Category: General

  • 06
  • Sep
Surgical Removal of Ganglions
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Surgical treatment may be needed for a ganglion that has not responded to nonsurgical treatment and:

  • Is painful.
  • Interferes with activity or motion.
  • Causes changes in sensation.
  • Becomes unsightly.
  • Is causing damage to wrist bones, finger bones, or ligaments.
Ganglion Cyst Wrist
Ganglion Cyst Wrist
Ganglion Cyst Foot
Ganglion Cyst Foot

The goal of surgery is to remove the ganglion sac and the connecting tissue that allows the fluid to collect.

Surgical removal of a ganglion is an outpatient procedure.

  • The area around the ganglion is cleaned with an antiseptic.
  • A local anaesthetic is injected to numb the area or a regional anaesthetic is injected to numb the whole arm and hand. (General anaesthetic is not usually used because the surgery does not take long and affects only the wrist or hand.)
  • A cuff (tourniquet), similar to the kind used for taking blood pressure, is placed on the upper arm. This is inflated before the procedure to decrease the blood flow to the hand and wrist.
  • An incision is made at the ganglion site. The surgeon is careful to protect nerves,tendons, ligaments, and blood vessels while removing the ganglion sac and the connecting tissue.
  • The incision is closed with stitches, and a bandage and (in some cases) a splint are applied to restrict movement and allow the incision to heal. Some surgeons encourage moving your wrist 3 to 5 days after surgery to prevent stiffness.

Infection and injury to other tissues are rare, but possible, risks of surgery.

Ganglions return in about 5% to 10% of people after surgery. This may happen if the connecting tissue is not completely removed. New ganglions may also form in the area.

In a mucous cyst ganglion, bone spurs (small, bony growths that form along a joint) are often present in the joint next to the cyst, and removing bone spurs makes it less likely that the cyst will return. The chance of infection is higher in mucous cysts.
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  • 07
  • Aug
Warts and Plantar Warts
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What are warts, and what causes them?

A wart is a skin growth caused by some types of the virus called the human papillomavirus (HPV). HPV infects the top layer of skin, usually entering the body in an area of broken skin. The virus causes the top layer of skin to grow rapidly, forming a wart. Various types of this virus thrive in warm, damp environments such as showers, locker room floors, and swimming pool areas.

Warts can grow anywhere on the body, and there are different kinds. For example,common warts grow most often on the hands, but they can grow anywhere. Plantar warts grow on the soles of the feet.

You are most likely to develop a wart where you have broken skin, such as a cut, a hangnail, a closely bitten nail, or a scrape. Plantar warts are common in swimmers whose feet are not only damp and softened but are also scratched and broken by rough pool surfaces.

Plantar Warts
Plantar Warts

How are warts spread?

Warts are easily spread by direct contact with a human papillomavirus. You can infect yourself again by touching the wart and then touching another part of your body. You can infect another person by sharing towels, razors, or other personal items. After you’ve had contact with HPV, it can take many months of slow growth beneath the skin before you notice a wart.

It is unlikely that you will get a wart every time you come in contact with HPV. Some people are more likely to get warts than others.

What are the symptoms for warts?

Warts come in a wide range of shapes and sizes. A wart may be a bump with a rough surface, or it may be flat and smooth. Tiny blood vessels grow into the core of the wart to supply it with blood. In both common and plantar warts, these blood vessels may look like dark dots in the wart’s center.

Warts are usually painless. But a wart that grows in a spot where you put pressure, such as on a finger or on the bottom of the foot, can be painful.

How are warts diagnosed?

A doctor usually can tell if a skin growth is a wart just by looking at it. Your doctor may take a sample of the wart and look at it under a microscope (a skin biopsy). This may be done if it isn’t clear that the growth is a wart. It may also be done if a skin growth is darker than the skin surrounding it, is an irregular patch on the skin, bleeds, or is large and fast-growing.

How are warts treated?

Most warts don’t need treatment. But if you have warts that are painful or spreading, or if you are bothered by the way they look, your treatment choices include:

  • Using a home treatment such as salicylic acid or duct tape.
  • Removing the wart with surgery.

Effective wart treatment will be removing it surgically. The goal of wart treatment is to destroy or remove the wart totally.

When To Call a Doctor

See your doctor if the wart is:

  • Painful.
  • Easily irritated.
  • Growing or spreading to other parts of your body or to other people.

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  • 01
  • Aug
Avascular Necrosis (Osteonecrosis)
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What is avascular necrosis?

Avascular necrosis is bone death that occurs when the blood supply to the bones is decreased or stopped. Without an adequate blood supply, the bone breaks down and dies and collapses. If the bone affected is near a joint, the joint may also collapse. Although any bone can be affected, avascular necrosis most often affects ends of the long bones, such as the upper leg bone at the hip.

Avascular necrosis is also called osteonecrosis, aseptic necrosis, or ischemic bone necrosis.

What causes avascular necrosis?

