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

When lameness is discovered in a child minutious investigations must be started in search of its cause. The first step in these investigations is to determine the exact location of the pain and to exclude all causes of lameness unrelated to the hip. In difficult cases, radioisotope scanning locates the pathological area. These points being acquired, the second step is to find whether the lesion is infectious, dystrophic, inflammatory, tumoral or traumatic. Usually, the investigations rapidly give a clue: transient discomfort, negative radiological results and clinical normalization indicate "growth pain". Transient acute synovitis is the most frequent of true lesions of the hip, followed by infectious arthritis and primary osteochondritis.
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PMID:[Hip pain in children]. 202 Aug 16

A variety of rheumatologic disorders affect the elderly. Some of these problems are seen almost exclusively in the elderly, such as temporal arteritis and pseudogout. Because of underlying chronic diseases, these patients are also at increased risk for joint infection and resultant sepsis. Evaluation of synovial fluid from the inflamed joint is important. Light microscopy evaluation with a red polarizing compensator can help diagnose crystal-mediated disease, such as gout or pseudogout. Examination of Gram stains can help diagnose infectious arthritis. Thus, appropriate processing of synovial fluid is mandatory for the diagnosis of many rheumatologic disorders that occur in the elderly. A variety of metabolic disorders are associated with pseudogout and should be searched for on laboratory evaluation. Appropriate laboratory evaluation and follow-up following the acute episode are important in the care of these patients. For example, temporal arteritis with resultant blindness is a feared disorder in the elderly. Transient blindness, headaches, jaw claudication, and an elevated Westergren sedimentation rate suggest this diagnosis. Aches and pain in the neck and shoulder area, especially in the morning, are typical of polymyalgia rheumatica. Polymyalgia rheumatica may also be a symptom of temporal arteritis.
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PMID:Acute rheumatologic disorders in the elderly. 218 87

Intra-articular injections with steroids may offer additional help in the treatment of inflammatory joint diseases. The major side effects are the systemic effects of steroids, infectious arthritis and cartilage damage. These are infrequent, however, and to a great extent preventable. Steroids are of little effect in radiological progression and function, and this is the most important limitation on liberal use. On the other hand, they powerfully suppress inflammation and pain, for a varying length of time which depends on the preparation used.
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PMID:Intra-articular steroid injection. A risk-benefit assessment. 219 May 96

Pain, swelling, and limited range of motion of a joint are extremely common complaints in the emergency department. In assessing joint complaints it is helpful for the emergency physician to keep in mind the major categories of diagnostic possibilities; it is also useful to distinguish between chronic and acute problems and between monoarticular and polyarticular problems. The emergency physician does not need to make a precise diagnosis of every joint complaint, but it is essential that infectious arthritis not be missed.
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PMID:Emergency department evaluation of the swollen joint. 639 10

Infectious arthritis caused by Candida spp was diagnosed in 2 horses. Source of infection was by direct inoculation in 1 horse and was presumed to be hematogenous in the other horse. On microbial culturing of synovial fluid and synovial membrane specimens, the organisms were isolated in both horses. In both horses, the joint infections resolved after i.v. administration of amphotericin B and joint drainage; however, 1 horse was eventually euthanatized because of signs of cervical pain and progressively worsening ataxia. Fungal organisms isolated on microbial culturing of joint specimens in horses, although uncommon, should not be dismissed as contaminants, particularly if the same organism is recovered from more than 1 specimen. Successful resolution of fungal arthritis may be achieved with appropriate antifungal treatment, combined with joint drainage.
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PMID:Amphotericin B treatment of Candida arthritis in two horses. 775 Dec 43

The etiology of shoulder pain can usually be placed into one of five categories: fracture and/or contusion, shoulder separation involving the clavicle, instability of the glenohumeral joint, impingement syndrome involving the rotator cuff or biceps tendinitis, and frozen shoulder. Non-shoulder pathology, such as cervical strain, thoracic outlet syndrome and referred pain from phrenic nerve irritation, should be excluded when evaluating patients presenting with shoulder pain. After inflammatory or infectious arthritis has been ruled out, the history should point to either acute trauma or an overuse injury. Physical examination may provide information about neurovascular status, palpable tenderness, range of motion, strength, instability and impingement. Radiographic studies are usually indicated in patients with a history of trauma, but they are often not necessary in the initial evaluation of overuse injuries. Magnetic resonance imaging and arthrograms should be reserved for patients who have not responded to six to eight weeks of conservative treatment and are candidates for surgery.
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PMID:Shoulder pain: a diagnostic dilemma. 775 27

