هذه الصورة paget disease من يستطيع التعليق على التغيرات المرضية فيها واعطاء بعض المعلومات عن المرض

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[ALIGN=LEFT] a chronic progressive disease osteoblasts and osteoclasts which results in abnormal bone remodeling - prevalence: - uncommon in pts under age of 55 yrs but relatively common in later life, occurring in 3-4% of persons over 55 yrs & occurs in 10% of population over the age of 80 yrs; - Clinical Presentation: - frequently is asymptomatic and diagnosed incidentally on x-rays obtained for other purposes; - may be localized to only one or several bones; - relative frequency of involvement: pelvis, femur, skull, tibia, and least often involved is the vertebrae; - wt bearing bones: - may present w/ pain, increasing deformity, Pathologic Frx, - local pain & tenderness over the affected bone are frequent. - one or many bones may be involved. - there may be night pain unrelated to change of position - spine: - neural compression may be the presenting problems; - skull: - headache and deafness due to skull involvement; - hat size may increase; - skull radiographs may reveal osteoporosis circum******a which is a lytic lesion seen in the early stages of Paget's disease; - cardiovascular: - may have high output failure and high pulse due to increase blood flow thru Pagetoid bone; []Radiographs- aggressive bone resorption; - lytic lesions w/ sharp borders that destroy the cortex; - new bone formation and sclerosis which causes thickening of the cortex and course trabeculae; - cortices will appear thickened and trabeculae will appear coarse; - skull radiographs may reveal osteoporosis circum******a which is a lytic lesion seen in the early stages of Paget's disease; - Lab Dx: - there is a marked increase in alk phos, which reflects increase in bone formation (w/ symptoms alk phos is 2x normal); - serum calcium & phosphorus, & acid phosphatase are usually normal (unless the patient has been immobilized in which case hypercalemia may occur); - uric acid level may be increased; - urinary hydroxyproline: - increased serum levels of hydroxyproline levels & increased urinary levels of hydroxyproline; - elevated urinary hydroxyproline is a reflection of bone lysis and is seen in other conditions such as RA, hyperparathyroidism, and osteomyelitis; - urinary pyridinium / pyridinoline peptides can also be used as markers of increased activity; --------------------------------------------------------------------------------- Treatment: - indications for treatment: - use of antipagetic medications prior to elective surgery is recommended; - goal is to reduce hypervascularity assoc w/ active disease (3x Alk Phos) which will reduce the amount of blood loss at operation; - to reduce bone pain (probably the most common complaint), excessive warmth over bones, headache, low back pain, & neural compression; - pain due to secondary arthritis from pagetic bone may or may not respond to antipagetic treatment; - presence of moderately active asymptomatic dz (alk phos which is 3 to 4 times higher than normal at sites where the potential problems or complications exists (wt bearing joints, spine ect); - presence of monstotic dz of a tibia or femur with minimal elevation of alk phos are also treatment candidates; - medications: - bisphosonates: - first line agent (low doses interfere w/ bone resorption where as high doses impair bone mineralization); - fosamax (alendronate): 40 mg/day (first line agent); - pamidronate: second line agent given IV (if fosamax is not tolerated); - etidronate - it is an oral agent and is less expensive than either of the calcitonins; - while side effects are < calcitonin, the efficacy is also less; - plicamycin - calcitonin - w/ extensive lytic disease in a wt bearing bone, calcitonin is the drug of choice & is probably also DOC when used prior to elective surgery; - indications: neurologic compression, given to patients prior to orthopaedic surgery or for pathologic frx, pain or deformity; - symptomatic benefit may be apparent in a few weeks; - alkaline phosphatase will decrease after 3-6 months; - major drawback is vomiting in 10-20% of patients;[/ALIGN]

ياريت تترجموا هذا حتى يعـــرف كلنا هذة المعلومات وأن يكـــــون هناك قسم خاص للغة الأنجليزية .

بالنسبة لقسم اللغة الإنجليزية الطبي فإن شاء الله قريبا .... و دمت ..

عندي ملاحظة بسيطه فقط و هي مقارنة بين مرض بهجت - هكذا هو إسمة بس الأجانب حرفوا إسمه علشان ما يكون لاي شخص غيرهم الفضل في إكتشاف الأمراض- المهم المقارنة بين مرض بهجت و الاكزيما العادية : [ALIGN=LEFT]Paget's disease of the nipple (comparison with eczema) ECZEMA bilateral occurs at lactation itching marked vesicles nipple intact no lump often history of atopy PAGET'S DISEASE unilateral occurs at menopause itching mild no vesicle nipple destroyed may be underlying lump[/ALIGN]

اخت وفاء قريبا في اقرب وقط اصبح فيه فارغا سأترجم الموضوع المشكلة الوقت وضعت الموضوع كنوع من التجديد لأنه يفيد طلبة الطب الذين اجد انهم يتكاثرون في المجلس امر الان بظروف تمنعني من الوقوف كثيرا امام النت وبالكاد تسمح لي بكتابة ردود وموضوع بالكثير