scholarly journals Venipuncture Induced Complex Regional Pain Syndrome Presenting as Inflammatory Arthritis

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Punit Pruthi ◽  
Pramod Arora ◽  
Manoj Mittal ◽  
Anugrah Nair ◽  
Waqia Sultana
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Inflammatory Arthritis ◽  
Young Male ◽  
Pain Syndrome ◽  
Poor Response ◽  
History Of ◽  
Diagnostic Modalities ◽  
Musculoskeletal Ultrasonography ◽  
The Right

Venipuncture is one of the most commonly done medical procedures. We report a unique case of a 23-year-old young male who presented with features suggestive of inflammatory arthritis. The symptoms, which initially started on the right side, also involved the other side after a few weeks. Although the patient’s symptoms and signs were simulating inflammatory arthritis, he had atypical features like poor response to anti-inflammatory medicines and normal laboratory parameters. His musculoskeletal ultrasonography was also not suggestive of arthritis. His history was reviewed and on direct questioning he revealed a history of venipuncture for blood sample withdrawal, done from right antecubital region for routine health check on the day prior to the onset of symptoms. Complex regional pain syndrome was suspected and triple-phase radioisotope bone scan was done which was highly suggestive of this diagnosis. The patient was managed with multidimensional approach and responded very well to the treatment. Complex regional pain syndrome is usually not thought of in the initial differential diagnosis of inflammatory arthritis. In this report we highlight the need to elicit the often overlooked history of trivial trauma like venipuncture, especially in atypical cases of arthritis. Also the role of newer diagnostic modalities in such cases is emphasized.

scholarly journals Complex Regional Pain Syndrome-Type 1 Presenting as deQuervain’s Stenosing Tenosynovitis

2016 ◽  
Vol 1;19 (1;1) ◽  
pp. E227-E234 ◽  
Author(s):  
Lakshmi Vas
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
Dry Needling ◽  
Ultrasound Guided ◽  
Extensor Muscles ◽  
Patient Health ◽  
Stenosing Tenosynovitis ◽  
History Of ◽  
Musculoskeletal Ultrasonography ◽  
Conservative And Surgical Treatment

Aim: To report the presentation of complex regional pain syndrome-1 (CRPS-1) as deQuervain’s stenosing tenosynovitis (DQST). Case report: A 24-year-old woman presented with 3-year history of clinical diagnostic criteria (CDC) of CRPS-1. Conservative and surgical treatment for this as DQST had failed to relieve her. We diagnosed the problem as CRPS-1with CDC as inflammatory manifestations of a mechanical tendinoses of all her 5 digital tendons caused by movement of the fingers and hand tethered by agonist (flexor)/ antagonist (extensor) muscles in co-contraction. Ultrasound guided dry needling (USGDN) relaxed the muscles, replacing the abnormal agonist/antagonist co-contraction with normal agonist/antagonist coordination. Resolution of tendinoses reversed the inflammation causing the CDC. Six months later she leads normal personal and professional life, with reduction of scores of painDetect (from 21 to 5), Patient Health Questionnaire (from 13 to 4), Disability of arm, shoulder and hand from 70.8 to 25 and reversal of muscle abnormality characteristic of CRPS1 on Musculoskeletal Ultrasonography (MSKUSG). Conclusion: We believe the primary pathology of CRPS-1 to be co-contraction of agonist (flexor)/antagonist(extensor) muscles of digits resulting in tendinoses akin to DQST. CDC of CRPS are actually inflammatory manifestations of tendinoses amenable to reversal by USGDN which also addresses the disability, a hallmark of CRPS. Key words: Complex regional pain syndrome-1 (CRPS-1), deQuervain’s stenosing tenosynovitis (DQST), neuropathy, co-contraction, dry needling (DN), ultrasound guided dry needling (USGDN), musculoskeletal ultrasonography (MSKUSG)

scholarly journals Complex Regional Pain Syndrome in Children: Asking the Right Questions

