Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Pain associated with hypertrophic pulmonary osteoarthropathy (HPOA) may be extremely disabling and resistant to treatment. The successful use of ketorolac, a new non-steroidal anti-inflammatory drug, given by subcutaneous infusion is reported in two patients with uncontrolled pain caused by HPOA.
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PMID:Treatment of resistant pain in hypertrophic pulmonary arthropathy with ketorolac. 851 41

A patient with florid hypertrophic pulmonary osteoarthropathy (HPOA) associated with metastatic nasopharyngeal carcinoma is presented. Despite the presence of metastatic disease in the thorax and in bone, the patient's main symptom was severe pain from the HPOA, which was temporarily relieved by chemotherapy. Her disease subsequently progressed during chemotherapy and the pain became resistant to conventional treatment, including high dose morphine, non-steriodal anti-inflammatory agents and steriods. It was only with local radiation to the involved joints that the pain could be controlled. Our patient demonstrates that local radiotherapy is an option for the palliation of extreme HPOA.
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PMID:Radiotherapy for extreme hypertrophic pulmonary osteoarthropathy associated with malignancy. 881 77

Pain in hypertrophic pulmonary osteoarthropathy (HPOA) due to periostitis and arthropathy can be a particularly disabling symptom, and resistant to a wide variety of treatments. The effectiveness of subcutaneous octreotide in relieving this pain in a patient with HPOA is reported.
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PMID:Treatment of resistant pain in hypertrophic pulmonary osteoarthropathy with subcutaneous octreotide. 909 53

Transient osteoporosis associated with pregnancy is a rare, self-limiting skeletal disorder, the origin of which remains unclear. We report the case of a 36-year-old Japanese woman who developed pain in the left hip, groin, and knee in the seventh month of pregnancy. The pain gradually worsened and prevented weight-bearing. The hip and knee pain progressed to bilateral involvement and persisted after an emergent cesarean section at 35 weeks. Radiographs after delivery revealed gross osteopenia of both the femoral heads, left distal femur, and proximal tibia, consistent with transient osteoporosis associated with pregnancy. The patient remained mostly wheelchair-dependent because of severe hip and knee pain. Several weeks later, the patient was started on alendronate, a biphosphonate, which provided dramatic relief of hip and knee pain. The patient's ambulatory function subsequently improved dramatically as a result of pain relief and assistance with gait training. This case is unique for several reasons. First, it is rare for transient osteoporosis associated with pregnancy to involve both hip joints, and it rarely involves the knee. Second, this is the first reported case of pain management of transient osteoporosis associated with pregnancy being successfully treated with an antiresorptive agent. Finally, the use of alendronate in transient osteoporosis associated with pregnancy may help shorten disability by providing pain relief and decreasing the fracture risk associated with this disease.
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PMID:Transient osteoporosis of the hip during pregnancy: a case report. 955 17

One of the universal characteristics of the long bones and spines of middle-age and older mammals is a loss in bone mass (osteopenia). In humans, if this bone loss is severe enough, it results in osteoporosis, a skeletal disorder characterized by a markedly increased incidence of fractures with sequelae that may include pain, loss of mobility, and in the event of hip fracture, even death within a relatively few months of injury. An important contributing factor to the development of osteoporosis appears to be a diminution in the number and activity of osteoblasts responsible for synthesizing new bone matrix. The findings in the present and other similar studies suggest that this reduction in osteoblast number and activity is due to an age-related diminution in the size and osteogenic potential of the bone marrow osteoblast progenitor cell (OPC or CFU-f) compartment. We previously postulated that these regressive changes in the OPC/CFU-f compartment occurred in old animals because of a reduction in the amount and/or activity of TGF-beta1, an autocrine growth factor important in the promotion of OPC/CFU-f proliferation and differentiation. In support of this hypothesis, we now report that (1) the osteogenic capacity of the bone marrow of 24-month-old BALB/c mice, as assessed in vivo, is markedly reduced relative to that of 3-4-month-old animals, (2) that the matrix of the long bones of old mice contains significantly less TGF-beta than that of young mice, (3) that OPC's/CFU-f's isolated from old mice produce less TGF-beta in vitro than those recovered from young mice, and (4) that OPC's/CFU-f's from old mice express significantly more TGF-beta receptor (Types I, II, and III) than those of young animals and that such cells are more responsive in vitro to exogenous recombinant TGF-beta1. We also find that colony number and proliferative activity of OPC's/CFU-f's of young mice and old mice, respectively, are significantly reduced when incubated in the presence of neutralizing TGF-beta1 antibody. Collectively, these data are consistent with the hypothesis that in old male mice the reduction in the synthesis and, perhaps, availability from the bone matrix of TGF-beta1 contributes to a diminution in the size and development potential of the bone marrow osteoprogenitor pool.
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PMID:Bone loss (osteopenia) in old male mice results from diminished activity and availability of TGF-beta. 971 46

