisted, such as in football, soccer, basketball and skiing. The ACL may also become injured when the knee is straightened further than it normal (hyperextended). It can also occur when the thigh bone is forcefully pushed across the shin bone, such as with a sudden stop while running or a sudden transfer of weight such as in skiing.
A chronic ACL injury is often the result of an injury in which the patient either did not consult a doctor after initial injury, the diagnosis was missed, or nonoperate care of an ACL injury was unsuccessful.
What are the symptoms?
Often the patient will hear a popping sound when the ACL injury occurs and will not be able to continue the activity. Swelling of the knee within the first several hours of injury will usually follow. In the case of a chronic ACL injury, the patient will sometimes experience increasing instability of the knee during twisting and pivoting movements and muscle weakness.
How is it diagnosed?
A doctor may suspect an ACL injury after noticing the knee is loose and swelling is present upon initial examination. To confirm diagnosis, the doctor may draw blood from the knee for testing and order x-rays to be taken to see if there is an injury to the bones in the knee. An MRI test may be done to show the condition of the ACL.
The doctor may also examine the ligament, lateral ligament and posterior cruciate ligament for injury, and may make a comparison of the injured and uninjured knee to make sure that another injury is not overlooked.
In a chronic ACL injury, the longer the injury has been present the more likely it is to have an abnormal appearance on MRI examination. The doctor should also determine if there is an associated instability from other tears.
What is the Treatment?
Initial treatment for an ACL injury may including icing the knee, keeping the knee elevated whenever possible and administering anti-inflammatory medications.
Long-term treatment for ACL injuries may vary for each patient. Activity level, age, job demands, and general medical condition may be factors in the decision to recommend reconstruction. If the knee "gives way" during daily activities, this is a strong indication for surgery to prevent injuries from falls.
Since a torn ACL will not heal by itself, reconstructions by using ligaments or tendons from another part of the body (graft) are used. During ACL reconstruction, holes are drilled in the femur and tibia, and the torn ACL is removed. The graft is passed through the drill holes to replace the ACL, and is anchored in place using screws or staples. The hope is that stabilized knees will allow patients to return to pre-injury activity level and prevent further damage to the knee.
New surgical equipment has made this operation easier to perform and more precise, so that more surgeons are able to perform it. Patients with a chronic ACL injury and recurrent giving way of the knee are also candidates for ACL reconstruction.
Self-care tips
With successful ACL reconstruction, the patient may expect to return to vigorous sporting activities and degenerative changes will be prevented. Current rehabilitation after ACL reconstruction includes achieving full motion very quickly after reconstructive surgery. Exercises such as the leg press, bicycling and stair-climbing machines are usually recommended during rehabilitation.
Ankylosing Spondylitis
Also known as: Rheumatoid spondylitis or Marie-Strumpell disease
What is it?
Ankylosing spondylitis (AS) is a disease of the connective tissue that results in the inflammation of the joints in the spine. The word "ankylosing" refers to a condition where the bones of a joint are fused, stiff, or rigid. "Spondylitis" is an inflammation of the spine.
Who gets it?
Ankylosing spondylitis (AS) is found in less than 1% of the population. It is three times more likely to occur in men than in women, with symptoms usually occurring for the first time between the ages of 20 and 40. People with a parent or sibling with AS are more likely to have the disorder. Afro-Americans have an approximately 25% higher incidence of AS than Caucasians.
What causes it?
The exact cause of AS is unknown. However, the fact that the disease tends to run in families makes genetics a likely factor. Researchers have identified a gene called HLA-B27 in more than 90% of patients with AS. However, the presence of this gene doesn't guarantee AS. Only around 10 to 15% of people who inherit the gene actually develop this disease.
What are the symptoms?
Like most forms of arthritis, AS flares up, so patients may have periods with no symptoms alternating with periods of mild to moderate symptoms. The most common symptom is back pain. Pain is often worse at night, and stiffness is worse upon waking in the morning. The pain and stiffness in the back can progress to the chest and neck. Patients may find that the pain is relieved by bending forward, which is why people with AS often have a stooped appearance. Eventually, the bones in the back may fuse. In some, the back ends up curved and inflexible. This condition is called "bamboo spine." In others, the back is straight and stiff. AS can also cause eye inflammation, damage to the heart valve, difficulty taking deep breaths, psoriasis, ileitis (inflammation of the small intestine), colitis (inflammation of the large intestine), fever, fatigue, and weight loss.
