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question:How would you treat a 55 year old female patient suffering from hip pain for years after a major car wreck whose recent MRI shows an acetabular subchondral cyst with reactive bone marrow edema extending into the supraacetabular portion of the right ilium?
answer:hi in my opinion subchondral cyst with reactive bone edema in supraacetabular part of Ilium (R) has to be investigated further . It is unlikely to be due to car wreck or cause of pain for many years.I would suggest 1. Pain killers 2. Contrast enhanced MRI to see the cause of cyst 3. Bone densitometry 4.Complete report of MRI to know the condition of hip bone,
question:I m a 32 year old woman. I tore my rotator cuff a few months ago and have noticed that the breast on the same side is now smaller. None of my bras fit anymore. Is this due to the injury? Is that possible? It is definitely taking a psychological toll on me.
answer:hi Rotator cuff tear has no effect on the breast size directly so you have to think of some other cause for reduction in the size of breast.It is quite possible that you may have a cervical spine injury with pressure on one of the nerves causing muscle weakness. I suggest you go for MRI Neck and NCV both upper limbs.
question:What is the suggested test & treatment for Fibro Myalgia?I am having fatigue, severe pain in legs and hands for the last two months.One doctor suspects that this could be Fibro Myalgia. I used have the pain and fatigue from October, 2012. But it used to vanish and resurface. Now the pain is terrible affecting my sleep and concentration on work. M.A.Subbaraman, Male 68 years.Mumbai
answer:Hi You have fatigue , severe pain in legs and hands for the last two months but have it from 2012.In my opinion you may be having deficiency of vitamin D and Vit B12 along with Osteoporosis. I suggest daily calcium , Vit D3 60K once a week + a combination of Vit B12 and Levo carnitine. Get S Vit D3 and S Vit B12 levels + Bone Densitometry ( Dexa Scan) at the earliest . If Se vit B12 is quite low then injections may be required else the oral tabs will be enough.
question:A couple weeks ago i came home from work only to realize that my entire left arm from shoulder to fingers was swollen i didn t think too much if just elevated it and put an ice pack on it a few times but the swelling has yet to go away and it is two weeks later i think some sort of bug bit or stung me and i know i got a bee sting on the same arm a couple days later which i think made it all worse. I have a really odd looking bruise on my bicep area that is normal looking in one spot and in another has small hairlike or vein bruises, this is not that close to either bite. I went to a local care spot and they put me on steroids to try and reduce swelling for five days and then an antibiotic when i had taken all of that and the swelling still hadn t gone down my last day for the antibiotic is tomorrow and i was supposed to see a big difference by the third dose and i haven t seen that much of a difference. The arm gets very tired easily and rather stiff at times and it was so swollen and numb that i didn t even feel the bee sting me. What should i do? Thanks
answer:HiSting takes 7 to 10 days to heal under cover of antibiotics, anti inflammatory and anti allergic meds. ,Local dressing with antiseptic oint ment..Do shoulder, elbow, wrist exercises, keep arms in a sling It will settle in few daysThanksBest wishes
question:I don t know where do go for help. My doctor was prescribing me Morphine sulphate 200mgs 9 per day and Norco for breakthrough. I suffer spinal nerve pain, have four compression fractures, and fibromyalgia. He suddenly had his licence suspended for failing a class and now I can t get my refills. All of his patients are calling the few Dr s in my area and I can t find one. I live in Fresno Ca and would travel as long as it wasn t more than 4 hours but with my tolerance to meds I need a Dr. that understands that. I m already in withdrawals and I m terrified of what s going to happen. I didn t do anything wrong and I can t just make the pain stop.
answer:HiYou may consult an orthopedics surgeon.For compression fractures of spine, a Taylor brace maybe worn in daytime, to remove in bed.Avoid, twisting, bending of spine.Take pregablin , amitriptyline, and tramadol instead of morvi or morphine, if your treating doctor agrees.Also take calcium and vitamin D3 supplements.Be in touch with fibromyalgia clinics and an orthopedist to obtain prescription meds.A physiotherapist can be engaged for supportive managementBest wishes
question:Been breaking out in a rash/hives for 2 weeks. Over last 2 days gotten considerably worse and now this afternoon I have a lump that has grown just above my knee. It is hot to the touch and hurts to walk. What could be going on with me? No other symptoms.
answer:Hives means some allergy phenomenon occurring.consult a physician to diagnose a cause.Symptomatic treatment is by steroids and anti allergic medications.Lump over knee should be evaluated physically by a doctor.Causes for allergy, in diet and environment should be sorted out by exclusion Best wishes