The purpose of this pictorial essay is to illustrate the radiologic spectrum of imaging findings of neuropathic osteoarthropathy. Typical findings include joint destruction, disorganization, and effusion with osseous debris. A variety of other imaging findings related to neuropathic osteoarthropathy such as resorption of the ends of tubular bones and neuropathic fracture are shown. The two prevailing theories for the pathophysiology of neuropathic bone and joint disease, the neurovascular and neurotraumatic theories, are briefly described. Examples of osteoarthropathy from diverse causes are presented including syringomyelia, spinal cord injury, meningomyelocele, diabetes mellitus, congenital insensitivity to pain, steroid injections, syphilis, leprosy, and others. The discussion focuses on key imaging features with emphasis on disease patterns and differential diagnosis, which vary by skeletal location.
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PMID:Neuropathic osteoarthropathy: diagnostic dilemmas and differential diagnosis. 1104 79

We describe an extremely rare case of a woman with pulmonary metastatic disease from breast cancer, who presented with features of hypertrophic pulmonary osteoarthropathy (HPOA). Pain associated with HPOA may be extremely disabling and resistant to treatment. Treatment with pamidronate, an inhibitor of osteoclastic bone resorption, given every 2 weeks by i.v. drip infusion, led to rapid disappearance of uncontrolled pain caused by HPOA.
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PMID:Pamidronate-induced remission of pain associated with hypertrophic pulmonary osteoarthropathy in chemoendocrine therapy-refractory inoperable metastatic breast carcinoma. 1159 54

Charcot's joint, also known as neuropathic osteoarthropathy, is a common complication of diabetes that often is unrecognized and misdiagnosed. It may be present in up to 35% of patients with diabetic neuropathy. This disorder causes progressive destruction of weight bearing joints leading to dislocations, fractures, and deformities. We report a case of Charcot's joint in a 55-year-old man with type two diabetes. He presented with unilateral foot and ankle swelling, foot pain, warmth, and erythema. A magnetic resonance image of his foot revealed changes consistent with a Charcot's joint. Treatment consisted of joint immobilization in a total contact cast and then an ankle foot orthosis with custom footware. Charcot's joint should be considered in patients with a unilateral, warm, erythematous, swollen foot without other systemic symptoms. Early recognition of a Charcot's joint is important in ultimate outcome. Immobilization of the joint, patient education, and proper footcare and footware are essential in preventing further complications including ulceration and amputation.
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PMID:Charcot's joint: an overlooked diagnosis. 1244 Jul 52

Clinical syndromes occasionally associated with or heralding cancer are summarized and classified.Some tumours present with manifestations of an endocrine or endocrine-like action; included in this group are thymomas, non-beta-cell tumours of the pancreas and carcinoids. Cushing's syndrome, hypoglycemia, hypercalcemia, polycythemia and gynecomastia have been produced by a wide variety of tumours. Tumour emboli, non-bacterial thromboendocarditis and thrombophlebitis occasionally occur, but thrombophlebitis is not so frequent as was previously considered. Neurological syndromes are rare and show a great variety of presentations. Other occult manifestations of cancer include hypertrophic pulmonary osteoarthropathy, various skin diseases, obscure pyrexias and, in Hodgkin's disease, pain secondary to alcohol consumption.
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PMID:Occult manifestations of cancer. 1395 5

This paper describes a case of Ollier's disease, an uncommon, nonhereditary skeletal disorder affecting enchondral ossification. The patient was referred to our Rehabilitation Unit after resection of scapular chondroma. He had previously been submitted to several surgical treatments for multiple enchondromatosis. Rehabilitation goals were increasing range of motion, relieving pain and training activities of daily living (ADL). After one month treatment, the patient reported pain relief and showed good improvement of articular function and better performances on ADL. According to our experience, it seems that rehabilitation could play a complementary role as regards surgical treatment of this complex pathology.
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PMID:Rehabilitation experience in a case of Ollier's disease. 1505 20


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