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Pyomyositis is a bacterial infection of the muscle, which can form abscesses and spread locally. It is relatively uncommon in temperate climates, often has an insidious onset, and can be difficult to diagnose. It is even more challenging in the paediatric population where the history may not be clear, examination is inconsistent, and blood tests are non-specific. It was initially described in 1885 as a disease predominating tropical areas (hence also known as tropical myositis or myositis tropicans). It differs from myositis in that it is always precipitated by bacteria and is confined to distinct areas in muscles +
Pompe disease is a Lysosomal Storage Disease (LSD), also a type of Glycogen Storage Disease (GSD II), that is caused by a deficiency in acid alpha-glucosidase (GAA), also known as acid maltase. GAA deficiency results in the accumulation of glycogen in lysosomes in all tissues. Unlike other GSDs, which affect glycogen synthesis or regulation of energy production, GAA deficiency affects lysosomal-mediated degradation of glycogen. GAA deficiency can present in two forms: an infantile-onset form, which typically involves hypertrophic cardiomyopathy and hypotonia, and a late-onset form, which is characterised by limb girdle and axial weakness and respiratory insufficiency in late disease. +
Medical diagnosis is a core feature of medicine. It is a cognitive classification or "categorisation task" which allows doctors to make certain predictions about clinical situations and develop a management plan. +
Z-Anatomy is a completely free open source 3D anatomy atlas. See [https://www.z-anatomy.com/ the official website]. +
Diffuse idiopathic skeletal hyperostosis (DISH) is a progressive noninflammatory condition causing calcification and ossification of ligaments and entheses with a spinal predominance. The condition may be asymptomatic, or may be associated with spinal pain and restricted movement +
Bradykinin is a potent inflammatory peptide messenger, and as a kinin is part of the kallikrein-kinin system which has wide ranging effects on the body. +
The prevalence of smoking in those with chronic pain is up to double that of the general population. In the short term smoking is an analgesic, however in the long-term it is deleterious for pain as it exacerbates nociceptive, neuropathic, and psychosocial pain. Smokers have higher pain intensities, number of painful areas, levels of disability, and opioid use to nonsmokers. There is a positive correlation even when controlling for confounding demographic, socioeconomic, and mood disorder factors. Many smokers identify coping with pain and anxiety as reasons for smoking. There is therefore a bidirectional relationship with smoking and pain. Pain increases the desire to smoke, and smoking increases pain. +
Cervical radicular pain is pain perceived as arising in a limb or the trunk wall caused by ectopic activation of nociceptive afferent fibres in a spinal nerve or its roots or other neuropathic mechanisms. Cervical radiculopathy is the objective loss of function in some combination of sensory loss, motor loss, or impaired reflexes, in a segmental distribution. Pain is not a component of radiculopathy, and so it can be helpful to distinguish it from cervical radicular pain. +
Referred pain is best described in neurological terms as "pain perceived as arising or occurring in a region of the body innervated by nerves or branches of nerves other than those that innervate the actual source of pain" (IASP definition). In topographical terms it is perceived in a region that is topographically distinct from the actual source of the pain. The topographical definition becomes ambiguous in cases where it is unclear where one region of the body ends and an adjacent region begins. Referred pain is a very common presentation of pain. For pain in a particular area, the diagnostic process should start by asking which body segment are they indicating, and then translate that into which structures are supplied by those spinal cord segments. +
Skeletal muscle consists of 40-50% of total body mass. It is composed of muscle cells, organised networks of nerves and blood vessels, and an extracellular connective tissue matrix. The framework helps to support and protect the structure against injury. It is organised into individual units into tissues and organs that contract to produce joint motion and locomotion. +
Neck-Tongue Syndrome is a rare condition characterised by brief attacks of neck and/or occipital pain with neck rotation associated with sensory changes of the ipsilateral half of the tongue. +
Biosynthesis starts with membrane phospholipids, present in the lipid bilayer of the cell membrane. The biosynthesis pathway has three main steps. Initially arachidonic acid is liberated from membrane phospholipids, by hydrolysis, by phospholipase A2 enzyme (PLA2). The second step involves the COX enzyme, through its cyclooxygenase site, which results in prostaglandin G2 (PGG2). The same COX enzyme converts PGG2 to prostaglandin H2 (PGH2) through the COX peroxidase catalytic site. One end of the COX enzyme has a membrane binding domain along with an epithelial growth factor domain, and the other end is the active enzymatic site. PGH2 is converted to various kinds of prostanoids by tissue-specific isomerases. For example prostacyclin (PGI2), prostaglandin D2 (PGD2), prostaglandin E2 (PGE2), prostaglandin F2a (PGF2a) and thromboxane A2 (TXA2). Arachidonic acid can also be converted to leukotrienes by the enzyme lipoxygenase. +
There are eight carpal bones of the wrist ("carpus") which are held together by ligaments. With ligamentous injury the wrist can become unstable and lead to post-traumatic osteoarthritis. +
Thoracic outlet syndrome (TOS) is caused by compression of the brachial plexus or subclavian vessels as they pass through the narrow passageways leading from the base of the neck to the axilla and arm. There is considerable disagreement about its diagnosis and treatment, particularly the neurogenic form. Practice guidelines are not currently possible due to the low level of evidence. +
Small fiber neuropathy (SFN) is a painful neuropathy involving selectively the Aฮด and C nerve fibres. This leads to sensory, autonomic, or combined symptoms. Small fibre neuropathy (SFN) and large fibre neuropathy belong to a group of diseases known as peripheral neuropathies. Polyneuropathy refers to cases where either the large fibres are affected, or both the large and small fibres are affected. SFN refers to isolated small fibre involvement. About 40-50% of patient with fibromyalgia meet the diagnostic criteria for SFN +
Baxter's nerve entrapment, also known as Baxter neuropathy, and inferior calcaneal nerve entrapment, is plantar heel pain arising from compression of the inferior calcaneal nerve (Baxter nerve). +
Chronic low back pain does not defy diagnosis. While the causes of acute low back pain are largely unknown, this is not the case for chronic low back pain, where a biomedical diagnosis is possible in the majority of cases. The exact figures depend on the age, but around 40% have disc pain, around 10-30% have facet joint pain, and around 10-20% have sacroiliac joint pain. +
The evidence does not support the use of medicinal cannabis in Musculoskeletal Medicine - it is not effective for pain and it may in fact lower pain thresholds. +
Scheuermann's disease (SD) is a developmental disorder in adolescence that causes a rigid or relatively rigid hyperkyphosis of the thoracic, thoracolumbar, or rarely lumbar spine and has specific radiographic findings. +
