What is nasolacrimal duct obstruction?

Tears normally drain away from the eye through small holes on the eyelid called puncta, then through the tear duct which opens into the nose. If the passageway is narrow (stenosed) or blocked, excessive tearing may result. Irrigation of the drainage system is performed in office to determine whether the tear duct is blocked.

What are treatments for nasolacrimal duct obstruction?

The main treatments for blocked tear duct include stenting with silicone tube (usually for partial blockage) and dacryocystorhinostomy (DCR, usually for more severe blockage).

What is silicone intubation?

A very thin silicone tube is passed through the openings of the tear drain in the upper and lower eyelids, passed down the tear duct, and secured with a suture to the inside of the nostril. The silicone tube is kept in place after the procedure to help open the drainage pathway. The procedure is performed in an operating room under sedation or anesthesia and usually takes less than 1 hour.

How long does the silicone tube stay in after the surgery?

The silicone tube will usually stay in place for 3-6 months and sometimes up to 9 months, depending on the degree and location of blockage. The tube will then be removed in office. Silicone tube Diagram of silicone intubation of the left eye Silicone tube is tied to the inside the nostril with a suture The only visible part of the silicone tube is at the corner of the eye Lacrimal sac Lacrimal gland Tear duct Tear flows across the eye.

What should I do after the silicone intubation procedure?

You should use antibiotics/steroids drops and sometimes ointment as instructed by your doctor, usually tapered over 3 weeks after the procedure. You may experience some bloody discharge from your nose for a few days after the surgery. Please avoid rubbing the inner corner of your eye, forceful nose blowing, nose picking or poking at the tube. This could cause the silicone tube to come out sooner than planned, and limit the effectiveness of the procedure.

What should I do if my nose is congested after the silicone intubation?

You can use over-the-counter nasal saline  as needed to relieve the nasal congestion. Afrin® may be used as well, but no longer than 3 days to prevent unwanted side effects. What does it look like to have a silicone tube in place? You may notice a clear plastic tube connecting at the inner corner of your eye. It is barely noticeable for most people. Why am I still tearing after I had a silicone intubation procedure? Most patients will notice a significant improvement in tearing shortly after silicone intubation. However, a subset of patients will have continued watering until the tube is removed. For a small group of patients (approximately 10%), the tearing is actually worse when the tubing is in place. Most, but not all, patients eventually notice improvement in the excess tearing by the time the tubing has been removed. Photo 2: Photograph of the right eye 1 week after silicone intubation. Please note the clear silicone tube at the inside corner of the right eye. If the silicone tube comes out, what should I do? Generally the tube will stay in place without problems. If the tube becomes dislodged, you may notice a loop of silicone tube coming out from the corner of your eye. You should tape the loop to your nose and call the doctor’s office as soon as possible. Do not pull it out or cut it.

Types

Psoriasis is a skin condition that causes skin cells to form too quickly. Because new skin cells grow faster than the body sheds existing skin cells, thick, scaly patches of skin form.

There are several types of psoriasis. Most types of psoriasis tend to be mild to moderate. However, some types of psoriasis are more likely to be severe.

Types of the condition include:

• plaque psoriasis
• psoriasis of the scalp
• guttate psoriasis
• inverse psoriasis
• pustular psoriasis
• erythrodermic psoriasis

People with psoriasis may develop one type of psoriasis and then develop another type at a later point in time.

General symptoms

While symptoms vary with the type of psoriasis a person has, most people with psoriasis will experience some combination of the following symptoms:

• itchy skin
• burning, sore, or painful areas on the skin
• patches of thick skin with silvery scales
• small scaly spots
• swollen or stiff joints

Psoriasis symptoms tend to be cyclical. This means that they will often become more intense during what are called flares and lessen at other times.

During flares, symptoms may be more severe even in cases of mild psoriasis. At other times, symptoms may be minimal.

Plaque psoriasis

Plaque psoriasis, also known as psoriasis vulgaris, is the most common form of psoriasis. It is marked by areas of plaque buildup on the skin.

