Histoplasmosis

Histoplasmosis is an infection due to the histoplasma capsulation fungus. There are several different categories of histoplasmosis: acute symptomatic pulmonary, chronic pulmonary and disseminated histoplasmosis. Some may not have any symptoms while others have fever, chills, cough, chest pain, cough, excessive sweating, weakness, mouth sores, and shortness of breath, rashes, or skin lesions. Symptoms normally occur within the first 3 to 17 days of exposure. Infections enter the body through the lungs. Histoplasma fungus grows as a mold in soil, and infection results from breathing in airborne particles. In the United States, it is most common in the southeastern, mid-Atlantic, and central states. It is best to stay away from dust in contaminated environments such as chicken coops and bat caves. Testing includes samples containing the fungus taken from sputum, blood, or infected organs. Chest x-rays are normal in 40-70% of cases. Chronic cases can resemble tuberculosis on chest x-rays. Primary treatments are normally an antifungal drug. Long term treatments with anti-fungal drugs are used after treatment with ampholericin.

Lumbar Compression Fractures

Lumbar Compression Fractures

Lumbar compression fractures occur when the vertebra in the spine collapse from the normal height to about half its size. A compression fracture is when the bone tissue of the vertebral body collapses. At times there can be multiple compression fractures of the spine. Osteoporosis is the most common cause of compression fractures. Other may include tumors and trauma to the back. If it results in any damage to the spinal cord symptoms may include numbness, tingling, and weakness. Depending on the area of the back, most compression fractures do not cause neurological symptoms. A spine x-ray shows at least one compressed vertebra that is shorter than the other vertebra. If there is no history of trauma, a bone density test needs to be done to evaluate for osteoporosis. If checking for a tumor that possibly made the vertebra weak, a CT or MRI scan can be used for evaluation. Majority of lumbar compression fractures are caused by osteoporosis in the elderly. These fractures generally do not cause spinal cord injury. Treatment includes treating the osteoporosis, employ back braces, or a minimally invasive technique.

Thoracic Spinal Stenosis & Thoracic Foraminal Stenosis

Thoracic Foraminal Stenosis & Thoracic Spinal Stenosis

Thoracic spinal stenosis occurs when the spinal cord or nerves are compressed by either the narrowing in the spinal canal or vertebrae. The size of the spinal cord will remain the same in the thoracic area; the canal is narrower in that region. Normally thoracic spinal stenosis is associated with either the cervical or lumbar region. The ribs provide more stability to the thoracic spine. Spinal stenosis can cause weakness in your extremities. Most cases will occur in the lower back than in the thoracic region. Thoracic foraminal stenosis symptoms are often the same. The difference in thoracic foraminal stenosis is one or more vertebral foramen is being affected. The foramen can become compressed overtime with age. Thoracic foraminal stenosis may be either congenital or degenerative. As degeneration occurs the person will experience worse pain. These symptoms can be reduced by anti-flammatory over the counter medications, laminectomy, and spinal fusions.

Clay-Shoveler's Fracture

Clay-Shoveler’s Fracture

The clay-shoveler’s fracture is an oblique fracture of the lower cervical or upper thoracic spinous processes. These fractures commonly occur at the levels of C6, C7, and T1. The clay-shoveler’s fractures results from hyper flexion of the neck. Hopefully, the avulsion fracture is only with the spinous process and does not extend into the lamina, which has a better chance for some type of spinal cord injury. These fractures can happen to laborers who perform activities involving lifting weights with arms extended. Symptoms include burning, “knife-like” pain at the level of the fractured spine between the upper shoulder blades. Most clay-shoveler receives no treatment. Pain medication, physical therapy, and massages can help reduce the symptoms. These fractures are diagnosed by an x-ray exam of the spine.

Carotid Body Tumor

Carotid Body Tumor



A Carotid body tumor is a mass that is found in the upper neck that branches off the carotid artery. Carotid body tumors are also called Chemodectoma or Paraganglioma. There are many paragangliomas in the head and neck, but carotid body tumors are the most common. Carotid body tumors are painless neck masses that lay lateral to the tip of the hyoid bone. These tumors cause a lateral displacement and widening of carotid artery bifurcation that is best demonstrated on radiographic imaging studies. The tumors measure approximately 4.0 cm in their greatest dimension, and they often lack a capsule. Most paragangliomas are benign neoplasm. Although these types are not normally deadly, they can be locally aggressive; therefore, many times, removal of the tumor is recommended.

Mucous Cyst

Mucous Cyst

A mucous cyst is a thin painless sac on the inner surface of the lips. It contains clear fluid. The sac is bluish clear in color. The sac can occur on the inside of the lip, tongue, palate, inside the cheeks, the floor of the mouth, or around tongue or lip piercings. A mucous cyst often can be left alone. Normally a mucous cyst will rupture spontaneously. Opening the top of the sac with a sterile needle will help it go away. If the cyst returns, it may need to be removed surgically. Oral surgeons and some dentists can easily remove the sacs if they continue to cause discomfort. Mucous cysts are common. Sucking the lip membranes into the teeth are thought to cause cysts. When the cysts are positioned on the floor of the mouth they are called ranula, when positioned on the gums they are called epulis. There is no known prevention for mucous cysts. They are diagnosed by visual examination.

ACHONDROPLASIA

Achondroplasia is a disorder of bone growth that causes the most common type of growth hormone deficiency. Achondroplasia is a genetic condition that results in abnormally short stature and is the most common cause of short stature. Although Achondroplasia means “without cartilage formation,” the defect in achondroplasia is not in forming cartilage but in converting it to bone, particularly in the long bones. Achondroplasia is one of the oldest known birth defects. Symptoms of Achondroplasia may include bowed legs, decreased muscle tone, disproportionately large head to body size ratio, prominent forehead, shortened arms and legs, short stature abnormal hand appearance, and spinal stenosis. People with achondroplasia seldom reach five feet in height. Infants who receive the abnormal gene from both parents do not often live beyond a few months. Complications may include clubbed feet and hydrocephalus (fluid build up in the brain).

T1 weighted MRI image of a child with Achondroplasia.