Posts Tagged ‘syndrome’
Monday, December 28th, 2009
So what are the differences between fibromyalgia and chronic fatigue syndrome? It depends on whom you ask.
Some experts think they might be two names for the same condition. Between 50 and 70 percent of people diagnosed with one condition could just as easily be diagnosed with the other, according to the Arthritis Foundation.
In fact, a physician’s familiarity with each disorder may influence the eventual diagnosis. For example, a doctor with a long history of treating fibromyalgia is more likely to diagnose this condition than CFS.
The National Institutes of Health says that CFS should not be diagnosed if a patient has a similar condition such as fibromyalgia, unless that condition has been adequately treated and would no longer be causing fatigue and other symptoms. However, some doctors may choose to make a dual diagnosis of CFS and fibromyalgia.
Though the two conditions share many symptoms (such as sleep problems and cognitive disturbances) some small but crucial distinctions can be made. Those distinctions may be summarized as fatigue or pain. Most patients have one symptom more than the other. For example:
* Pain is a more prominent feature of fibromyalgia than CFS. Injuries and trauma (physical or emotional) may trigger fibromyalgia. Chemicals that help the body transmit and interpret pain signals may not be present at normal levels in fibromyalgia patients.
* Fatigue is a more prominent feature of CFS. A flu-like illness often precedes CFS symptoms, and patients with this condition are less likely than patients with fibromyalgia to have individual tender areas on their bodies.
Of the two conditions, fibromyalgia is more readily acknowledged as a legitimate condition by the medical community. The nature of CFS remains controversial, with disagreement over its definition, diagnosis and treatment. Some doctors may still not even recognize CFS as a legitimate disorder, but recent research shows it has a biological basis.
Treatment options
Because fibromyalgia and chronic fatigue syndrome are so similar, they share many treatments. These include:
* Exercise therapy. Steady, gradual exercise is typically recommended. Patients may use a combination of aerobic, strength training and flexibility exercises. Experts such as physical therapists may devise an appropriate exercise program, and teach patients how to recognize when they should be active and when they need to rest.
* Medications. Drugs may be used to treat pain, depression, fatigue and other symptoms. Such medications include nonsteroidal anti-inflammatory drugs (NSAIDs, such as aspirin), analgesics and antidepressants. One drug, an anticonvulsant, has been approved specifically to treat fibromyalgia. Sometimes medication may be causing symptoms, so it’s good to talk to your doctor about possible side effects of the drug.
* Cognitive behavioral therapy. This treatment has been shown to help fibromyalgia and CFS patients cope with their symptoms. This therapy helps patients stay positive and increase activity.
* Stress management and relaxation therapy. Classes, support groups and other methods can help patients reduce stress and insomnia, both of which can worsen fibromyalgia symptoms. Biofeedback (in which patients use their minds to control symptoms in their bodies) and massage therapy also can help.
If you experience chronic pain or fatigue, consult your physician. Diagnosis and treatment can significantly reduce symptoms associated with these syndromes.
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Tuesday, June 9th, 2009
Fibromyalgia is a complex and multifaceted syndrome causing chronic pain. It involves both widespread myalgia (muscle pain) and localized pain in specific areas, particularly in the muscles around the joints. The musculoskeletal symptoms include pain, stiffness and tenderness. Pain commonly occurs in the neck, back, shoulders, pelvis and hands. The vast majority of the individuals affected are women.
Contrary to popular belief, it is a disorder of muscles, not of joints. Though pain is the main component of this condition, fibromyalgia may also involve fatigue, sleep disturbances and mood disturbances, such as depression and anxiety. The condition is episodic, with flare-ups that vary in intensity and come and go over time.
Although no identifying agent has been thoroughly identified at the root of the problems associated with fibromyalgia, it is generally agreed that certain body chemicals, including substance P (responsible for initiating pain signals after injuries) and serotonin (responsible for toning down the intensity of pain signals) exist in abnormal levels. This causes ordinarily nonpainful stimuli to be translated into pain (allodynia) and amplifies the pain, resulting in a lowering of the pain threshold and increase in pain sensitivity.
