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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Senile osteroporosis itself is asymptomatic unless pain is induced by the static insufficiency of the skeleton, in long lasting disease. Conventional procedures for early diagnosis and control of patients are invasive and therefore not suitable for routine purposes. The efficiency of sodium fluoride for the treatment of senile osteoporosis after a minimum of 12 months has been established by invasive methods. It is the purpose of this study, to examine the value of photoabsorption-densitometry with double-isotope-method (125-J, 241-Am) for the evaluation of a therapeutic effect in this disorder. 7 patients with clinical and radiological evidence of senile osteoporosis (6 female, 1 male patient with ages of 56 to 87 years) underwent regular follow-up examinations for one year while on a regimen of 25mg. sodium fluoride, as retard, twice daily. The bone mineral content registered 1 cm. proximal of the proc. styloideus ulnaris (representative for the trabecular bone) and 8 cm proximal from the proc. styloideus ulnaris of the right forearm (representative for cortical bone) was not statistically different from the measurements registered prior to the study. However, the bone mineral content registered in both regions increased significantly, after 12 months treatment (p less than 0.05). This indicates that the assessment of bone mineral content by photonabsorptiondensitometry is a valuable method for therapeutic control of this disorder. The method is recommended as a routine procedure for the early diagnosis and for follow up of sodium fluoride therapy geriatric patients.
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PMID:[Value of photon-absorption densitometry for the assessment of bone density]. 61 Mar 37

Os acromiale (an apparently supernumerary bone) corresponds to persistence of the lateral end of acromion ossification nucleus over 18 years of age. Os acromiale is articulated with the clavicle and the base of acromion; its incidence is high and often bilateral. A rarer variant is secondary os acromiale, lying between acromion and great humeral tuberosity. Both variants predispose to the onset of pain due to acromiohumeral impingement. Rotator cuff tears are frequently associated due to direct injury to subacromial compartment structures and to overtraction of acromiocoracoid ligament following functional overuse. Three hundred and ninety-eight patients were examined (313 males and 85 females, aged 12 to 71 years): 265 of them underwent conventional radiography with specific projections for the shoulder and 133 underwent CT. Dysplasia was observed in 9.55% of cases (38 patients), which is in agreement with reports by other authors. CT demonstrates the presence of os acromiale better than specific radiographic projections, without requiring painful patient positioning. Axial CT scans allow the depiction of subacromial compartment structures that cannot be demonstrated by US. The evident and frequent association of arthrotic-degenerative acromioclavicular alterations even after os acromiale assimilation confirms the close relationship of the latter bone to rotator cuff conditions, especially to rotator cuff tears. In our opinion, the correct description of this finding has high prognostic value in the subjects likely to experience functional shoulder overuse and allows the correct etiopathogenesis of pain. Therefore CT, which is an elective imaging method especially suited to demonstrate calcium-density structures, thanks to its high spatial and contrast resolution, can be used concurrently with MR imaging because it is less expensive and more easily available.
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PMID:[The incidence and role of the os acromiale in the acromiohumeral impingement syndrome]. 147 20

The authors describe 42 cases of lesions of the musculoskeletal apparatus (traumatic, pseudoneoplastic or tumorous) in which selective arterial transcatheter percutaneous embolization (SAE) was indicated. In 3 patients SAE was not performed because the angiography had shown it to be too dangerous for the spinal cord. Out of 39 patients 2 were embolized in order to stop unrestrainable hemorrhaging (1 post-traumatic and 1 post-bioptic), 7 in order to reduce intraoperative bleeding, while in 7 cases (aneurysmal bone cyst, angioma of bone) the aim was curative. In the remaining 23 patients SAE was performed for adjuvant (8) or palliative (15) purposes in association with radio-and/or chemotherapy (11). In these last 15 cases the clinical results obtained were good in 67% of the cases, with partial or total regression of pain. Healing was obtained in 100% of the patients treated for curative purposes.
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PMID:Selective arterial embolization in the treatment of lesions of the musculoskeletal apparatus. 172 64