How is it diagnosed?
If your pattern of symptoms fits the description of AS, your doctor will order x-rays of the spine and pelvis. He or she will look for wear at the joint between the spine and the hip bone, and for abnormalities in the vertebrae. A simple blood test may also reveal the HLA-B27 gene. If AS is diagnosed, you will be referred to a rheumatologist, which is a doctor who specializes in treating arthritis.
What is the treatment?
Treatment of AS is focused on relieving pain and restoring mobility. Drugs called nonsteroidal anti-inflammatories (NSAIDs) are prescribed to relieve pain and stiffness. Your doctor may recommend corticosteroid drugs to treat severe joint and eye inflammation. Corticosteroids are only prescribed for short-term use because of potential side effects. A physical therapist can teach you exercises that will help with breathing and posture, as well as to increase and maintain flexibility. A back brace may also be needed to keep the back straight. Surgery, performed by an orthopedic surgeon, is only considered in severe cases where the hip or knee joint is completely worn away or permanently bent. Alternative treatments, such as herbal remedies and acupuncture, have brought relief to some patients. Consult your doctor before trying any alternative treatments.
Self-care tips
While there is no known way to prevent AS, most patients lead full, productive lives with treatment to control and relieve symptoms
What is it?
Ankylosing spondylitis (AS) is a disease of the connective tissue that results in the inflammation of the joints in the spine. The word "ankylosing" refers to a condition where the bones of a joint are fused, stiff, or rigid. "Spondylitis" is an inflammation of the spine.
Who gets it?
Ankylosing spondylitis (AS) is found in less than 1% of the population. It is three times more likely to occur in men than in women, with symptoms usually occurring for the first time between the ages of 20 and 40. People with a parent or sibling with AS are more likely to have the disorder. Afro-Americans have an approximately 25% higher incidence of AS than Caucasians.
What causes it?
The exact cause of AS is unknown. However, the fact that the disease tends to run in families makes genetics a likely factor. Researchers have identified a gene called HLA-B27 in more than 90% of patients with AS. However, the presence of this gene doesn't guarantee AS. Only around 10 to 15% of people who inherit the gene actually develop this disease.
What are the symptoms?
Like most forms of arthritis, AS flares up, so patients may have periods with no symptoms alternating with periods of mild to moderate symptoms. The most common symptom is back pain. Pain is often worse at night, and stiffness is worse upon waking in the morning. The pain and stiffness in the back can progress to the chest and neck. Patients may find that the pain is relieved by bending forward, which is why people with AS often have a stooped appearance. Eventually, the bones in the back may fuse. In some, the back ends up curved and inflexible. This condition is called "bamboo spine." In others, the back is straight and stiff. AS can also cause eye inflammation, damage to the heart valve, difficulty taking deep breaths, psoriasis, ileitis (inflammation of the small intestine), colitis (inflammation of the large intestine), fever, fatigue, and weight loss.
How is it diagnosed?
If your pattern of symptoms fits the description of AS, your doctor will order x-rays of the spine and pelvis. He or she will look for wear at the joint between the spine and the hip bone, and for abnormalities in the vertebrae. A simple blood test may also reveal the HLA-B27 gene. If AS is diagnosed, you will be referred to a rheumatologist, which is a doctor who specializes in treating arthritis.
What is the treatment?
Treatment of AS is focused on relieving pain and restoring mobility. Drugs called nonsteroidal anti-inflammatories (NSAIDs) are prescribed to relieve pain and stiffness. Your doctor may recommend corticosteroid drugs to treat severe joint and eye inflammation. Corticosteroids are only prescribed for short-term use because of potential side effects. A physical therapist can teach you exercises that will help with breathing and posture, as well as to increase and maintain flexibility. A back brace may also be needed to keep the back straight. Surgery, performed by an orthopedic surgeon, is only considered in severe cases where the hip or knee joint is completely worn away or permanently bent. Alternative treatments, such as herbal remedies and acupuncture, have brought relief to some patients. Consult your doctor before trying any alternative treatments.
Self-care tips
While there is no known way to prevent AS, most patients lead full, productive lives with treatment to control and relieve symptoms
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