Physicians often use fibromyalgia as a classic example of a central pain state, in which the cause of the pain cannot be identified in the local pain site and most of the processes Anatomy of the spine includes the cervical spine, thoracic spine, lumbar spine and sacral region.resulting in pain occur at the level of the spinal cord and brain. However, the pain is not “imagined” or psychological. Some form of input from the pain site is required – even if it is as common as a touch, light or sound. In patients with fibromyalgia, these stimuli are misinterpreted as painful events.
Fibromyalgia is considered a benign condition. It is not degenerative or deforming, nor is it life-threatening. Though the pain may be severe and may significantly reduce quality of life, fibromyalgia causes no lasting tissue damage.
The symptoms associated with fibromyalgia may seriously affect competitive employment. Though most patients remain in the workforce, some claim disability. Doing so can be difficult, even when physicians agree that symptoms are severe enough to warrant aid.
Although fibromyalgia has been recognized by the Social Security Administration as a medically determinable impairment, a general misunderstanding and lack of education regarding it may cause many organizations and individuals to disregard the condition. The Arthritis Foundation reports that disability rates among fibromyalgia patients may be as high as 44 percent.
Fibromyalgia is the second most common disorder seen by rheumatologists and among the most common causes of widespread, chronic pain. According to the Arthritis Foundation, fibromyalgia affects an estimated 2 percent of the United States population – about 3.5 million Americans.
Men and women of all races and ages, including children and the elderly, may be affected, but fibromyalgia occurs most often in women over the age of 30. According to the American College of Rheumatology, about 80 percent to 90 percent of those affected by fibromyalgia are women.
Though uncertainty remains regarding the underlying cause, diagnosis and optimal treatment exist for fibromyalgia. Many professionals and researchers are making efforts to improve the quality of life for patients with fibromyalgia. Better ways to diagnose and treat this condition are being researched. In addition, remaining active as much as possible is a must for fibromyalgia patients.
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Monday, June 8th, 2009
Also called: Fibromialgia, Muscular Rheumatism, Fibrositis, Fibromyalgia Syndrome, Psychogenic Rheumatism, Fibromyositis, Chronic Rheumatism, Tension Myalgia
Fibromyalgia is a chronic musculoskeletal syndrome in which the central nervous system translates normally nonpainful stimuli into pain. A range of symptoms may occur, including widespread and localized pain, fatigue, sleep problems and mood disturbances such as depression. These symptoms vary in intensity and come and go over time.
Certain conditions, such as poor sleep, physical activity and anxiety, may aggravate the symptoms. Though fibromyalgia is not a progressive or life-threatening condition, it impairs quality of life. Patients often have other conditions including migraines, irritable bowel syndrome, TMJ disorder or restless leg syndrome.
Fibromyalgia mainly affects women. Its cause or causes are not known. There are many theories, including abnormalities in brain chemicals, infections, trauma and genetics.
Laboratory and imaging tests cannot identify the condition. The American College of Rheumatology has established two criteria for diagnosis: widespread pain and the presence of 11 of 18 specified tender areas known as trigger points.
There is no known cure for fibromyalgia, but the symptoms can be treated. The U.S. Food and Drug Administration has approved one medication, an anticonvulsant, specifically to treat fibromyalgia. Antidepressants and analgesics may also relieve symptoms. Nutrition, exercise and sleep therapy can help. Some patients benefit from complementary treatments such as massage, acupuncture, relaxation techniques or biofeedback.
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Wednesday, May 27th, 2009
Ankylosing spondylitis (AS) is type of chronic arthritis that primarily affects the spine. The joints between the vertebrae of the spine and ligaments that allow the back to move become inflamed, sometimes leading to the joints and bones fusing together. This inflammation often leads to stiffness of the back and hips.
The name of the disease describes its destructive nature. “Ankylosing” means stiff or rigid, “spondyl” refers to the spine, and “itis” means inflammation. AS belongs to a family of diseases known as spondylarthropathies that attack the spine. These diseases include psoriatic arthritis, Reiter’s syndrome (a form of reactive arthritis, sparked by infection) and enteropathic arthritis (arthritis related to digestive disorders such as inflammatory bowel disease or celiac disease).
While AS progresses, it can also cause inflammation of other organs in the body, including the eyes, lungs and heart valves. Anemia (reduced number of red blood cells) is also associated with the chronic inflammation of ankylosing spondylitis.
The impact of AS varies widely from individual to individual. Some patients experience episodes of back pain that come and go, whereas others have chronic symptoms that worsen and cause severe joint and back stiffness, loss of motion and deformity.
