Cortisone

Cortisone is a steroid and it prevents release of inflammation-causing substances. Cortisone injections are usually used to relieve pain and inflammation. Cortisone is effective against allergic conditions like psoriasis, ulcerative colitis, arthritis, lupus and breathing conditions. Cortisone is also administered to alleviate pain and inflammation in patients suffering from frozen shoulder, plantar fasciitis, carpal tunnel syndrome and bursitis. Typically, most patients experience headache, nausea, stomach pain and bloating. Severe side effects of cortisone include rapid weight gain, vision problems, Pancreatitis, reduced potassium and hypertension. Do not change your cortisone or steroid medication without consulting your physician.

Erythema Nodosum

Inflammation of the skin that shows up as painful reddish tender lumps is called Erythema nodosum. This inflammation is usually located in a part of the fatty layer of skin (subcutaneous fat). The size of the lump could vary in size from 1 to 5 cm. The inflammation causes nodular swelling. The inflammation remains for about a week and then becomes flat leaving behind a bruised appearance. They usually show up on the shins (front portion of the legs, just below the knee). Erythema nodosum is a type of panniculitis, i.e. inflammation that can cause nodules below the surface of the skin. The condition is more common among youngsters aged between 12-20 years.

Erythema nodosum settles down on its own after a period of three to six weeks. It may leave behind a temporary bruised appearance or a chronic indentation in the part where the fatty layer has been injured. Though the condition is annoying and painful, the condition does not cause any damage to the internal organs of our body. In adults, the condition is more often seen in women than in men. In kids, it affects boys and girls equally. In a few people the trigger can be identified and in yet a few it cannot be identified. However identifying the trigger becomes very important as it needs to be treated.

Erythema nodosum causes

Erythema nodosum may show up on its own or may occur in association with other conditions. In about 30-50% of cases, the cause is unknown. However the common triggers that may cause Erythema nodosum include:

• Step throat (streptococcal infection) in adults and kids
  
• Fungal diseases
  
• Tuberculosis
  
• Cat scratch disease
  
• Few medications like penicillin, oral contraceptive, Hepatitis B vaccination, etc
  
• Sarcoidosis
  
• Inflammatory bowel diseases
  
• Behcet's disease
  
• Pregnancy
  
• Certain types of cancers like lymphoma, leukemia, etc

Erythema nodosum symptoms

• Painful nodules are commonly seen on the shin and sometimes on the arms, thighs and trunk of the body. The nodule when it first appears is red, hot and firm to touch and becomes flat over a few days. It appears as bruise that is blue in color and later turns yellowish as it fades. A person may develop just a couple of nodules or much more.
  
• Flu-like feeling before the appearance of lumps.
  
• Aching joints and legs before the appearance of lumps. Ankle, knee and wrist joints are the most affected.
  
• Loss of weight.
  
• Symptoms may vary depending on the underlying trigger that caused the condition.

Erythema nodosum diagnosis

• By means of physical examination
  
• Biopsy of the affected area
  
• Blood test to identify the trigger
  
• Chest X-ray in case of TB or sarcoidosis induced condition
  
• Throat swab

Erythema nodosum treatment

• Cortisone injection
  
• Oral cortisone
  
• Anti-inflammatory drugs
  
• Bed rest
  
• Compression bandages
  
• Cool wet compresses
  

Iliotibial Band Syndrome

Iliotibial Band Syndrome or 'Ilitibial Band Friction Syndrome' is a common sports injury generally associated with running. This syndrome is bound to cause lateral knee pain in runners. This injury can also be caused by biking, hiking and weight lifting. This Iliotibial band is a thick fibrous tissue that runs from the outside of the pelvis, over the hip, knee and below the knee joint. The band stabilizes the knee during movements like running. The band coordinates with several other thigh muscles and moves from behind the femur in the thigh to the front during the gait cycle. The Iliotibial Band Syndrome refers to the superficial thickening of the tissue that is on the outside of the thigh. Continuous rubbing and flexing of the band causes irritation usually over the outside of the knee joint.

Common causes of the Iliotibial Band Syndrome among runners

• Iliotibial Band Syndrome occurs when the level of activity increases especially among runners who tend to increase their mileage. Increasing distance too quickly or excessive downhill running is a common cause among runners.
  
• Poor training habits in runners can cause this syndrome. While running on an indoor track, the leg bends slightly inwards and this causes extreme stretching of the Iliotibial band and the resultant injury.
  
• Inadequate warm up and cool down sessions among sports persons can cause this syndrome.
  
• While cycling, having the feet 'toed in' at an extreme and excessive angle can cause the Iliotibial band injury.

Individuals with anatomical abnormalities of the leg such as bow legs, high or low arches, overpronation of the foot and uneven leg length are prone to this condition. Muscle imbalance such as weak hip abductor muscles can lead to iliotibial band syndrome.

Symptoms of this syndrome include pain in the knee joint that worsens with continued movement and resolves on rest. There is persistent pain below the knees or stinging sensation just above the knee joint. Often swelling or thickening is noticed at the point of knee joint where the band moves over the femur. Persons suffering these symptoms must avoid running downhill or squatting, playing tennis or basketball and indulging in martial arts.

Treatment for Iliotibial Band Syndrome normally begins with applying ice the area of injury, selection of proper footwear and stretching routine. While icing, the injured part has to be kept elevated as this helps to reduce swelling. Anti-inflammatory medications and cortisone injections may be prescribed to reduce the inflammation. Surgery is rarely resorted to.