2012 ◽  
Vol 17 (6) ◽  
pp. 386-390 ◽  
Author(s):  
Kenneth R Goldschneider
Keyword(s):  
Risk Factors ◽  
Nervous System ◽  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
Developmental Factors ◽  
Motor Component ◽  
The Right ◽  
Sensory Condition ◽  
Significant Motor

BACKGROUND: Complex regional pain syndrome (CRPS) is a painful disorder without a known unifying mechanism. There are little data on which to base evaluation and treatment decisions, and what data are available come from studies involving adults; however, even that literature is relatively sparse. Developing robust research for CRPS in children is essential for the progress toward optimal treatment.OBJECTIVES: To determine potential avenues of research in pediatric CRPS based on a review of the literature. Areas of concern include diagnostic criteria, peripheral mechanisms, central nervous system mechanisms, the role of the autonomic nervous system, possible risk factors, options for prevention and potential avenues of treatment.METHODS: A literature review was performed and the results applied to form the hypotheses posited in the form of research questions.RESULTS AND CONCLUSIONS: CRPS is a complicated entity that is more than a painful sensory condition. There is evidence for peripheral inflammatory and neurological changes, and reorganization in both sensory and motor cortexes. In addition, a significant motor component is frequently observed and there appear to be tangible risk factors. Many of these pieces of evidence suggest options for prevention, treatment and monitoring progress and outcome. Most of the data are derived from adult studies and need to be replicated in children. Furthermore, there may be factors unique to pediatrics due to developmental changes in neuroplasticity as well as somatic, endocrinological and emotional growth. Some of these developmental factors may shed light on the adult condition.

Young Male with Bilateral ICA Dissection: Beyond CADISS Trial

2021 ◽  
pp. 251660852098428
Author(s):  
Vikas Bhatia ◽  
Chirag Jain ◽  
Sucharita Ray ◽  
jay Kumar
Keyword(s):  
Management Strategies ◽  
Young Male ◽  
Acute Onset ◽  
The Body ◽  
Artery Dissection ◽  
Cervical Artery Dissection ◽  
Stroke Study ◽  
History Of

Objective: To report a case of young male with stroke and bilateral internal carotid artery (ICA) dissection. Background: Cervical Artery Dissection in Stroke Study trial has provided some insight on management of patients with ICA dissection. However, there is a need to modify the management strategies as per specific clinical scenario. Design/Methods: Case report and literature review. Results: A 45-year-old male presented with 1 month old history of acute onset numbness of right half of the body with slurring of speech. Computed tomography angiography showed complete occlusion of left cervical ICA just beyond origin with presence of fusiform dilatation and spiral flap in right extracranial cervical ICA. The patient was started on antiplatelets and taken for endovascular procedure using 2-mesh-based carotid stents. Patient was discharged after 3 days on antiplatelet therapy. At 1-year follow-up, there were no fresh symptoms. Conclusion: This case emphasizes the role of successful endovascular management of carotid dissection in a young male. These clinical situations may not be fully represented in trials, and a case-based approach is required.

scholarly journals Treatment of Type 1 Complex Regional Pain Syndrome in 14 Years Old Child

2014 ◽  
Vol 21 (4) ◽  
pp. 79-82
Author(s):  
V. N Merkulov ◽  
A. I Dorokhin ◽  
A. I Krupatkin ◽  
M. V Merkulov ◽  
M. A Avakova
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
Hand Injury ◽  
Psychological Status ◽  
Interventional Treatment ◽  
Bolus Administration ◽  
Right Hand ◽  
Foot Injury ◽  
The Right