Plaque is the thickened areas of skin that often have a white or silvery, scaled appearance. They tend to appear most on elbows, knees, and lower back but may form anywhere on the body.

Plaque psoriasis tends to be mild to moderate. Mild plaque psoriasis covers less than 3 percent of the body, and moderate plaque psoriasis covers less than 10 percent of the body.

Symptoms

Symptoms of plaque psoriasis vary from person to person. These symptoms can include the following:

• areas of dry, red skin lesions covered with silvery scales
• plaques that itch or burn
• problems that affect the nails

Areas of plaque may appear anywhere on the body but are most common on the knees and elbows.

Treatment

Treatment of mild or moderate plaque psoriasis varies and often requires trial and error before determining the best treatment combination for that person.

Treatment options include the following:

• exposing the skin to ultraviolet (UV) light
• creams and ointments applied to affected areas to slow down skin growth

Drugs that affect the whole body are rarely used for mild psoriasis. However, these drugs may be used if other treatments fail.

Scalp psoriasis

When psoriasis appears on the scalp, it is known as scalp psoriasis. It can appear on the forehead, or back of the head and extend down the neck or behind the ears.

Symptoms

Scalp psoriasis usually has the same symptoms as plaque psoriasis. In scalp psoriasis, the plaques appear on the scalp and under the hair.

A person with scalp psoriasis can have psoriasis on other parts of their body at the same time.

Other symptoms of scalp psoriasis include:

• red patches of thick skin on the scalp
• silvery dandruff-like flakes on the scalp
• itching and bleeding scalp
• a dry scalp
• temporary hair loss during flares

Treatments

Treatment for scalp psoriasis often involves more than one method at a time. As with plaque psoriasis, it may take some time to find the best approach for the individual.

Treatment options for scalp psoriasis include:

• medicated shampoos and ointments
• UV light therapy
• injections
• scalp therapy

In more severe cases, drugs that affect the whole body may be added to a treatment plan.

Guttate psoriasis

Guttate psoriasis is characterized by red dots and spots spread throughout the skin. The dots and spots are not as thick as plaques in plaque psoriasis.

This type of psoriasis often starts in childhood or young adulthood and appears after an infection.

Symptoms

Most often, guttate psoriasis is mild psoriasis. In some cases, however, it may cause moderate to severe symptoms. Symptoms may include the following:

• small, red spots on the skin
• potentially hundreds of red dots on skin
• a rash that can appear anywhere but mostly on the trunk
• sudden onset of a rash after illness or infection

Treatments

Most doctors consider topical treatments very effective for guttate psoriasis. However, people with guttate psoriasis may find applying the cream on so many individual spots very tiring, so topical treatments may be used more when the rash is confined to a smaller area.

Other treatment options include light therapy. Doctors rarely use drugs affecting the whole body for guttate psoriasis.

Inverse psoriasis

Inverse psoriasis appears as red marks that are most often found in the folds of the skin, such as in the armpits and groin.

People with inverse psoriasis often have other forms of psoriasis elsewhere on their body.

Symptoms

Areas of the body that are most likely to be affected by inverse psoriasis include:

• armpits
• groin
• under the breasts
• behind the knee

Areas affected by inverse psoriasis rarely have scaly plaques that are common with other forms of psoriasis.

Treatment

The areas of the body that are most often affected by inverse psoriasis tend to be quite sensitive and have thinner skin than other areas. This can make treating this type of psoriasis more difficult.

Steroid creams and ointments are effective, but the risk of side effects is higher due to the thinness of the skin.

Pustular psoriasis

This type of psoriasis is marked by white blisters that contain pus. This pus is not infectious and is made of white blood cells.

Symptoms

The blisters that are caused by pustular psoriasis can be limited to one area of the body or appear more generally across the whole body.

Before the blisters appear, the skin tends to redden. Once the blisters have gone away, the skin may become scaly.

A specific kind of pustular psoriasis called palmoplantar pustulosis causes blisters to form on the palms and soles of the feet. These blisters form in a studded pattern. Over time, the blisters turn brown and become crusty.

