כאבים והגבלה ביישור המרפק
דיון מתוך פורום אורתופדיה
I am a man of 30 years old,married+4. Background: borderline hypertension S/p laminectomy C3-4-5 (1988) Current problem: During the last seven months I suffer from pain and edema in my RT elbow. In addition, I cannot extend it fully (angle of 30 degrees). I have preformed the following tests: 1) CBC, ESR, Uric acid-normal 2) CT of elbows-bones are normal, there is soft tissue or exudative fluid instead of the fat pad in the RT side of olecranon fossa. (exudate? ,hemarthrosis?, synovial solid process?) 3) Bone scan- diffuse high intake in RT elbow. Can be due to inflammatory diffuse process in the elbow. 4) U.S.- in the back side of elbow there is a process wich looks solid in a diameter of 1.5cm. hematoma?, tumor? 5) MRI with gadolinum- there is an exudate in all the spaces of the elbow. At the end of the triceps there is a tumor with extention to the olecranon fossa around wich the fat intakes gadolinum. The bones and articular plates are normal. This finding can suggest tendinosis of the triceps with ganglion. I have consulted a few orthopedic surgeons who suggested the following options: A. arthroscopy of the elbow- suggested by head of "Shaare Zedek Medical Center Jerusalem " orthopedic department. He told me that there is 5 percent risk to the function of the elbow in this procedure and that it is a procedure done rarely in the elbow. B. Prednisone for few months. I need a consultation regarding: *what is the preferred treatment for my problem? *If I really need arthroscopy of the elbow , who are the leading surgeons in this field in Israel or abroad?
גברי שלום רב מאחר שנראה לי לפי הסברך כי מדובר בבעיה חוץ מפרקית ובעלת אופי דלקתי אני סבור כי כדאי להשלים את הברור על ידי מיפוי עם גליום או עם תאי דם לבנים מסומנים ולבצע ניתוח פורמלי ולא ארתרוסקופיה לשם ביופסיה . בברכה דר' א. לב-אל