Hepatitis C is an infection caused by the hepatitis C virus (HCV) that attacks the liver and leads to inflammation. The World Health Organization (WHO) estimates that about 3% of the world’s population has been infected with HCV and that there are more than 170 million chronic carriers who are at risk of developing liver cirrhosis and/or liver cancer. The image below depicts the HCV genome.

A diagnosis of sarcoidosis is established on the basis of compatible clinical and radiologic findings and histologic evidence of the presence of noncaseous epithelioid cell granulomas in one or more organs and the absence of causative organisms or particulates (16). Granulomas of known causes and local sarcoidlike reactions must be excluded. Granulomatous lesions may result from many conditions, including tuberculosis, berylliosis, leprosy, hypersensitivity pneumonitis, Crohn disease, primary biliary cirrhosis, and fungal disease. Moreover, local sarcoidlike reactions may be seen in lymph nodes that drain a neoplasm or a site of chronic inflammation (19). Such reactions also have been seen in patients who have undergone chemotherapy and radiation therapy (23). If biopsy of lymph nodes or pulmonary or pleural tissue is necessary for diagnosis, one of three techniques may be used: transbronchial biopsy, CT-guided biopsy, or surgical biopsy (24). The use of a surgical technique may be warranted when the results of biopsy with another procedure are not definitive and biopsy of mediastinal lymph nodes, lung, or both is required. This can generally be done with minimally invasive procedures, such as cervical mediastinoscopy, the Chamberlain procedure (a parasternal minithoracotomy for biopsy of the aortopulmonary window or para-aortic nodes), or video-assisted thoracoscopic surgical biopsy (25).

Sarcoidosis is an inflammatory disease that affects multiple organs in the body, but mostly the lungs and lymph glands. In people with sarcoidosis, abnormal masses or nodules (called granulomas) consisting of inflamed tissues form in certain organs of the body. These granulomas may alter the normal structure and possibly the function of the affected organ(s).

in this patient the aneurysm wasarising from middle cerebral artery M1 segment dividng into three branches,it is mandatory topreserve all three divisions,as was done in this case,this pt 25 yrs young man presented with sub arachnoid haemorrhage

The goal of surgical clipping is to isolate an aneurysm from the normal circulation without blocking off any small perforating arteries nearby. Under general anesthesia, an opening is made in the skull, called a craniotomy. The brain is gently retracted to locate the aneurysm. A small clip is placed across the base, or neck, of the aneurysm to block the normal blood flow from entering. The clip works like a tiny coil-spring clothespin, in which the blades of the clip remain tightly closed until pressure is applied to open the blades. Clips are made of titanium and remain on the artery permanently.

Medulloblastoma is a fast-growing, high-grade tumor. It is the most common of the embryonal tumors—tumors that arise from “emybryonal” or “immature” cells at the earliest stage of their development. The most common symptoms of medulloblastoma include behavioral changes, changes in appetite, symptoms of increased pressure on the brain (eg, headache, nausea, vomiting, and drowsiness, as well as problems with coordination). Unusual eye movements may also occur. Like many tumor types, the exact cause of medulloblastoma is not known. However, scientists are making significant strides in understanding its biology. Changes have been identified in genes and chromosomes (the cell’s DNA blueprints) that may play a role in the development of this tumor. There are also a few rare, genetic health syndromes that are associated with increased risk for developing this tumor.

Surgeon performs a dissection of the transverse process during spine surgery, explaining the benefits of including the AQUAMANTYS System from Salient Surgical Technologies during the procedure. The AQUAMANTYS System uses Salient's patented TRANSCOLLATION technology, which has been clinically shown to reduce blood loss and lower blood transfusion rates when used during surgery.

A talus fracture is a break in one of the bones that forms the ankle. This type of fracture often occurs during a high-energy event, such as a car collision or a high-velocity fall. Because the talus is important for ankle movement, a fracture often results in significant loss of motion and function. In addition, a talus fracture that does not heal properly can lead to serious complications, including chronic pain. For this reason, many talus fractures require surgery.

The lateral approach is used for insertion of fixation devices after closed reduction of a proximal femoral fracture. Reduction of a displaced fracture is usually done with a fracture table, or alternatively a large distractor spanning the hip joint. After satisfactory reduction is confirmed by image intensifier, the lateral approach can be used for insertion of a sliding hip screw or multiple screws. The approach provides limited access to the lateral surface of the femur sufficient for hardware placement. The incision can be extended proximally to accommodate a trochanteric stabilizing plate (TSP), or even anteriorly so that it becomes an anterolateral approach with direct, although limited, access to the femoral neck.