Treatment

Some forms of pustular psoriasis can be difficult to treat. Doctors will often switch between oral medications and light therapy, to reduce the risk of side effects.

Acitretin and methotrexate are two drugs that can treat the condition quickly and clear up the affected areas of skin.

Pustular psoriasis that only affects one area of the body may also be treated with medication applied to the skin.

Erythrodermic psoriasis: need to see a doctor

While most forms of psoriasis tend to be mild or moderate, erythrodermic psoriasis is severe and can be a life-threatening medical emergency.

This type of inflammatory psoriasis covers most of the body in a red, peeling, extremely painful rash that looks as if it has been caused by a burn.

 

Symptoms

Unlike symptoms of the types of psoriasis that are usually mild, symptoms of erythrodermic psoriasis tend to be very serious. They may include a combination of the following:

• widespread area of inflamed, red skin
• skin that peels off in sheets
• skin that looks as if it has been burned
• severe itching, pain, or burning
• faster heart rate
• fever or lower body temperature
• swelling in feet or ankles

People suffering from erythrodermic psoriasis are prone to infection. They may also experience other serious problems, including heart failure and pneumonia.

Treatments

People with erythrodermic psoriasis are often hospitalized. Unlike in cases of mild or moderate psoriasis, topical creams are not the first line of treatment. Instead, most people with erythrodermic psoriasis need drugs that affect the whole body.

Outlook

Most types of psoriasis tend to be mild to moderate except erythrodermic psoriasis, which can be a life-threatening medical emergency.

Psoriasis varies in its appearance and symptoms, but most treatment approaches are very similar.

People who suspect that they have psoriasis should consult their doctor before beginning treatment. People with symptoms of erythrodermic psoriasis should seek immediate medical attention.

A skin tag is a small piece of soft, hanging skin that may have a peduncle, or stalk. They can appear anywhere on the body, but especially where skin rubs against other skin or clothing.

Other names are an acrochordon, cutaneous papilloma, cutaneous tag, fibroepithelial polyp, fibroma molluscum, fibroma pendulum, soft fibroma, and Templeton skin tags.

Skin tags are very common and generally occur after midlife. They affect men and women equally.

What are skin tags?

They may appear on the:

• eyelids
• armpits
• under the breasts
• groin
• upper chest
• neck, in the case of papilloma colli

They often go unnoticed, unless they are in a prominent place or are repeatedly rubbed or scratched, for example, by clothing, jewelry, or when shaving.

Some people may have skin tags and never notice them. In some cases, they rub off or fall off painlessly. Very large skin tags may burst under pressure.

The surface of skin tags may be smooth or irregular in appearance. They are often raised from the surface of the skin on fleshy peduncles, or stalks. They are usually flesh-colored or slightly brownish.

Skin tags start small, flattened like a pinhead bump. Some stay small, and some grow bigger. They can range in diameter from 2 millimeters (mm) to 1 centimeter (cm), and some may reach 5cm.

Treatment

As skin tags are usually harmless, removal is normally for aesthetic or cosmetic reasons.

Large skin tags, especially in areas where they may rub against something, such as clothing, jewelry or skin, may be removed due to irritation.

Removing a large skin tag from the face or under the arms can make shaving easier.

Surgery

The following procedures may be used:

• Cauterization: The skin tag is burned off using electrolysis
• Cryosurgery: The skin tag is frozen off using a probe containing liquid nitrogen
• Ligation: The blood supply to the skin tag is interrupted
• Excision: The tag is cut out with a scalpel

These procedures should only be done by a dermatologist, or specialist skin doctor, or a similarly trained medical professional.

Skin tags on the eyelid, especially those close to the eyelid margin, may have to be removed by an ophthalmologist, or specialist eye doctor.

Removing a skin tag at home is not normally recommended, due to a risk of bleeding and possible infection.

However, very small tags can be removed by tying dental floss or thin cotton thread around the base of the tag to cut off circulation to the tag.

What is neurogenic bladder?

