The Experts below are selected from a list of 183 Experts worldwide ranked by ideXlab platform
Chinar Osman - One of the best experts on this subject based on the ideXlab platform.
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Tabes Dorsalis and Argyll Robertson Pupils
The New England journal of medicine, 2016Co-Authors: Chinar Osman, Tristan W ClarkAbstract:A 47-year-old man with HIV infection had shooting pains in his legs, progressive difficulty in walking, tinnitus, and incontinence. Examination showed Argyll Robertson pupils, which are nonreactive to bright light but constrict when focused on a near object. A video is available at NEJM.org.
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Tabes Dorsalis in the post antibiotic era never say never
Journal of Neurology Neurosurgery and Psychiatry, 2015Co-Authors: Chinar Osman, Tristan Luke Clark, Boyd Ghosh, Christopher HalfpennyAbstract:Background Tabes Dorsalis is a neurological form of tertiary syphilis and is considered to be rare in the post antibiotic era. It results from damage to nerve cells in the dorsal column and roots of the spinal cord. It is characterised by sensory ataxia, lightening pains and urinary incontinence. If left untreated it can progress to paralysis and dementia. Case summary We present the case of an HIV positive 47 year old male with a CD4 count of 400 and an undetectable viral load on HAART. He presented with an 8 month history of progressively severe lightening pains, gait disturbance, tinnitus, hearing loss, and urinary incontinence. He had a positive plasma VDRL with a titre of 1:32, and his CSF was VDRL positive. Whole spine MRI scan demonstrated high signal in the dorsal cord with associated atrophy. He was treated with intravenous benzylpenicillin 2.4 grams 4 hourly for 14 days. Follow up at 4 and 8 months demonstrated marked clinical improvement with a falling serum VRDL titre. Repeat LP at 6 month post treatment demonstrated VDRL negativity. Discussion Tabes Dorsalis may still occur in the post antibiotic era. Early recognition and appropriate treatment can lead to good clinical outcomes.
Brian E. Brigman - One of the best experts on this subject based on the ideXlab platform.
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case report neuropathic arthropathy of the hip as a sequela of undiagnosed tertiary syphilis
Clinical Orthopaedics and Related Research, 2010Co-Authors: Nicholas A. Viens, Emily N. Vinson, Tyler Steven Watters, Brian E. BrigmanAbstract:Background Neuropathic arthropathy is characterized by rapidly progressive bone destruction in the setting of impaired nociceptive and proprioceptive innervation to the involved joint. It is seen most commonly in the foot and ankle, secondary to peripheral neuropathy in patients with diabetes mellitus. Other less common sites of involvement may include the knee, hip, shoulder, and spine, depending on the underlying etiology. Neuropathic arthropathy can be associated with Tabes Dorsalis, a unique manifestation of late, tertiary neurosyphilis that may arise in individuals with untreated syphilis many years after initial infection, and usually involves the knee, or less commonly, the hip.
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Neuropathic Arthropathy of the Hip as a Sequela of Undiagnosed Tertiary Syphilis
2010Co-Authors: Nicholas A. Viens, Tyler Steven, Emily N. Vinson, Brian E. BrigmanAbstract:Background Neuropathic arthropathy is characterized by rapidly progressive bone destruction in the setting of impaired nociceptive and proprioceptive innervation to the involved joint. It is seen most commonly in the foot and ankle, secondary to peripheral neuropathy in patients with diabetes mellitus. Other less common sites of involvement may include the knee, hip, shoulder, and spine, depending on the underlying etiology. Neuropathic arthropathy can be associated with Tabes Dorsalis, a unique manifestation of late, tertiary neurosyphilis that may arise in individuals with untreated syphilis many years after initial infection, and usually involves the knee, or less commonly, the hip. Case Report We report the case of a 73-year-old man with neuropathic arthropathy of the hip and Tabes Dorsalis attributable to previously undiagnosed tertiary syphilis. There was considerable delay in the diagnosis and unnecessary diagnostic testing owing to failure to consider syphilis as the cause. Literature Review With the advent of effective antimicrobial therapy and public health campaigns, the relationship between untreated syphilis and neuropathic arthropathy has been primarily a historic point of interest. However, current epidemiologic research suggests a resurgence of syphilis in the United States, with an increased incidence of patients presenting with manifestations of tertiary syphilis from unidentified and untreated primary infections. Treatment options for neuropathic arthropathy of the hip are limited. Arthrodesis has had poor success and treatment with THA has had high complication rates. Conclusions Syphilis is not merely a historic cause of neuropathic arthropathy. Neurosyphilis and Tabes Dorsalis should be considered in the differential diagnosis for patients presenting with rapid joint destruction consistent with Charcot arthropathy and no other apparent cause.