Our results in this study of MIPO treated with conventional plates are comparable to the results of the femoral shaft fractures treated with intramedullary nailing. The technique can be used for all femoral shaft fractures. Although the biomechanics of the plate fixation are less stable compared to the intamedullary nail, the mechanical stability is stable enough for bone healing. Healing was rapid, and postoperative care was simplified. The two major complications were malalignment and screw breakage. We recommend using at least three separated screws in each fragment to prevent stress on the screw and screw breakage. Intraoperative limb length, axial alignment, and rotation must be carefully assessed to prevent malalignment. The limitations of our study include lack of a comparison group, retrospective data collection, and no randomisation in outcome evaluation

The procedure was performed under wrist block regional anesthesia with tourniquet control. A single Chinese finger trap was used on the thumb with 5 to 8 lb of ongitudinal traction. The arm was held down with wide tape around the tourniquet securing it to the hand table to serve as countertraction. A shoulder holder, rather than a traction tower, was used to facilitate fluoroscopic intervention more easily. The Trapeziometacarpal joint was detected by palpation. Joint distension was achieved by injecting 1 to 3 mL of normal saline (Fig. 1). It is important to distally direct the needle approximately 20 degrees to clear the dorsal flare of the metacarpal base and enter the joint capsule. This course should be reproduced upon entering with arthroscopic sleeve/ trocar assembly to minimize iatrogenic cartilage injury. Fluid distention is important to facilitate this. The incision for the 1-R (radial) portal, used for proper assessment of the dorsoradial ligament, posterior oblique ligament, and ulnar collateral ligament, was placed just volar to the abductor pollicis longus tendon. The incision for the 1-U (ulnar) portal, for better evaluation of the anterior oblique ligament and ulnar collateral ligament, was made just ulnar to the extensor pollicis brevis tendon. A short-barrel, 1.9-mm, 30- degree inclination arthroscope was used for complete visualization of the CMC joint surfaces, capsule, and ligaments, and then appropriate management was done, as dictated by the stage of the arthritis detected (Fig. 2A). A full-radius mechanical shaver with suction was used in all the cases, particularly for initial debridement and visualization. Most of the cases were augmented with radiofrequency ablation to perform a thorough synovectomy and radiofrequency was also used to perform chondroplasty in the cases with focal articular cartilage wear or fibrillation. Chondroplasty refers to thedebridement of the fibrillated cartilage to improve vascularity of the cartilage and enhance the growth of fibrocartilage. Ligamentous laxity and capsular attenu- ation were treated with thermal capsulorraphy using a radiofrequency shrinkage probe. We were careful to avoid thermal necrosis; hence, a striping technique was used to tighten the capsule of the lax joints. The striping technique refers to thermal shrinkage performed in longitudinal stripes on the lax capsule, so as to leave vascular zones between the stripes; hence, thermal necrosis is prevented. Arthroscopic stage I disease was characterized by synovitis without any cartilage wear, wherein a synovectomy coupled with thermal capsulor- raphy as described was performed.

Open reduction and internal fixation (ORIF) is surgery used to stabilize and heal a broken bone. You might need this procedure to treat your broken thighbone (femur). The femur is the large bone in the upper part of your leg. Different kinds of trauma can damage this bone, causing it to fracture into 2 or more pieces. This might happen to the part of the femur near your knee, near the middle of the femur, or in the part of the femur that forms part of your hip joint. In certain types of femur fractures, your femur has broken, but its pieces still line up correctly. In other types of fractures (displaced fractures), the trauma moves the bone fragments out of alignment. If you fracture your femur, you usually need ORIF to bring your bones back into place and help them heal. During an open reduction, orthopedic surgeons reposition your bone pieces during surgery, so that they are back in their proper alignment. This contrasts with a closed reduction, in which a healthcare provider physically moves your bones back into place without surgically exposing your bone.

An arthroscopic meniscectomy is a procedure to remove some or all of a meniscus from the tibio-femoral joint of the knee using arthroscopic (aka 'keyhole') surgery. In a complete meniscectomy the meniscus including the meniscal rim is removed. A partial meniscectomy involves partial removal of the meniscus. This may vary from minor trimming of a frayed edge to anything short of removing the rim. This is a minimally invasive procedure often done as day suas an outpatient in a one-day clinic [1] This procedure is performed when a meniscal tear is too large to be corrected by a surgical meniscal repair.[1] When non-operative therapy provides some degree of symptom relief over the long-term, these benefits may wane with continued meniscal degeneration. In such patients, arthroscopic partial meniscectomy can be effective in improving patient quality of life.

Boxer’s Knuckle is an injury to the structures around the first knuckle of a finger, also known as the metacarpophalangeal joint (MPJ). The skin, extensor tendon, ligaments, joint cartilage, and the bone of the metacarpal head may all be involved. Repeated impacts to the extensor tendon over the knuckle causes Hypertrophic Interstitial Tendonosis, or HIT Syndrome. This is a thickening, weakening, inflammation, and scarring of the extensor tendon.