When neurological (nervous system) conditions affect the bladder, it is called neurogenic bladder. There are two major types of bladder control problems that are associated with a neurogenic bladder. Depending on the nerves involved and nature of the damage, the bladder becomes either overactive (spastic or hyper-reflexive) or underactive (flaccid or hypotonic).

What is the bladder?

The bladder is a hollow organ located in the pelvis, or lower abdomen. The bladder has two important functions:

• It stores urine.
• It removes urine from the body through a complex communication circuit in the spinal cord and brain.

Urinary incontinence occurs when a person cannot control the flow of urine. The storage of urine can be a problem if the bladder is unable to empty fully or if it begins to empty itself before the person reaches the bathroom (a condition known as overactive bladder). Leakage can occur if the bladder cannot empty (overflow incontinence), if the sphincter controlling urination doesn’t work (stress incontinence), or if bladder spasms cause the bladder to shrink before the person reaches the toilet (urge incontinence).

                                   

What causes neurogenic bladder?

Neurogenic bladder can be congenital (present at birth). Birth defects that can cause neurogenic bladder include:

• Spina bifida (myelomeningocele): This disorder occurs when the fetus’ spine does not completely develop during the first month of pregnancy. Babies born with myelomeningocele often have paralysis or weakness that affects how the bladder works.
• Sacral agenesis: This is a condition in which parts of the lower spine are missing.
• Cerebral palsy: Cerebral palsy is a group of chronic (long-term) disorders that weaken a person’s ability to control body movement and posture. These disorders result from injury to the motor areas of the brain. The problem causing cerebral palsy may occur while the infant is still in the womb or after birth. Cerebral palsy is not always found during a child’s first year of life.

Various medical conditions can cause neurogenic bladder, including the following:

• Stroke
• Parkinson’s disease
• Multiple sclerosis
• Spinal cord injuries
• Spinal surgeries
• Erectile dysfunction
• Trauma/accidents
• Central nervous system tumors
• Heavy metal poisoning

What are the symptoms of neurogenic bladder?

The most common symptom of neurogenic bladder is being unable to control urination. Other symptoms include:

• A weak or dribbling urinary stream
• Frequent urination (urinating eight or more times daily)
• Urgency (a feeling or need to urinate immediately)
• Painful urination, which may mean there is a urinary tract infection

How is neurogenic bladder treated?

The main treatments for neurogenic bladder are the following:

• Clean intermittent catheterization (CIC): Catheters are thin, flexible tubes that can be inserted through the urethra and into the bladder to drain urine.
• Drugs: These include anticholinergic medications (oxybutynin, tolterodine, and others.)
• Injections of botulinum A toxin (Botox): A doctor injects Botox into the bladder or urinary sphincters.
• Bladder augmentation (augmentation cystoplasty): This is a surgery in which segments of the intestine (sigmoid colon) are removed and attached to the walls of the bladder. This reduces the bladder’s internal pressure and increases its ability to store urine.
• Ileal conduit: Part of the small bowel is used to make a urine stoma. This stoma drains to a bag attached to the outside of the body.
• Lifestyle changes: These might include avoiding certain foods or drinks that can irritate the bladder. These include certain caffeinated drinks like coffee, carbonated beverages, spicy foods, and citrus fruit. Losing weight can ease stress on the bladder. A behavioral treatment called delayed voiding may help some people with urine control.

Absorbent undergarments, pads, panty shields, panty liners, and adult diapers can help prevent wetness and odors while protecting skin and clothing. Bed pads can protect sheets and mattresses.

 

Gastritis is a general term for a group of conditions with one thing in common: inflammation of the lining of the stomach. The inflammation of gastritis is most often the result of infection with the same bacterium that causes most stomach ulcers. Regular use of certain pain relievers and drinking too much alcohol also can contribute to gastritis.

Gastritis may occur suddenly (acute gastritis), or appear slowly over time (chronic gastritis). In some cases, gastritis can lead to ulcers and an increased risk of stomach cancer. For most people, however, gastritis isn’t serious and improves quickly with treatment.

