Kienböck's disease: A rare wrist disorder in a young male.

Kienböck's disease is a rare disorder involving the lunate, one of the carpal bones, and is, therefore, not commonly included in the differential diagnosis of patients presenting to the emergency department with wrist pain. Delay in diagnosis inevitably leads to disease progression, thereby reducing surgical options. This article presents a patient's case including patient history, differential diagnosis, radiographic findings, and management. The challenges in the diagnosis of this disease are discussed in relation to significance to clinical practice for nurse practitioners and emergency department physicians.

Postmenopausal females and the link between oral bisphosphonates and osteonecrosis of the jaw: a clinical review.

PURPOSE: To increase awareness for nurse practitioners (NPs) of new information concerning the plausible link between the oral bisphosphonate drug classification and necrosis in the jaw. DATA SOURCES: Selected research and clinical articles. In addition, several peer-reviewed, refereed medical and dental journals were consulted. CONCLUSIONS: Oral bisphosphonates are commonly prescribed by NPs for postmenopausal females with the diagnosis of osteoporosis to arrest bone loss and preserve bone density. Recent reports have shown a link between these medications and osteonecrosis of the jaw, which is a complication resulting in necrotic bone inside the mouth. IMPLICATIONS FOR PRACTICE: NPs must be able to determine early warning signs of osteonecrosis to ensure prompt referral to a dental specialist in order to prevent irreversible sequelae. Because of the aging population, osteoporosis is predicted to increase; therefore, treatment with these drugs and the side effects that go along with them will most likely also increase.

Bisphosphonate-associated osteonecrosis of the jaw: patient care considerations: overview for the orthopaedic nursing healthcare professional.

An emerging problem for patients taking bisphosphonate (BSP) medications for osteoporosis or cancer therapies has been the occurrence of osteonecrosis of the jaws (ONJ), most often after dental surgical procedures. ONJ can be a persistent and discomforting condition that can also be refractory to various therapies. This article will overview the pathophysiology of ONJ, the proposed causal relationship between BSP use and ONJ, and the current guidelines for dental care of a patient who will be, or is taking, this class of medications. Included are suggested guidelines for the orthopaedic nurse who may interact with these patients. Alternate names for this malady are as follows:

Complication related to bisphosphonate therapy: osteonecrosis of the jaw.

Bisphosphonates are synthetic analogs of naturally occurring pyrophosphates, and they inhibit osteoclast-mediated bone resorption. They are widely used for the prevention and treatment of osteoporosis, treatment of Paget's disease of bone, management of metastatic cancer in bone, and short-term management of acute hypercalcemia. Osteonecrosis of the jaw is an adverse drug effect of bisphosphonates, and it typically presents as infection and necrotic bone in the mandible or maxilla. This article discusses pharmacology of bisphosphonates and osteonecrosis of the jaw, including its contributing factors, pathophysiology, prevention, and management, as well as appropriate nursing interventions.

Skeletal and cutaneous sequelae to meningococcal purpura.

Meningococcal infection can produce symptoms that have severe morbid or even fatal effects. The survival rate has increased over the last 20 years and health care workers are now faced with managing the sequelae of cutaneous and skeletal necroses. It is important for nurses to recognize symptoms of the disease as well as associated complications. A multidisciplinary approach is needed to manage all phases of the illness. This phenomenon occurs most commonly in children but may be seen in adolescents and young adults as well. Despite extensive alteration in body image and the need for long-term rehabilitation, with proper management, a full recovery may be expected.