Ann Acad Med Singap
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Ann Acad Med Singap · Jan 2002
Comparative StudyDifferentiation of malignant vertebral collapse from osteoporotic and other benign causes using magnetic resonance imaging.
Elderly patients presenting with backache and vertebral collapse are a diagnostic challenge. Plain X-rays, computed tomography and radionuclide bone scans have not always reliably distinguished between benign and malignant causes. Magnetic resonance imaging (MRI) may be able to do so. ⋯ This study shows that MRI can be used to accurately differentiate between benign and malignant causes of vertebral collapse. Further differentiation between an osteoporotic, traumatic or infective cause can be done with the help of clinical history and evaluation of end-plate integrity.
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Intussusception is the commonest cause of intestinal obstruction in infants and young children. ⋯ As the four classical features of intussusception were present together in only 7.5% of our patients, a high index of suspicion is necessary when any of the signs and symptoms are present in an infant or young child. Abdominal ultrasonography is the diagnostic investigation of choice. Air enema reduction was successful in 84.4% of patients and the duration of symptoms did not reduce the success rate. Thus, air enema reduction should be attempted in most patients unless they have absolute contraindications.
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Ann Acad Med Singap · Jan 2002
Percutaneous vertebroplasty in the management of osteoporotic vertebral compression fractures: initial experience.
Vertebral compression fractures related to osteoporosis may cause persistent pain which impairs mobility and reduces the quality of life. Percutaneous vertebroplasty is a therapeutic interventional radiology procedure which is used in the management of pain relief in such fractures. It involves the injection of bone cement [polymethylmethacrylate (PMMA)] into the collapsed vertebrae under radiological guidance. This provides pain relief as well as increases the strength and stability of the vertebra. ⋯ Percutaneous vertebroplasty is a new and minimally-invasive modality of treating pain in patients with osteoporotic compression fractures who are refractory to medical therapy. Under adequate imaging guidance, the risks of complications are minimal while the potential benefit to patients and their care-givers are significant.
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Ann Acad Med Singap · Jan 2002
Osteoporotic hip fractures in Singapore--costs and patient's outcome.
Little data are available on costs and outcome associated with osteoporotic hip fractures in Singapore. ⋯ The mortality rates and functional outcome are not very different from published studies in the West. More of our patients returned to their own homes after hospitalisation. Early surgery, close involvement of the medical social worker and intensive physiotherapy or provision of outpatient therapy facilities may help cut cost of treatment.
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Ann Acad Med Singap · Jan 2002
ReviewOsteoporosis risk factor assessment and bone densitometry--current status and future trends.
Osteoporosis and fragility fractures are problems which will increase in significance as the population of the elderly in many countries increases. The availability of bone mineral density (BMD) measurements, which can define osteoporosis, allows the implementation of effective therapeutic interventions to those at risk for fractures before they occur. Because of the increasing at-risk population and the relatively high cost of these measurements and interventions, a case-finding strategy to detecting osteoporosis has been widely recommended. This review highlights the approach to detecting and diagnosing osteoporosis. ⋯ Proper selection of individuals for evaluation and treatment for osteoporosis would include risk factor assessment and appropriate BMD measurement to determine the risk of fracture and the need for intervention.