Infectious arthritis is mostly caused by hematogenous spread of Gram-positive bacteria, which often infects a previously damaged joint. During the past 20 years there has been a notable increase in joint infections caused Gram-negative bacteria. They develop mostly in patients with systemic diseases, such as malignancy, cirrhosis or HIV infection, which cause an immune deficient state. We present an 84-year old man admitted because of fever and a diagnosis of pneumonia. During hospitalization he complained of pain in his right knee. On physical examination there was evidence of local inflammation. Infection with E. coli originating in the urinary tract was diagnosed, based on synovial fluid, blood and urine cultures. He was treated with antibiotics intravenously, the knee was surgically drained, and he was discharged 4 weeks after admission. There was no underlying systemic disease in this case that could have caused an immune deficient state, which could promote the Gram-negative joint infection. The case is presented to draw attention to the possibility of infectious arthritis in an elderly patient presenting with fever. In such cases the location of the infection may not be obvious if the infected joint is deeply located parts of bones such as those of the hip, shoulder, or vertebrae. In these cases the diagnosis may be overlooked or delayed and irreversible damage to the infected joint may result.
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PMID:[Bacterial arthritis with E. coli in an elderly patient]. 781 26

The case records of 64 patients with 65 episodes of infectious gonarthritis during 1979-88 were reviewed regarding epidemiological, clinical and laboratory data of possible relevance to the course and outcome of the disease. Long-term healing results were evaluated by means of a new scoring system 2-11 years after the acute disease in 46 patients. The infection was acquired by inoculation in 37% and by the hematogenous route in 55%. The major risk factors were trauma to the joint and arthrosis. Staphylococcus aureus was the causative agent in 58% and Streptococci in 15%. Treatment consisted of suction irrigation (86%) or intermittent aspiration (5%) combined with systemic antibiotic treatment. At follow-up, the pain and ache scores of the arthritic joint had decreased by 21% and 16% respectively, compared with the scores of the contralateral control joints. Anatomy and motility were reduced by 9% and 8% respectively. Age < 45 was associated with a greater score loss than in older patients. Treatment delayed by > 5 days was associated with increased loss of motility. We estimate that 79% of the patients had excellent or good long-term results following treatment of infectious arthritis of the knee. Evaluation of healing after infectious gonarthritis by use of a scoring system is quite feasible and allows comparison of different treatment regimes with improved accuracy.
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PMID:Septic arthritis of the knee: a 10-year review and long-term follow-up using a new scoring system. 819 Dec 45

Interactions of physical, emotional, cognitive and behavioural impairments after severe closed head injury (CHI) remain poorly understood. A 47-year-old man was referred to our department 13 months after a severe CHI. He demonstrated severe left hemiplegia and disabling orthopaedic complications (left hip infectious arthritis, after surgical treatment for heterotopic ossification). His hip was blocked and extremely painful. He was totally dependent for daily-life activities (Functional Independence Measure (FIM) score = 18). Moreover he exhibited severe cognitive and behavioural troubles, which had been stable for many months beforehand, e.g. complete disorientation for time and place, major memory disorders, agitation, anxiety, depression, irritability, disinhibition, aggressiveness and lack of initiative. Pain disappeared within a few weeks after treatment. Progressively, functional improvement occurred (sitting position, transfers, walking between parallel bars). The FIM score increased to 63. Aggressiveness, irritability and agitation disappeared. Surprisingly, neuropsychological assessment demonstrated parallel improvement of cognitive functions, especially in regard to orientation, and to a lesser degree attention and memory. Such an observation should encourage use of active treatment of physical disabilities, even in patients presenting with an apparently poor cognitive prognosis at a late stage of severe CHI.
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PMID:Late cognitive and behavioural improvement following treatment of disabling orthopaedic complications of a severe closed head injury. 869 16

A calf was treated for chronic infectious arthritis and osteomyelitis of the carpus and metacarpus by carpal bone excision, debridement, and cancellous bone graft placement in the metacarpal medullary cavity. Following 6 weeks of limb immobilization, carpal-metacarpal arthrodesis was achieved. The heifer is pain free, and has produced 3 calves.
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PMID:Partial carpal arthrodesis in a calf with chronic infectious arthritis of the carpus and osteomyelitis of the carpal and metacarpal bones. 975 14


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