Symptoms

The signs and symptoms of gastritis include:

• Gnawing or burning ache or pain (indigestion) in your upper abdomen that may become either worse or better with eating
• Nausea
• Vomiting
• A feeling of fullness in your upper abdomen after eating

Gastritis doesn’t always cause signs and symptoms.

When to see a doctor

Nearly everyone has had a bout of indigestion and stomach irritation. Most cases of indigestion are short-lived and don’t require medical care. See your doctor if you have signs and symptoms of gastritis for a week or longer. Tell your doctor if your stomach discomfort occurs after taking prescription or over-the-counter drugs, especially aspirin or other pain relievers.

If you are vomiting blood, have blood in your stools or have stools that appear black, see your doctor right away to determine the cause.

Causes

Gastritis is an inflammation of the stomach lining. Weaknesses or injury to the mucus-lined barrier that protects your stomach wall allows your digestive juices to damage and inflame your stomach lining. A number of diseases and conditions can increase your risk of gastritis, including Crohn’s disease and sarcoidosis, a condition in which collections of inflammatory cells grow in the body.

Risk factors

Factors that increase your risk of gastritis include:

• Bacterial infection. Although infection with Helicobacter pylori is among the most common worldwide human infections, only some people with the infection develop gastritis or other upper gastrointestinal disorders. Doctors believe vulnerability to the bacterium could be inherited or could be caused by lifestyle choices, such as smoking and diet.
• Regular use of pain relievers. Common pain relievers — such as aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve, Anaprox) — can cause both acute gastritis and chronic gastritis. Using these pain relievers regularly or taking too much of these drugs may reduce a key substance that helps preserve the protective lining of your stomach.
• Older age. Older adults have an increased risk of gastritis because the stomach lining tends to thin with age and because older adults are more likely to have H. pylori infection or autoimmune disorders than younger people are.
• Excessive alcohol use. Alcohol can irritate and erode your stomach lining, which makes your stomach more vulnerable to digestive juices. Excessive alcohol use is more likely to cause acute gastritis.
• Stress. Severe stress due to major surgery, injury, burns or severe infections can cause acute gastritis.
• Your own body attacking cells in your stomach. Called autoimmune gastritis, this type of gastritis occurs when your body attacks the cells that make up your stomach lining. This reaction can wear away at your stomach’s protective barrier.Autoimmune gastritis is more common in people with other autoimmune disorders, including Hashimoto’s disease and type 1 diabetes. Autoimmune gastritis can also be associated with vitamin B-12 deficiency.
• Other diseases and conditions. Gastritis may be associated with other medical conditions, including HIV/AIDS, Crohn’s disease and parasitic infections.

Diagnosis:

Although your doctor is likely to suspect gastritis after talking to you about your medical history and performing an exam, you may also have one or more of the following tests to pinpoint the exact cause.

• Tests for H. pylori. Your doctor may recommend tests to determine whether you have the bacterium H. pylori. Which type of test you undergo depends on your situation. H. pylori may be detected in a blood test, in a stool test or by a breath test.For the breath test, you drink a small glass of clear, tasteless liquid that contains radioactive carbon. H. pylori bacteria break down the test liquid in your stomach. Later, you blow into a bag, which is then sealed. If you’re infected with H. pylori, your breath sample will contain the radioactive carbon.
• Using a scope to examine your upper digestive system (endoscopy). During endoscopy, your doctor passes a flexible tube equipped with a lens (endoscope) down your throat and into your esophagus, stomach and small intestine. Using the endoscope, your doctor looks for signs of inflammation.If a suspicious area is found, your doctor may remove small tissue samples (biopsy) for laboratory examination. A biopsy can also identify the presence of H. pylori in your stomach lining.
• X-ray of your upper digestive system. Sometimes called a barium swallow or upper gastrointestinal series, this series of X-rays creates images of your esophagus, stomach and small intestine to look for abnormalities. To make the ulcer more visible, you may swallow a white, metallic liquid (containing barium) that coats your digestive tract.

Treatment of gastritis depends on the specific cause. Acute gastritis caused by nonsteroidal anti-inflammatory drugs or alcohol may be relieved by stopping use of those substances.

