Myelography
Myelography or myelogram is used to make a diagnosis of spinal canal and spinal cord disorders like nerve compression that in turn causes pain and weakness. A special dye is introduced into the spinal sac that in turn shows up in the x-ray to signify any deformities. The dye acts as an exclusive agent to outline the nerve roots and the spinal cord thus helping the doctor determine if there are any abnormal shapes in the spinal cord. Before CT scans and MRI scans were introduced, it was myelography that was used to study any abnormalities in the spinal cord. Current medical world uses myelography only for complicated revision spine surgeries and for patients who have metal plates or screws in their spine. Myelography is primarily used to identify slipped disk by exactly locating the disk or disks concerned. Spinal arthritis can develop bone spurs that may press against the nerves and cause pain, myelography can help identify if surgery is required and can also help spot if the spinal canal is narrowed. Tumors can be accurately located. A patient preparing for myelogram must stop a solid diet for a day and drink plenty of clear fluids.
Paget's Disease
Paget’s disease is named after James Paget, the doctor who first described the disease. It affects bones, mostly of the spine, thigh, shin or pelvis. This disease affects the process of breaking down and rebuilding of bones. Since new bones are built at a faster rate, there is likelihood of fractures and deformities. Consequently there is destruction of bone since the new bone that is formed is weak and porous. As a result, these bones are likely to bend easily and break. Paget's disease also leads to additional blood vessels (hypervascularity in the affected area. This condition affecting the bones is more likely to affect men and people over 40. Paget's disease is also known as osteitis deformans. Over time, Paget's disease can lead to osteoarthritis, kidney stones and heart disease. In rare cases, severe Paget's disease has been associated with heart failure or cancer.
The symptoms of Paget's Disease include pain and deep ache in the affected bones. The patient is likely to experience bone deformity or fracture in the affected area. There may be damage to the cartilage lining of the joints near the affected ones leading to osteoarthritis. Persons suffering from Paget's disease may suffer pain from nerve compression due to the pressure from bones. A person suffering from Paget's disease is likely to suffer elevated alkaline phosphate levels in the blood. There might be bone abnormalities such as enlargement, reabsorption and bowing.
Bone scans aid diagnosis of Paget's disease. Bone scintiscan can help detect the bones that have been affected. X-rays and blood test to check blood serum alkaline phosphatase can help in the diagnosis of Paget's disease. Treatment for Paget's disease is based on the extent of the disease, location of the affected bones and the medical history of the patient. Physical therapy and medication to inhibit abnormal bone reabsorption are prescribed. Bisphosphonates can reduce the activity of Paget's disease and are often prescribed for a period of 2 - 6 months. NSAIDs are given to alleviate pain and reduce inflammation. Surgery to realign affected bones or joint replacement are resorted to in cases where the joints are severely damaged or deformed.
Bibliography / Reference
| 