Case report on 14 years old girl with type 1 complex regional pain syndrome (CRPS) is presented. At first admission in 5.5 months after right hand injury and development of type 1 CRPS, paravasal sympathectomy on the right upper extremity was performed. Complete elimination of pain syndrome and restoration of the extremity function was achieved. Five and a half months after discharge the left foot and in 3 weeks later the right hand were injured. In both cases injuries were accompanied by pronounced CRPS clinical picture. At second admission in 6 weeks after foot injury interventional treatment with placement of catheters next to nerve trunks and bolus administration of antibiotics was performed for 1 week and enabled to achieve remission of the disease. It was noted that not only hypersymphaticotony but also psychological status of a patient were important for the disease development.

scholarly journals Increased calcium-mediated cerebral processes after peripheral injury: possible role of the brain in complex regional pain syndrome

2020 ◽  
Vol 33 (2) ◽  
pp. 131-137
Author(s):  
Francis Sahngun Nahm ◽  
Jae-Sung Lee ◽  
Pyung-Bok Lee ◽  
Eunjoo Choi ◽  
Woong Ki Han ◽  
...  
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
Peripheral Injury ◽  
The Brain

scholarly journals «Мертвые Цари всегда должны по смерти своей быть судимы»: Посмертная судьба одного древнеегипетского обычая в русской и европейской словесности XVI – XIX вв. [“Dead Kings Must Always be Judged after Their Demise”: The Afterlife of an Ancient Egyptian Custom in the Russian and European Literature of the 16th to 19th Centuries]

2021 ◽  
Vol 8 ◽  
pp. 9-47
Author(s):  
Maria Neklyudova
Keyword(s):  
Literary Criticism ◽  
French Literature ◽  
History Of Ideas ◽  
Ancient Egyptian ◽  
Diodorus Siculus ◽  
History Of ◽  
Generous Support ◽  
The Subject ◽  
The Right

In his Bibliotheca historica, Diodorus Siculus described a peculiar Egyptian custom of judging all the dead (including the pharaohs) before their burial. The Greek historian saw it as a guarantee of Egypt’s prosperity, since the fear of being deprived of the right to burial served as a moral imperative. This story of an Egyptian custom fascinated the early modern authors, from lawyers to novelists, who often retold it in their own manner. Their interpretations varied depending on the political context: from the traditional “lesson to sovereigns” to a reassessment of the role of the subject and the duties of the orator. This article traces several intellectual trajectories that show the use and misuse of this Egyptian custom from Montaigne to Bossuet and then to Rousseau—and finally its adaptation by Pushkin and Vyazemsky, who most likely became acquainted with it through the mediation of French literature. The article was written in the framework (and with the generous support) of the RANEPA (ШАГИ РАНХиГС) state assignment research program. KEYWORDS: 16th to 19th-Century European and Russian Literature, Diodorus Siculus (1st century BC), Jean-Jacques Rousseau (1712—1778), Alexander Pushkin (1799—1837), Prince Pyotr Vyazemsky (1792—1878), Egyptian Сourt, Locus communis, Political Rhetoric, Literary Criticism, Pantheonization, History of Ideas.

scholarly journals Atypical presentation of complex regional pain syndrome: neuropathic itching - A case report -

2021 ◽  
Author(s):  
Syn-Hae Yoon ◽  
Woojong Cho ◽  
Juhan Mun ◽  
Wonyeong Jeong ◽  
Young Do Kim ◽  
...  
Keyword(s):  
Complex Regional Pain Syndrome ◽  
Pain Syndrome ◽  
Treatment Modalities ◽  
Atypical Presentation ◽  
Foot And Ankle ◽  
Main Symptom ◽  
Hypoxic Brain Damage ◽  
Hypoxic Brain ◽  
History Of ◽  
Ankle Mobility