Medications used to treat gastritis include:

• Antibiotic medications to kill H. pylori. For H. pylori in your digestive tract, your doctor may recommend a combination of antibiotics, such as clarithromycin (Biaxin) and amoxicillin (Amoxil, Augmentin, others) or metronidazole (Flagyl), to kill the bacterium. Be sure to take the full antibiotic prescription, usually for seven to 14 days.
• Medications that block acid production and promote healing. Proton pump inhibitors reduce acid by blocking the action of the parts of cells that produce acid. These drugs include the prescription and over-the-counter medications omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), esomeprazole (Nexium), dexlansoprazole (Dexilant) and pantoprazole (Protonix).Long-term use of proton pump inhibitors, particularly at high doses, may increase your risk of hip, wrist and spine fractures. Ask your doctor whether a calcium supplement may reduce this risk.
• Medications to reduce acid production. Acid blockers — also called histamine (H-2) blockers — reduce the amount of acid released into your digestive tract, which relieves gastritis pain and encourages healing. Available by prescription or over-the-counter, acid blockers include ranitidine (Zantac), famotidine (Pepcid), cimetidine (Tagamet HB) and nizatidine (Axid AR).
• Antacids that neutralize stomach acid. Your doctor may include an antacid in your drug regimen. Antacids neutralize existing stomach acid and can provide rapid pain relief. Side effects can include constipation or diarrhea, depending on the main ingredients.

Complications

Left untreated, gastritis may lead to stomach ulcers and stomach bleeding. Rarely, some forms of chronic gastritis may increase your risk of stomach cancer, especially if you have extensive thinning of the stomach lining and changes in the lining’s cells.

Tell your doctor if your signs and symptoms aren’t improving despite treatment for gastritis.

Prevention

Preventing H. pylori infection

It’s not clear how H. pylori spreads, but there’s some evidence that it could be transmitted from person to person or through contaminated food and water. You can take steps to protect yourself from infections, such as H. pylori, by frequently washing your hands with soap and water and by eating foods that have been cooked completely.

Hallux valgus is the commonest forefoot deformity, with an estimated prevalence of 23% to 35%. It causes symptoms on the medial edge of the foot, the sole, and the small toes. Non-operative treatment may alleviate symptoms but does not correct the deformity of the big toe. Surgery is indicated if the pain persists. The correct operation must be selected from a wide variety of available techniques.

Hallux valgus causes symptoms in three particular ways. First and foremost is pain in the bunion, the pressure-sensitive prominence on the medial side of the head of the first metatarsal. It hurts to wear a shoe. Furthermore, the valgus deviation of the great toe often results in a lack of space for the other toes. They become displaced, usually upwards, leading to pressure against the shoe. This is termed hammer toe or claw toe. Finally, normal function of the forefoot relies heavily on the great toe pressing down on the ground during gait. Since the valgus deformity stops this happening to a sufficient degree, metatarsal heads II–V are overloaded. The resulting pain is referred to as transfer metatarsalgia.

Conservative treatment

Only while the skeleton is still growing can the position of the great toe be improved with lasting effect. A night splint can be prescribed to move the great toe to medial. After the end of growth, adequate correction is no longer possible and conservative treatment is restricted to alleviation of symptoms.

By the time patients consult a physician, most of them have already resorted to softer and wider shoes to alleviate pain from pressure on their bunion. Ring pads and other dressings tend to increase the prominence of the bunion and are usually unsuccessful. Antiphlogistic salves can be administered locally, nonsteroidal anti-inflammatory drugs systemically.

Pain in the smaller toes can be alleviated with pads and toe straighteners. Wide, soft shoes are helpful if they give the toes enough space. Once hammer toes or claw toes have developed, however, surgery is necessary.

In our experience, insoles are effective for alleviation of metatarsalgia. They must feature a pad that pushes the metatarsals upward proximal to the pressure-sensitive heads. It often suffices to advise the patient to wear shoes with soft soles and without excessively high heels (no more than 4 cm). The malposition of the great toe, of course, cannot be corrected with insoles alone.

