RESUMO
Herpes zoster probably occurs more often than generally thought. Since it produces a radicular distribution of pain, it should be included in the differential diagnosis of radiculopathy. A case is presented in which evaluating the radicular low back pain before the characteristic rash appears was misleading. Careful history-taking concerning the exact nature of the pain and sensory changes is needed to differentiate between zoster and radiculopathy, if no rash is evident.
Assuntos
Herpes Zoster/diagnóstico , Radiculopatia/diagnóstico , Dor nas Costas/diagnóstico , Dor nas Costas/etiologia , Diagnóstico Diferencial , Eletromiografia , Herpes Zoster/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Condução Nervosa , Radiculopatia/complicações , Ciática/diagnóstico , Ciática/etiologiaRESUMO
We report a rare case of degenerative joint disease of both knees, complicated by a Baker cyst. Our emphasis is on the role of electromyography and electrodiagnosis in the localization of this nerve entrapment syndrome. The patient presented with pain and swelling; venography revealed deep venous thrombosis of the right calf, including the popliteal and proximal superficial femoral vessels. The patient responded well to bed rest, analgesics, intravenous heparin and subsequent Coumadin anticoagulation, and was discharged two weeks later. Five weeks after onset of these acute problems, nerve conduction studies were done, leading to a diagnosis of Baker cyst with nerve entrapment. He responded well to knee joint aspiration and intraarticular prednisolone injection. Some evidence of improvement in the flexor hallicus longus muscle was detected at three-month follow-up.
Assuntos
Articulação do Joelho , Síndromes de Compressão Nervosa/etiologia , Cisto Sinovial/complicações , Nervo Tibial , Eletrodiagnóstico , Eletromiografia , Humanos , Artropatias/complicações , Masculino , Pessoa de Meia-Idade , Síndromes de Compressão Nervosa/diagnóstico , Prednisolona/uso terapêutico , Tromboflebite/complicaçõesRESUMO
Much of what is known about the psychological response to amputation is derived from studies of veterans. Most recent amputees come from a different group; they are typically older and have experienced medical problems prior to their amputation. In order to investigate the effects of age and time since amputation on psychological response, 66 amputees were assessed by the Symptom Checklist-90, Beck Depression Inventory and interviewed. When classified by time since amputation and by age, the results indicate that older amputees exhibited less depression and fewer psychological symptoms: in contrast, younger amputees evidenced increased depression and psychological symptomatology the longer the time since their amputation.
Assuntos
Adaptação Psicológica , Amputação Cirúrgica/psicologia , Adolescente , Adulto , Fatores Etários , Idoso , Depressão/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicopatologia , Fatores de TempoRESUMO
A 35% prevalence of major depressive disorder was found in a prospective study of 65 amputees evaluated in a Physical Medicine and Rehabilitation Department. The findings indicate significantly more alcohol abuse among the depressed group. Higher percentages of female than male amputees were found to be depressed and unmarried. The prevalence of smoking was significantly higher among those whose amputations were due to vascular disease rather than other causes (e.g., trauma). In addition to the physical care of amputees, their emotional needs and well-being merit serious consideration.
