Epidemiology
The branch of medicine which deals with the incidence, distribution, and possible control of diseases and other factors relating to health.
Hip and Thigh Anatomy
Physical examination
Examining the muscles to effectivess.
Take history information.
Clinical diagnostics is done using hand, eyes.
Diagnostic images
Tools used for diagnosis for evidence based treatment
Tools (X-RAy, CT Scan, MRI Scan, fMRI Scan, USG [Ultrasound] & etc.)
Example,
Hip osteo arthritis, X-Ray can be used.
Pathology
Tests are done on Blood, urine, stool, semen sample.
Example
Cox spine (Infection, Bone TB) may cause transaction injury(dislocation after fracture in Spine), may lead to paraplegia, so blood tests may be required.
In case of Ankylosing spondylitis, CVC, ESR, CRP, HLA27 (Antigen found in such patients) FNAC tests may have to be done.
Incidence
Hip and Thigh pain are chief complaint of office workers.
Runners report an average yearly hip/pelvic injury 2%-11%
If the bones are not strong in a paralysis patient, recovery will be difficult.
About 14.3% of patients aged 60 years and older report significant hip pain on most days.
People who exercise in gym do more weights or exercise without building the muscles, they may damage spine or hips. In such cases, proper clinical examination is required.
When we ask patient about history, they may give a story and it is not nonsense. It is only giving clue about how it happened.
Take below items from patients,
- Name,
- Address,
- How many Kms from clinic,
- Married/ Bachelor,
- How many people are dependent on him/her (His wife is working?)
There are occupational related disorders.
For examples, orthopedic surgeons have slip disks, hip pain & etc.
So, it is important to understand the occupation.
Classification of pain.
Ask patient to mark the area of pain.
Ask, what kind of pain;
Long standing, recent
Is it increasing/decreasing?
Any other feeling with pain (Shock, numbness, pinching in joint & etc.)
If pain is due to deficient Vitamin D3/D or magnesium any treatment would not help.
Vitamin D3 will be absent if one is not exposing oneself to sunlight.
If Vitamin D3 is absent, bone will not absorb calcium.
If one is not exposing oneself to sunlight, they may get osteoporosis at young age.
So, we must find out nutritional deficiency of the patient.
Also, we need to find the toxicity in the body. Due to fungal infection, mouth infection & various other infections also cause issues. So, we will have to find invective pathology in the patient.
If patient is having lice, that also causing issues. Bone TB, Osteomyelitis is also a type of infection.
We need to find out the cause of the pain that is happening to the patient.
When pain is accompanied by electric shock, burning sensation, if patient is feeling too much inside the body, it means that patient is having Neuropathy.
Neuropathy can be classified into
- Peripheral neuropathy,
- Diabetic neuropathy,
- Mixed neuropathy, and
- Demyelinating neuropathy ()
When the pain is accompanied by tingling sensation, burning sensation, pulling sensation, it may mean that patient is having neurogenic condition or it means that nerve roots and nerves are involved.
This is classified by nerve conduction test (NCV study).
In case of Demyelinating neuropathy, myelin sheath gets damaged in the nerve and gradually patient becomes paralyzed; first it starts from lower limb and spreads to top and finally patient dies. This is most dangerous form of neuropathy and this can be repaired using Acupuncture.
Guillain-Barre syndrome is another type of nerve degenerating condition.
In this discussion, we are only focusing on orthopedic conditions,
- Affection of arteries
- Musculoskeletal injury
Hip Bones
- Pelvis, (Reference1 & Reference 2)
- Ilium
- Ischium
- Pubis
- Sacrum
- Femur
Additional notes
Relief is not recovery.
After pain is relieved, the treatment needs to be done.
One who knows the medical terminologies, pathological terminologies is specialist in Acupuncture.
Credits: Dr. Rahul
No comments:
Post a Comment