Periodontal disease can be divided into two categories: gingivitis (inflammation of the soft tissue) and periodontitis (destruction of the alveolar bone). Swelling, erythema, bleeding and gingival recession are common signs of gingivitis. However, most patients with gingivitis are asymptomatic. When patients complain of tooth pain and mobility, they already have severe periodontal disease. Dental loss secondary to periodontal disease may result in inadequate mastication, impaired phonetics and loss of self-esteem. Patients should be counseled that good oral hygiene and regular dental examinations can prevent periodontal disease.
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PMID:Periodontal disease and the family physician. 185 6

A 25-year-old woman was admitted in our hospital with back pain and both hip joint pain. Pain was abruptly occurred from the beginning of March 1990. Physical examination revealed wide spread pain (occipital area, both shoulder, lumber area, bilateral gluteal area, inguinal area, both Achilles-plantar area) and more than 12 tender points (occiput, trapezius, second rib, supraspinatus, gluteal, greater trochanter, hip joints, pubic bone). Laboratory examination showed no abnormal findings except ANF (1:160). Any examination including X-ray, bone scintigraphy, CT and MRI did not disclose spondylitis, sacroiliitis and enthesopathy. She was diagnosed as primary fibromyalgia/fibrositis syndrome. Treatment with maprotine hydrochloride (30 mg/day) and phenobarbital (120 mg/day) brought approximately 1/3 reduction of pain and tenderness. Psychoanalysis revealed that she had psychological conflicts against her parents and her colleagues at the work. EEG showed a borderline record with irregular basic pattern and 14 & 6 Hz positive burst at the sleep stage. Although the newly proposed criteria for the classification of fibromyalgia was proposed by ACR, fibromyalgia/fibrositis syndrome has been seldom discussed in the Japanese literature. As this syndrome is frequently associated with various rheumatic diseases, hypothyroidism and malignant diseases, we should pay much more attention to understand this syndrome.
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PMID:[Fibromyalgia (fibrositis) syndrome--a case report]. 192

1. In chloralose-anaesthetized cats, lumbosacral dorsal horn neurones driven by receptors in skeletal muscle and other deep tissues (tendon, joint, bone) were studied. 2. Upon mechanical stimulation two main types of neurones were found: units having exclusive input from deep tissues (D cells, 28.8%) and units with input from both cutaneous (C) and deep (D) receptors (C-D cells, 71.2%). In both categories, low-threshold mechanosensitive (LTM) and high-threshold mechanosensitive (HTM) elements were present. 3. Neurones responding exclusively to noxious stimulation of skeletal muscle were not found; the input from muscle nociceptors converged on the dorsal horn cells together with other deep or cutaneous input. D cells with exclusively HTM input were numerous; these could from the anatomical basis for a specific spinal pathway for deep pain. 4. For C-D neurones with input from deep nociceptors the cutaneous receptive field (RF) was usually located distal to the deep one. This arrangement might be of relevance for the occurrence of hyperaesthetic skin distal to painful deep lesions. 5. Cold block of the spinal cord resulted in a marked increase in the neurones' mechanical responsiveness and in the number of RFs per neurone. Simultaneously, the proportion of HTM RFs increased, particularly in cells with input from skeletal muscle. 6. The recording sites in the dorsal horn were located in the superficial dorsal horn and in and around laminae V/VI. Evidence is presented that in dorsal horn cells with deep input not only the mechanical excitability but also the degree of convergence is controlled by descending spinal pathways.
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PMID:Response behaviour of cat dorsal horn neurones receiving input from skeletal muscle and other deep somatic tissues. 223 99

Although fluoride increases bone mass, the newly formed bone may have reduced strength. To assess the effect of fluoride treatment on the fracture rate in osteoporosis, we conducted a four-year prospective clinical trial in 202 postmenopausal women with osteoporosis and vertebral fractures who were randomly assigned to receive sodium fluoride (75 mg per day) or placebo. All received a calcium supplement (1500 mg per day). Sixty-six women in the fluoride group and 69 women in the placebo group completed the trial. As compared with the placebo group, the treatment group had increases in median bone mineral density of 35 percent (P less than 0.0001) in the lumbar spine (predominantly cancellous bone), 12 percent (P less than 0.0001) in the femoral neck, and 10 percent (P less than 0.0001) in the femoral trochanter (sites of mixed cortical and cancellous bone), but the bone mineral density decreased by 4 percent (P less than 0.02) in the shaft of the radius (predominantly cortical bone). The number of new vertebral fractures was similar in the treatment and placebo groups (163 and 136, respectively; P not significant), but the number of nonvertebral fractures was higher in the treatment group (72 vs. 24; P less than 0.01). Fifty-four women in the fluoride group and 24 in the placebo group had side effects sufficiently severe to warrant dose reduction; the major side effects were gastrointestinal symptoms and lower-extremity pain. We conclude that fluoride therapy increases cancellous but decreases cortical bone mineral density and increases skeletal fragility. Thus, under the conditions of this study, the fluoride-calcium regimen was not effective treatment for postmenopausal osteoporosis.
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PMID:Effect of fluoride treatment on the fracture rate in postmenopausal women with osteoporosis. 237 Aug 93