Background: In some patients with neuropathic pain (NP), such as complex regional pain syndrome (CRPS), itching rather than pain is the main symptom making diagnosis and treatment difficult.Case: We report a case of a 23-year-old man with a history of hypoxic brain damage who presented with pruritus of the left foot and ankle. His left foot was fractured, and he underwent surgery 6 months previously. After the operation and cast application, he developed uncontrolled pruritus, swelling, sweating, and flushing of the left foot skin with limping. On examination, he showed well-known features of CRPS without pain. He was diagnosed with an atypical CRPS with neuropathic itching (NI). With treatment modalities used for NP and CRPS, his pruritus subsided gradually, and the his ankle mobility improved.Conclusions: Unexplained itching can be the main symptom in some CRPS patients. Treatment according to NP can improve symptoms of NI in CRPS patients.

scholarly journals ROLE OF VIRECHANA KARMA & MADHUTAILIKA BASTI IN THE MANAGEMENT OF EKAKUSHTA

2021 ◽  
Vol p5 (5) ◽  
pp. 3050-3054
Author(s):  
Shubha C ◽  
Amanda Kittie Kynshikhar ◽  
Pooja B A ◽  
Sangamitra Pattnaik ◽  
Abhishek Biswas
Keyword(s):  
Female Patient ◽  
Signs And Symptoms ◽  
Medical College ◽  
History Of ◽  
The Right

A Hindu female patient of age 30 yrs. with a history of dry scaly white patches over the skin since childhood with prevailing signs of swelling wounds over the patches on the right foot and left palm for six months, diagnosed as a case of Psoriasis came for treatment at Sushrutha Ayurvedic Medical College & Hospital, Bangalore. Considering the signs and symptoms patient was treated in the line of Ekakustha. Classical Virechana Karma followed by Shamana Aushadhi and Madhutailika Basti was administered. Significant relief was found in the signs and symp- toms with no recurrence after the treatment. Keywords: Ekakushta, Psoriasis, Classical Virechana, Madhutailika Basti, Shamana Aushadhi.

Use of micropulse trans-scleral cyclophotocoagulation for acute rise in intraocular pressure due to anterior segment inflammation

2020 ◽  
pp. 112067212092434
Author(s):  
Shotaro Asano ◽  
Victor Koh Teck Chang ◽  
Maria Cecilia Domingo Aquino ◽  
Paul Chew Tec Kuan
Keyword(s):  
Intraocular Pressure ◽  
Rescue Therapy ◽  
Anterior Segment ◽  
Poor Response ◽  
Posterior Capsular Opacification ◽  
Nd:Yag Laser Capsulotomy ◽  
Pressure Spike ◽  
History Of ◽  
The Right ◽  
Rescue Procedure

Purpose The aim of this study was to report the use of micropulse trans-scleral cyclophotocoagulation as an adjunct therapy for two cases of medically uncontrolled intraocular pressure spikes due to anterior segment inflammation. Case description: Case 1 had previous cataract surgery and exhibited an intraocular pressure spike due to phacoantigenic uveitis (right eye intraocular pressure = 52 mmHg). Despite medical treatment, the right eye intraocular pressure remained high (43 mmHg), thus micropulse trans-scleral cyclophotocoagulation was carried out as a rescue therapy. After micropulse trans-scleral cyclophotocoagulation, the intraocular pressure at 1 day and 3 weeks was 9 and 16 mmHg, respectively. Case 2 had a history of previous blunt ocular trauma and 180° of angle recession. Both eyes were pseudophakia and underwent right eye Nd:YAG laser capsulotomy for posterior capsular opacification. Immediately after the procedure, the right eye intraocular pressure increased to 64 mmHg. Due to poor response to medical therapy, rescue micropulse trans-scleral cyclophotocoagulation was performed. After micropulse trans-scleral cyclophotocoagulation, the intraocular pressure at 1 day and 2 months was 12 and 21 mmHg, respectively. Conclusion Micropulse trans-scleral cyclophotocoagulation successfully decreased intraocular pressure in both cases of acute rise in intraocular pressure. Micropulse trans-scleral cyclophotocoagulation can potentially be useful as a rescue procedure to safely reduce medically uncontrollable intraocular pressure spike due to anterior segment inflammation.

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