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Saturday, April 25th, 2009
Psoriatic arthritis (PA) can be difficult to diagnose because in adults, psoriasis and arthritis rarely occur at the same time. In addition, PA also mimics other conditions, such as:
* Rheumatoid arthritis (RA). Occurs when an autoimmune response causes inflammation in the lining of the joints, especially those in the hands and feet.
* Gout. Arthritis characterized by sudden, severe attacks of pain, redness and tenderness in a single joint, usually at the base of the big toe.
* Reiter’s syndrome. Form of reactive arthritis that inflames the joints, eyes, genitals, and urinary or digestive tract.
* Infection. An infection of the joint can mimic arthritis as it causes a red, swollen and inflamed joint. Psoriasis patients can have an episode of infectious joint without any evidence of arthritis related to the psoriasis.
In attempting to diagnose PA, a physician will review the patient’s medical history and perform a physical examination.
Additional tests that may be used to diagnose PA include:
* X-rays. Can reveal changes in the joints that occur in PA. In severe disease, the distal interphalangeal (DIP) joints of the fingers or toes give a distinctive “pencil-in–cup” appearance on an x-ray.
* Arthrocentesis. A small sample of fluid is removed from a joint, typically in the knee, for laboratory analysis. A physician can use this test to rule out gout, which is indicated by the presence of uric acid crystals.
* Erythrocyte sedimentation rate (ESR). Blood test that checks ESR, or “sed rate,” by measuring how far from the top of a glass tube red blood cells (erythrocytes) fall in a given time. Generally, blood cells fall when inflammation is present. However, this test alone cannot confirm the presence of PA as inflammation can be caused by many factors.
* Rheumatoid factor (RF) test. Lupus is a chronic autoimmune disease that can cause joint pain and inflammation (arthritis). RF is an antibody (protein made by the immune system) present in the blood of people with RA, lupus or certain other diseases. This test can help determine if a patient’s symptoms are due to PA or another condition.
* Skin biopsy. This may be needed to rule out other conditions, such as fungal infection.
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Saturday, April 18th, 2009
Preparing questions in advance can help patients have more meaningful discussions with their physicians regarding their conditions. Patients may wish to ask their doctor the following questions about Reiter’s syndrome:
1. Could my symptoms be due to Reiter’s syndrome?
2. What else could explain my symptoms?
3. What diagnostic tests might I need to undergo?
4. How is this diagnosis confirmed?
5. How is Reiter’s syndrome different from other kinds of arthritis?
6. Can I transmit Reiter’s syndrome to another person?
7. What are the potential risks of these treatments?
8. What are the risks if I do not use these treatments?
9. Do I need to see an ophthalmologist, urologist, rheumatologist or other specialist?
10. Does having Reiter’s syndrome put me at risk for other conditions?
11. If my symptoms go away now, can I get reinfected later?
12. How can I prevent Reiter’s syndrome?
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Friday, April 17th, 2009
Once Reiter’s syndrome is diagnosed, each aspect of the condition may be treated by a different specialist. A rheumatologist specializes in inflammatory diseases and may treat the arthritis. An ophthalmologist specializes in eye diseases and may treat the conjunctivitis (inflammation of the eyelid and lining of the eye). A gynecologist may treat any genital symptoms for women, and a urologist may treat urinary or genital symptoms for men or women.
The aim of treatment is to reduce the symptoms, prevent or limit joint damage and restore the function of damaged joints.
Several forms of medication are used to treat Reiter’s syndrome. These include:
* Antibiotics. A bacterial infection, either from the original source or in the joints, eyes or genital system, may be treated with antibiotics. This may be in several forms, including oral, injection or eye drops. Some patients may require long courses of antibiotics (up to three months). However, the use of antibiotics without a known source of infection is controversial and usually not recommended.
* Nonsteroidal anti-inflammatory drugs (NSAIDs). These drugs are used to reduce pain and inflammation. They come in prescription and non-prescription forms. Some may affect renal or gastrointestinal function. COX-2 inhibitors may be prescribed if other NSAIDs are not effective.
