Assuntos
Falanges dos Dedos da Mão/diagnóstico por imagem , Deformidades Adquiridas do Pé , Deformidades Adquiridas da Mão , Hanseníase , Osteólise , Radiografia/métodos , Falanges dos Dedos do Pé/diagnóstico por imagem , Idoso de 80 Anos ou mais , Diagnóstico Diferencial , Falanges dos Dedos da Mão/patologia , Deformidades Adquiridas do Pé/diagnóstico por imagem , Deformidades Adquiridas do Pé/etiologia , Deformidades Adquiridas da Mão/diagnóstico por imagem , Deformidades Adquiridas da Mão/etiologia , Humanos , Hanseníase/complicações , Hanseníase/diagnóstico , Masculino , Osteólise/diagnóstico por imagem , Osteólise/etiologia , Falanges dos Dedos do Pé/patologiaRESUMO
Leprosy is a medical - social disease, it is associated with stigma in the society due to the resulting deformities in some persons. Although stigma has decreased after the widespread use of MDT, some disabilities do occur which are mostly due to late initiation of treatment and inappropriate care. Besides the nerve and skin involvement bone changes have been reported to be common in leprosy. These bony changes need to be understood in the present MDT era specially in the context of clinical spectrum and duration of disease/ deformities. Fifty clinically diagnosed and histologically classified leprosy patients with deformities/ disabilities of either hands/feet/face who attended the OPD of Department of Dermatology, Venereology and Leprosy, Government Medical College, Amritsar were examined and evaluated in the study. Radiological examination of hands, feet and skull was done in each case and the bone changes in hands and feet; and skull and paranasal sinus changes were correlated with clinical parameters. Bone changes were observed in 90% of cases radiologically. Specific bone changes in hands and feet, non-specific bone changes in hands, feet, skull and paranasal sinuses were seen in 66%, 82% and 32% of cases respectively. Common specific bone changes in hands and feet observed were primary periostitis (14%), honey combing (46%), bone cyst (36%), thinning and irregularity of cortex (28%) and area of bone destruction (20%); Among the non-specific bone changes observed were contracted fingers/claw hands/claw toes (64%) and absorption of terminal phalanges (40%). The maxillary sinus, and paranasal sinus changes were the most common radiological findings observed in skull. The study of the radiological changes may help the clinicians to understand the gravity of the situation and undertake steps for timely prevention of permanent loss of function and the occurrence of deformities and disabilities.
Assuntos
Deformidades Adquiridas do Pé/diagnóstico por imagem , Deformidades Adquiridas da Mão/diagnóstico por imagem , Cabeça/diagnóstico por imagem , Hanseníase/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Cistos Ósseos/diagnóstico por imagem , Criança , Pessoas com Deficiência , Feminino , Cabeça/anormalidades , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Adulto JovemRESUMO
Neurophatic foot ulceration (NFU) is a common problem in leprosy patients. Three cases of NFU, who did not respond to conservative measures, were treated with orthopaedic surgery. The purpose of the treatment was, by using different approaches, the reduction of bone hyper pressure areas, allowing the ulcer to heal.