Osteonecrosis (aseptic or avascular necrosis of bone) is an entity with many causes that can occur at a variety of sites. It is a known complication of corticosteroid therapy, either alone or combined with other drugs in the treatment of malignancy. Osteonecrosis associated with chemotherapy that does not include corticosteroids is rare; three such cases have been reported in the English literature. One received cyclophosphamide alone, another vinblastine and bleomycin, while the third received cyclophosphamide, methotrexate, and 5-fluorouracil. The authors report a 40-year-old woman who had a left radical mastectomy in 1978 and a right radical mastectomy in 1980 for infiltrating ductal adenocarcinoma of the breasts. She received melphalan following the first surgery and a combination of doxorubicin, cyclophosphamide, and 5-fluorouracil after the second operation. In 1984 she noted pain in both knees that slowly increased in severity. A bone scan revealed increased periarticular activity in the medial and lateral femoral condyles of both knees compatible with bilateral osteonecrosis. There was no evidence of metastatic carcinoma on the bone scan. The patient was treated surgically with drilling and autologous bone grafting. A bone biopsy at the time of surgery revealed osteonecrosis but no metastatic adenocarcinoma.
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PMID:Osteonecrosis of bone associated with combination chemotherapy without corticosteroids. 300 60

Ballet dancers are athletes susceptible to ligamentous and bony injury. We reviewed retrospectively the bone scans (technetium-99m methylene diphosphonate) of 23 ballet dancers with pain in the back and/or lower extremities to determine the usefulness of scintigraphy in the detection of stress lesions of bone. The scintigraphic studies in 19 dancers identified multiple areas of stress injury in both symptomatic and asymptomatic locations. Thirteen dancers had 22 stress fractures (microfractures of trabeculae with associated bone repair) manifested by an intense focus of increased uptake of radiopharmaceutical, and 19 dancers had stress reactions (areas of accelerated remodeling and resorption of bone) demonstrated by diffusely increased uptake of radiotracer. Ten of the 13 dancers with stress fractures were symptomatic and six of the 19 dancers with stress reactions were symptomatic. The radiographs of 10 dancers with positive bone scans were normal or showed no distinction between acute and chronic injuries. Stress fractures were most prevalent in the feet, and stress reactions were most prevalent in the tibiae. The study confirmed that ballet dancers sustain significant bone stress in their legs and feet. Our results show that scintigraphy can be used to detect stress fractures and stress reactions at both symptomatic and asymptomatic sites in this population.
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PMID:Bone stress lesions in ballet dancers: scintigraphic assessment. 210 44

61 cases of histiocytosis X of jaws were reported here. They occurred more often in man (72% of men) than in woman, with an average age of 27 years. The mandible was affected more frequently than the maxilla. Clinically, dental expulsion, gingival swelling, fractures or pain were the usual symptoms. Roentgenographic examination showed either central or peripheral (alveolar bone) osteolytic areas. The histologic diagnosis was easy when eosinophilic polymorphous leukocytes or histiocytes were preponderant. In the other cases, immunohistochemistry (positivity of S-100 protein) and electron microscopy (presence of Birbeck granules about paraffin embedded specimens) were of a great usefulness. The prognosis of the disease was mainly related to the diffusion of lesions to other skeletal portions or extraskeletal localizations (37% of our cases). It has been improved by combination of chemotherapy to surgery (despite of frequent recurrences), 40 upon 45 patients are well after a follow-up of 2 to 10 years after the last localization.
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PMID:[Histiocytosis X of the jaw. I. Anatomico-clinical study apropos of 61 cases]. 350 9


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