* Corticosteroids. These anti-inflammatories may be given as Osteoporosis involves the bones becoming thin, brittle and more prone to fracture, causing pain.pills or injections to reduce inflammation. If only a few joints are inflamed, a physician can give an injection. If many joints are inflamed, oral corticosteroids may be prescribed. Long-term use of corticosteroids can have many side effects, including osteoporosis and diabetes.
* Disease-modifying antirheumatic drugs (DMARDs). These drugs are more commonly prescribed for patients with rheumatoid arthritis but may be used for Reiter’s syndrome patients who have not experienced relief from NSAIDs. Side effects include liver and kidney complications and repression of immune responses to infection.
* Tumor necrosis factor (TNF) blockers. Protein blockers that inhibit the body’s inflammatory response. This class of biologic response modifiers (BRMs) may help to reduce inflammation, pain and stiffness.
People with more damage to joints may also benefit from physical therapy to improve joint function and range-of-motion exercises and exercise programs that strengthen muscles and add support to the joints. Sometimes splints are needed to decrease joint pain.
Most people with Reiter’s syndrome recover fully from the initial flare-up of symptoms and are able to return to regular activities within two to six months.
Prevention methods for Reiter’s syndrome
Prevention of Reiter’s syndrome involves avoidance of the initial bacterial infections. Gastrointestinal infections may not be completely avoided, but they can be minimized by ensuring that food is stored at the proper temperatures (refrigerated when necessary) and cooked at temperatures high enough to kill any bacteria. People should ensure they handle uncooked food properly by not transmitting fluids from uncooked meat to the mouth or to other foods.
Reiter’s syndrome triggered by chlamydia and other sexually transmitted diseases (STDs) may be prevented by practicing safe sex. These methods include limiting the number of sexual partners, always using latex condoms during sex and getting tested regularly for STDs.
Prompt treatment of the initial symptoms of infection (e.g., diarrhea, vomiting, unusual genital discharge) may prevent the progression of the infection to Reiter’s syndrome.
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Tuesday, April 14th, 2009
Reiter’s syndrome can be difficult to diagnose because the symptoms may be mild and occur sporadically. No specific laboratory test can confirm the diagnosis. However, episodes of arthritis of one month with urethritis/cervicitis and conjunctivitis are specific and sensitive for this disease.
Diagnosis begins with a physical examination. A medical history, including the recent symptoms of any infection, and a sexual history may also be taken. A patient’s history of any unusual symptoms, fever or pain can help the diagnostic process. The patient may be asked to complete a pain assessment form.
Certain blood tests may be used to rule out other form of arthritis. Some of these tests, which frequently yield positive results for many forms of arthritis, are negative for people with Reiter’s syndrome. Many laboratory tests are used to screen for specific kinds of arthritis or other disease.
Blood tests that used include:
* Antinuclear antibody (ANA) test and rheumatoid factor test. These usually yield a positive result for some forms of arthritis. However, patients with Reiter’s syndrome usually test negative for both tests.
* Creactive protein test. An elevated level of this protein produced by the liver suggests an inflammatory disease.
* HLA-B27 test. Presence of this genetic marker in the white blood cells may indicate Reiter’s syndrome, or other conditions including ankylosing spondylitis, rheumatoid arthritis or juvenile rheumatoid arthritis.
* Erythrocyte sedimentation rate (ESR). This blood test measures how long it takes red blood cells (erythrocytes) to separate from plasma in a blood sample. It is nonspecific: An elevated ESR indicates inflammation that could be caused by many conditions.
Other tests that may be performed include:
* Urine tests and stool samples. A physician may test a sample for infections that originated with a gastrointestinal source.
* Chlamydia test. A swab of cells from the throat and the urethra in men and women and the cervix in women is used to test for this sexually transmitted disease in cases where it is the suspected originating infection. A more advanced urine test can also test for chlamydia. If a patient tests positive for chlamydia, the physician may test for other sexually transmitted infections, including gonorrhea and the human immunodeficiency virus (HIV).
* Synovial fluid analysis. A needle is used to remove fluid from an inflamed joint. Testing the fluid may indicate several forms of arthritis, such as gout, infectious arthritis or juvenile rheumatoid arthritis.
Most patients with Reiter’s syndrome do not show any joint damage on x-rays in the early stages of the disease. The use of x-rays may serve to rule out other forms of arthritis. X-rays that show bony outgrowths or changes in the size of joint spaces may indicate such diseases as osteoarthritis. If Reiter’s syndrome is more advanced at diagnosis, the patient may show some joint changes, especially if the joints in the lower back are affected.
