Discusión entre pares / My mother.59yr old,known to be osteoporotic on aclasta for 3 years.hysterectomy 7 years ago

د.محمد الشريف

My mother.59yr old,known to be osteoporotic on aclasta for 3 years.hysterectomy 7 years ago.complaining from localized pain at dorsal spine increasing with standing or walking and decreasing with rest.no radiculopathy.what is the best for her???

Me gusta ·  · 15 de marzo a la(s) 2:51

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  Ahmad Bo-Eisa I think she has ankylosing spondylitis. This means you need to investigate in this line with mri and HLA B27. Then start first line treatment.

  15 de marzo a la(s) 12:51 · Me gusta · 3
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  Tamer Makshat

  الف سلامة أولا

  15 de marzo a la(s) 14:46 · Me gusta · 1
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  Tamer Makshat Ankylosing spondylitis is a posiibility .try to have an x ray on pelvis to realize rarefaction of both sacro illiac joints. If suspected manage as Rheumatoid arthritis.

  15 de marzo a la(s) 14:51 · Me gusta · 1
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  د.محمد الشريف Thank u for all my colleagues and professors

  15 de marzo a la(s) 15:33 · Me gusta
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  Ahmed Abdel Aziz Ortho multiple spondylotic changes at 3 disc levels may indicate old asymptomatic multiple dorsal disc degeneration or prolapse.....the vertebral endplate changes (Modic type II) at the affected levels support the diagnosis... it is not uncommon and needs MRI for confirmation or exclusion..........Also ankylosing spondylitis must be excluded........وربنا يطمنك عليها و يشفيها ان شاء الله

  15 de marzo a la(s) 16:31 · Me gusta · 1
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  Twins Drs it is not ankylosing spondylitis it is DISH with degenerative scoliosis
  what about her neurological examination??
  did you examine her cervical region ??
  what about dorsolumbar MRI??

  15 de marzo a la(s) 21:54 · Editado · Me gusta · 2
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  Twins Drs this is not the age for ankylosing spondylitis 1st presentation
  and this is not it's picture !!!!!

  16 de marzo a la(s) 13:27 · Editado · Me gusta · 2
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  د.محمد الشريف She has no neurological manifestations

  16 de marzo a la(s) 0:05 · Me gusta
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  Professor-Abdelsalam Eid Sorry for the late comment. Not ankylosing. DISH is a possibility, or just advanced degenerative spine. Notably there is scoliosis. Could be a cause or a sequel of degenertion (not a spine surgeon to tell). I think take it easy. Manage as degenerative osteoporotic spine. Medical ttt and physio.

  16 de marzo a la(s) 13:00 · Me gusta · 4
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  Twins Drs did you examine her cervical region?? 
  dorsal spine pain may be a result of cervical spondylotic myelopathy
  please examine cervical region and don't forget to examine reflexes both UL and LL

  16 de marzo a la(s) 13:31 · Me gusta
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  Walid Alshaer MY impression this is spondylotic(degenerative) changes .... in DISH disc height is preserved and it involve at least 4 vertebrae so mostly it is degenerative changes with some canal stenosis

  16 de marzo a la(s) 13:46 · Me gusta