An injury, such as a forceful impact in an auto accident, or a complication of a hip fracture or dislocation can lead to avascular necrosis. Diseases such as sickle cell disease, gout, and lupus also may lead to avascular necrosis.

Long-term use of corticosteroids or drinking a large amount of alcohol over a long time increases the risk of avascular necrosis.

What are the symptoms?

Symptoms include mild to moderate hip or groin pain, decreased hip movement, and a limp. Pain may be sudden and become worse with standing or walking. Rest usually relieves the pain. Avascular necrosis occurs most often in men between 40 and 50 years old.

Children with avascular necrosis may have spasms in the hip muscle, have a limp, or refuse to bear weight. Legg-Calve-Perthes disease is a type of avascular necrosis in children that causes hip symptoms.

How is avascular necrosis treated?

Doctors usually start with treatments to limit further damage to the bone and joint and to help the bone to grow. These may include medicines, exercises, limiting weight bearing on the joint, and electrical stimulation. Anti-inflammatory drugs (NSAIDs) may be prescribed to reduce pain. Eventually, most people with avascular necrosis need surgery.
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  • 01
  • Aug
Animal Bites: When Stitches Are Needed
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A bite injury may need to be closed by a health professional, may require antibiotic medicines, or both. The decision to close a wound with stitches, staples, or skin adhesive depends on:

  • The type of biting animal.
  • The size and location of the bite.
  • The time that has passed since the bite occurred.
  • The general health of the person bitten.

It is important to determine if your wound needs to be closed by a health professional. Your risk of infection increases the longer the wound remains untreated. Most wounds that require treatment should be stitched, stapled, or closed with skin adhesives (also called liquid stitches) within 6 to 8 hours after the injury. Some wounds that require treatment can be closed as long as 24 hours after the injury. If stitches may be needed, avoid using an antiseptic or antibiotic ointment until after a doctor has examined the wound.

  • Most dog bites can be stitched, especially if the wound is large.
  • In general, cat bites are not stitched. Cat bites are usually puncture wounds and can be quite deep. Cat bites have a higher risk of infection than dog bites.
  • Most facial bites can be safely stitched. The risk of infection to the face is lower because the face normally has good blood flow. Because of good blood flow, a face wound may heal faster if it is stitched as soon as possible after a bite.
  • Bites to the hand or foot, whether from an animal, are generally not stitched. These bites carry a high risk of infection, and stitching the wound further increases the likelihood of infection. In some situations, a dog bite to the hand may be stitched.

When Should I See A Doctor?:

  • Bites that are more than 0.25 in. (6.5 mm) deep, that have jagged edges, or that gape open.
  • Deep bites that go down to the fat, muscle, bone, or other deep structures.
  • Deep bites over a joint, especially if the bite opens when the joint is moved or if pulling apart the edges of the bite reveals fat, muscle, bone, or joint structures.
  • Deep bites on the hand or fingers.
  • Bites on the face, lips, or any area where scarring may be a concern (for cosmetic reasons). Bites on the eyelids often need sutures for both functional and cosmetic reasons.
  • Bites longer than 0.75 in. (20 mm) that are deeper than 0.25 in. (6.5 mm) when the edges are pulled apart.
  • Bites that continue to bleed after 15 minutes of direct pressure.

Bites such as these should be evaluated by a health professional, but they may not always need stitching.
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  • 19
  • Jun
6 Common Questions Ask on Osteoporosis
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1. What is Osteoporosis?

Osteoporosis is a disorder of the skeleton in which bones become fragile and susceptible to fractures. If it’s not prevented or treated, it can progress painlessly until a bone breaks.

2. Who Gets Osteoporosis?

Anybody can get osteoporosis; but women are more likely to develop osteoporosis than men because their oestrogen decreases at menopause, which often results in significant bone loss. However, men also get osteoporosis. People with a family history of osteoporosis or fragility fractures are more susceptible to getting osteoporosis.

3. What Causes Osteoporosis?

The most common causes of osteoporosis are inadequate diet, smoking, heavy drinking, insufficient weight-bearing activity and a decrease in oestrogen or testosterone.

4. How is Osteoporosis Diagnosed?

The most common test for diagnosing osteoporosis is called a DEXA test (dual energy x-ray absorptiometry).

5. What can I do to Prevent Osteoporosis?

  • Eat a balanced diet
  • Exercise
  • Avoid smoking and excessive drinking

6. When Should I Have a Bone Density Test?

If you’re a woman, it can be helpful for you to establish a baseline for your bone density either at the age of 50 or around the time of menopause, whichever comes earlier. Establishing a baseline can help you to determine your rate and amount of loss during menopause. Examining your test results can increase your awareness of osteoporosis and encourage you to take preventive measures against it.

Men aged 50 or older should be tested. And whether you’re a man or a woman, bone density tests are usually advisable if you:

  • have had a fracture resulting from minor impact
  • have a chronic disease that causes bone loss
  • take antiseizure drugs
  • take high doses of thyroid medication

Screening package starts at $379.

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