The combination of the patient’s medical history and test results may enable a physician to diagnose Reiter’s syndrome or continue investigating other potential conditions.
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Sunday, April 12th, 2009
Reiter’s syndrome is a reaction to bacterial infection in other body systems. Although many people contract these infections, few of them go on to develop Reiter’s syndrome. The mechanism that makes an infection progress to Reiter’s syndrome is not well understood.
In the urogenital system, the initial infection may be caused by bacteria such as Chlamydia trachomatis or Ureaplasma urealyticum, which are transmitted through sexual contact. The initial infection may also be caused by the human immunodeficiency virus (HIV), the virus that causes acquired immune deficiency syndrome (AIDS). In the gastrointestinal system, some infections with certain microorganisms, including the Salmonella, Campylobacter or Shigella bacteria, may progress to Reiter’s syndrome. These bacteria may enter the body when a person comes into contact with contaminated feces or eats or handles food contaminated with the bacteria, such as raw or undercooked meat.
Elements called risk factors may increase the likelihood of developing a disease or condition. However, not everyone with the disease may exhibit risk factors and not everyone with risk factors may develop the disease.
Risk factors associated with Reiter’s syndrome include:
* Sex and age. Reiter’s syndrome is much more common in men than in women, and most common in men between the ages of 20 and 40. Most men with Reiter’s syndrome develop it from chlamydia, ureaplasma or HIV/AIDS. Most women with Reiter’s syndrome develop it from a gastrointestinal infection.
* Genetics. Studies show that a genetic marker called HLA-B27 may indicate a tendency to develop Reiter’s syndrome. About 8 percent of healthy people have this gene, according to the National Institutes of Health. However, about 80 percent of people with Reiter’s syndrome have the gene. Although the presence of HLA-B27 may indicate a tendency to develop the syndrome, it is not a certainty. Of the people with the gene who are exposed to a triggering infection, only 20 percent develop Reiter’s syndrome.
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Wednesday, April 8th, 2009
Reiter’s syndrome is a condition in which a bacterial infection causes inflammation in a joint (arthritis,) in the lining of the eyes (conjunctivitis) and in the urinary tract (urethritis). Some patients may experience skin and mouth lesions as well.
Reiter’s syndrome is a type of reactive arthritis, meaning that an infection elsewhere causes inflammation in a joint or joints. Reactive arthritis is similar to infectious arthritis, where an infection directly invades and inflames a joint.
Infections in the gastrointestinal or urogenital systems can trigger Reiter’s syndrome. This initial infection may or may not produce symptoms. Several days or weeks later, the infection can cause inflammation in the areas affected by Reiter’s syndrome. It may inflame joints in the knee, foot, ankle, hips and lower back, causing pain, swelling or stiffness.
The conjunctiva, the membrane that lines the eye and inside of the eyelid, may become red and inflamed in one or both eyes. The cervix (mouth of the uterus in women) and urethra (in men and women) may become inflamed and cause urgency or burning during urination. Men, women and children may all come into contact with bacterial agents that trigger Reiter’s syndrome.
Joint pain caused by Reiter’s syndrome is most common in the legs, spine or hands. Reiter’s syndrome belongs to a family of diseases known as spondylarthropathies that attack the spine. These diseases include psoriatic arthritis, ankylosing spondylitis and enteropathic arthritis (arthritis related to digestive disorders such as inflammatory bowel disease or celiac disease).
Reiter’s syndrome is an uncommon form of arthritis. Other forms of reactive arthritis may also cause joint inflammation triggered by an infection but may not involve the eyes or genitals. Reiter’s syndrome can occur in adults and children. Among adults, it is much more common in men than women.
Most people will recover from the initial symptoms after treatment, although some mild arthritis symptoms may remain for up to 12 months. Some patients experience recurrence of symptoms, which may be due to reinfection. A small percentage of patients may develop chronic, severe arthritis that is difficult to control, according to the National Institutes of Health. The frequency is estimated at 3.5 cases per 100,000.
Reiter’s syndrome was first described in 1916 when arthritis, urethritis and conjunctivitis were identified in one patient by Hans Reiter, a German military physician later convicted of Nazi war crimes.
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