RESUMO
New insights into the metabolism of cartilage have increased respect for efforts designed to prevent osteoarthritis. The aging of the population adds to the desire to diagnose and manage the disease before patients become seriously disabled.
Assuntos
Osteoartrite/diagnóstico , Osteoartrite/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/metabolismo , Cartilagem/metabolismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoartrite/metabolismo , Osteoartrite/prevenção & controle , Fatores de RiscoRESUMO
Patients with paralysis may develop radiographic changes in the axial skeleton and sacroiliac joints that resemble those seen in ankylosing spondylitis. These similarities can result in confusion when evaluating paralysed patients with back pain. We report on a patient with paralysis secondary to amyotrophic lateral sclerosis who developed back pain, apparent sacroiliac joint fusion, and a 'bamboo spine', leading to the misdiagnosis of ankylosing spondylitis. Serial radiographs of the bony changes in our patient are presented, along with a brief review of the literature on axial skeletal abnormalities in paralysis and a discussion of the subtle changes that distinguish immobilization spondyloarthropathy from ankylosing spondylitis.
Assuntos
Paralisia/diagnóstico por imagem , Articulação Sacroilíaca/diagnóstico por imagem , Coluna Vertebral/diagnóstico por imagem , Espondilite Anquilosante/diagnóstico por imagem , Diagnóstico Diferencial , Humanos , Masculino , Pessoa de Meia-Idade , RadiografiaRESUMO
Zinc ingestion has become increasingly popular in the lay and food faddist population. Herein described by way of a case report and review of the 13 cases in the literature is the syndrome of severe anemia associated with excessive and prolonged intake of oral zinc. The syndrome is characterized by anemia, granulocytopenia, and bone marrow findings of vacuolated precursors and ringed sideroblasts. Serum analysis reveals increased zinc levels, decreased copper levels, and a decrease in ceruloplasmin. The mechanism appears to be zinc-induced copper deficiency, which is instrumental in producing the profound bone marrow abnormalities, as zinc itself is of low toxicity. Importantly, the syndrome is totally reversible with cessation of zinc intake. Hematologists should be aware of this form of reversible sideroblastic anemia.