Biceps tenodesis is a common procedure performed for tendinopathy of the long head of the biceps brachii (LHB). Indications include partial-thickness LHB tear, tendon subluxation with or without subscapularis tear, and failed conservative management of bicipital tenosynovitis. Biceps tenodesis may also be performed for superior labrum anterior to posterior tears.

... Orthopedics & Sports Medicine Our Services Where Does it Hurt? SNAPPING SCAPULA SYNDROME PDF Icon PRINTABLE BOOKLET A PATIENT'S GUIDE TO SNAPPING SCAPULA SYNDROME INTRODUCTION The scapulothoracic joint is located where the shoulder blade (also called the scapula) glides along the chest wall (the thorax). When movement of this joint causes feelings or sounds of grating, grinding, popping, or thumping, doctors call it snapping scapula syndrome. Snapping scapula syndrome is fairly rare. When it happens, the soft tissues between the scapula and the chest wall are thick, irritated, or inflamed. Snapping scapula syndrome can also happen if the bones of the shoulder blade or rib cage grate over one another. This guide will help you understand what causes snapping scapula syndrome how doctors treat this condition ANATOMY What parts of the body are involved in this condition? The shoulder is made up of three bones: the humerus (upper arm bone), the clavicle (collarbone), and the scapula(shoulder blade). Two large muscles attach to the front part of the scapula where it rests against the chest wall. One of them, called the subscapularis muscle, attaches over the front of the scapula where it faces the chest wall. The serratus anterior muscle attaches along the edge of the scapula nearest the spine. It passes in front of the scapula, wraps around the chest wall, and connects to the ribs on the front part of the chest. A bursa is a fluid-filled sac that cushions body tissues from friction. A bursa sits between the two muscles of the scapula. There is also a bursa in the space between the serratus anterior muscle and the chest wall. When bursa sacs become inflamed, the condition is called bursitis. Scapulothoracic bursitis refers to inflammation in the bursa under the shoulder blade. This type of bursitis is most common in the upper corner of the scapula nearest the spine. It also occurs under the lower tip of the scapula. In either case, it can cause the sounds and sensations of snapping scapula syndrome. A person can have bursitis in the joint without any grinding or popping. Related Document: A Patient's Guide to Shoulder Anatomy CAUSES What causes this condition? Snapping scapula is caused by problems in the soft tissues or bones of the scapula and chest wall. It can start when the tissues between the scapula and shoulder blade thicken from inflammation. The inflammation is usually caused by repetitive movements. Certain motions of the shoulder done over and over again, such as the movements of pitching baseballs or hanging wallpaper, can cause the tissues of the joint to become inflamed. In other cases, the muscles under the scapula have shrunk (atrophied) from weakness or inactivity. The scapula bone then rides more closely to the rib cage. This means the scapula bumps or rubs on the rib bones during movement. Changes in the alignment or contour of the bones of the scapulothoracic joint can also cause snapping scapula. When a fractured rib or scapula isn't lined up just right, it can cause a bumpy ridge that produces the characteristic grind or snap as the scapula moves over the chest wall.

Glomus tumors are rare soft tissue neoplasms that typically present in adults (ages 20-40 years) as small, blue-red papules or nodules of the distal extremities, with most cases involving subungual sites. These tumors are typically painful, often causing paroxysmal pain in response to temperature changes or pressure. Glomus tumors are thought to arise from the glomus body, a thermoregulatory shunt concentrated in the fingers and toes. Most lesions are solitary and localized to cutaneous sites; however, generalized glomuvenous malformations, or multiple glomangiomas, have also been described, and may have extracutaneous involvement.

Educational video describing injection techniques for painful conditions of the foot and ankle.

Arthrocentesis involves both the puncture of a joint and the aspiration of its synovial fluid. It is typically used to make an accurate diagnosis of a painful, warm, swollen joint. Removal of excess fluid can be therapeutic. Analysis of the removed fluid helps to decipher its etiology. [1]

Compartment syndrome can develop in the foot following crush injury or closed fracture. Following some critical threshold of bleeding and/or swelling into the fixed space compartments, arterial pulse pressure is insufficient to overcome the osmotic tissue pressure gradient, leading to cell death. The complicating factor is related to the magnitude of the force of the crush injury. The amount of swelling or bleeding has to be sufficient to impair arterial inflow, while not being of sufficient magnitude to produce an open injury, which decompresses the pressure within the affected compartments. When the injury is open, we then attribute the late disability primarily to the crushing injury to the involved muscles.