What is a Spinal Hemangioma?

A spinal hemangioma is a tumor that mostly occurs in the thoracic and the lumbar spine. Also referred to as vertebral hemangioma, it is non-cancerous and has few symptoms. This is why most people do not realize that they have this condition unless an imaging test for another condition reveals its presence. The vertebral body is the most commonly affected by this tumor; however, it may also affect the muscles around the spine. Pain is the most common symptom and is reported by around 20% of the patients. Let’s have a brief look at the causes and treatments of spinal hemangioma pain.

Causes of Vertebral Hemangioma Pain:

The causes of spinal hemangioma are not much known, however, it is believed that there may be a genetic cause involved. Studies have also found that a high amount of estrogen present after birth may also increase the chances of this tumor. This is also considered to be a likely cause because the condition is more common in females than in men.

As mentioned above, there are rarely any symptoms when this tumor is present. In fact, the tumor is often found in 10-12% autopsies, which indicates that a person can actually go through life without even experiencing any symptom. However, some individuals may experience pain. A likely cause of this pain is a spinal hemangioma that is quite large and involves the entire vertebral body. There may also be a collapse and loss of height in the vertebrae if the tumor is extensive. A severe collapse means that the spinal cord and the nerves emanating from it will get compressed causing pain, numbness or weakness in the legs, and even loss of function in the bowel or bladder.

Hemangioma diagnosis

If a hemangioma is suspected, the doctor will order an x-ray to check for a specific pattern on the bone, called a trabecular pattern. Trabecular, or cancellous, bone is a lattice-shaped structure within the bone.

A CT scan may also show a polka dot appearance in the bone. If this appears, an MRI will be ordered to show whether the tumor has expanded into the spinal column or spinal canal, or encroached on the spinal cord. MRI can also show the extent of nerve damage in the spine and can assist in planning surgical treatment.

Hemangioma symptoms

Most hemangiomas are symptom-free, but symptoms may include:

• Back pain
• Pain that radiates along a nerve due to inflammation or irritation of the nerve root
• Spinal cord compression

Treatments:

It is also possible that the spinal hemangioma may extend beyond the vertebrae. This could be a cause of back pain in some individuals. Trauma may also occur and lead to a compression fracture of the vertebrae causing hemorrhage or bleeding. Extra pressure due to a pregnancy may put extra pressure on the vertebrae and cause or increase the back pain.

Once the tumor is discovered, these patients need to go for regular checkups to diagnose the presence of compression fractures, neurological dysfunction, or the development of a soft tissue mass. If pain and other symptoms are present due to a hemorrhage or another reason, the treatment will depend on the extent of the bleeding and the severity of the neurological symptoms. The size and location of the hemangioma will also determine the treatment administered.

Embolization is one of the treatment options available. In this procedure, a tiny catheter or tubing is inserted and a specific material, such as polyvinyl alcohol foam, is injected. This material travels to the bleeding site. As it builds up at the site of the hemorrhage, the flow of blood stops.

The most common treatment for these painful lesions is radiotherapy, in which high energy X-rays are used to kill the tumor cells. Studies have found that high doses administered to patients with pain associated with spinal hemangioma are quite successful in achieving complete pain relief.

Excision or surgical removal of the spinal hemangioma may be required if spinal cord compression is present causing pain, numbness, and weakness. In cases where, a partial removal of the tumor is performed, radiotherapy is required as an additional treatment. It is also the most common treatment for children since they are more prone to the harmful effects of radiation.Radiation therapy is effective in the treatment of pain caused by hemangiomas. Ethanol injections with fluoroscopic guidance have also proven effective in treating pain. Another treatment option is embolization followed by removal of the small bones that make up a vertebra (laminectomy) or removal of the vertebra (vertebrectomy).

The presence of spinal hemangioma pain and neurological symptoms are the likely reasons that treatment is required. If the symptoms are worsening rapidly, surgical procedures are recommended. However, if the symptoms develop slowly, radiotherapy or embolization are considered to be better options.