Tristan W Clark - One of the best experts on this subject based on the ideXlab platform.
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Tabes Dorsalis and Argyll Robertson Pupils
The New England journal of medicine, 2016Co-Authors: Chinar Osman, Tristan W ClarkAbstract:A 47-year-old man with HIV infection had shooting pains in his legs, progressive difficulty in walking, tinnitus, and incontinence. Examination showed Argyll Robertson pupils, which are nonreactive to bright light but constrict when focused on a near object. A video is available at NEJM.org.
Ranjan Gupta - One of the best experts on this subject based on the ideXlab platform.
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A short history of neuropathic arthropathy : The diabetic foot
Clinical Orthopaedics and Related Research, 1993Co-Authors: Ranjan GuptaAbstract:Neuropathic joint disease or Charcot joints are a chronic form or a degenerative arthropathy that is associated with decreased sensory innervation of the involved joints. Neuropathic arthropathies are considered to be an accelerated osteoarthritis that is precipitated by trauma to a joint not protected by its proprioceptive or nociceptive reflexes. This process continues until destruction or the joint occurs. The etiology or Charcot joints has varied throughout history as different diseases have become less or more prominent. Some of the of renders include diabetic neuropathy, Tabes Dorsalis, syringomyelia, and congenital indifference to pain
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A short history of neuropathic arthropathy.
Clinical Orthopaedics and Related Research, 1993Co-Authors: Ranjan GuptaAbstract:Neuropathic joint disease or Charcot joints are a chronic form of a degenerative arthropathy that is associated with decreased sensory innervation of the involved joints. Neuropathic arthropathies are considered to be an accelerated osteoarthritis that is precipitated by trauma to a joint not protected by its proprioceptive or nociceptive reflexes. This process continues until destruction of the joint occurs. The etiology of Charcot joints has varied throughout history as different diseases have become less or more prominent. Some of the offenders include diabetic neuropathy, Tabes Dorsalis, syringomyelia, and congenital indifference to pain. The morphology and pathogenesis of this condition has intrigued the minds of many, including Musgrave, Charcot, Virchow, Eloesser, Soto-Hall, and Key.
Nicholas A. Viens - One of the best experts on this subject based on the ideXlab platform.
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case report neuropathic arthropathy of the hip as a sequela of undiagnosed tertiary syphilis
Clinical Orthopaedics and Related Research, 2010Co-Authors: Nicholas A. Viens, Emily N. Vinson, Tyler Steven Watters, Brian E. BrigmanAbstract:Background Neuropathic arthropathy is characterized by rapidly progressive bone destruction in the setting of impaired nociceptive and proprioceptive innervation to the involved joint. It is seen most commonly in the foot and ankle, secondary to peripheral neuropathy in patients with diabetes mellitus. Other less common sites of involvement may include the knee, hip, shoulder, and spine, depending on the underlying etiology. Neuropathic arthropathy can be associated with Tabes Dorsalis, a unique manifestation of late, tertiary neurosyphilis that may arise in individuals with untreated syphilis many years after initial infection, and usually involves the knee, or less commonly, the hip.
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Neuropathic Arthropathy of the Hip as a Sequela of Undiagnosed Tertiary Syphilis
2010Co-Authors: Nicholas A. Viens, Tyler Steven, Emily N. Vinson, Brian E. BrigmanAbstract:Background Neuropathic arthropathy is characterized by rapidly progressive bone destruction in the setting of impaired nociceptive and proprioceptive innervation to the involved joint. It is seen most commonly in the foot and ankle, secondary to peripheral neuropathy in patients with diabetes mellitus. Other less common sites of involvement may include the knee, hip, shoulder, and spine, depending on the underlying etiology. Neuropathic arthropathy can be associated with Tabes Dorsalis, a unique manifestation of late, tertiary neurosyphilis that may arise in individuals with untreated syphilis many years after initial infection, and usually involves the knee, or less commonly, the hip. Case Report We report the case of a 73-year-old man with neuropathic arthropathy of the hip and Tabes Dorsalis attributable to previously undiagnosed tertiary syphilis. There was considerable delay in the diagnosis and unnecessary diagnostic testing owing to failure to consider syphilis as the cause. Literature Review With the advent of effective antimicrobial therapy and public health campaigns, the relationship between untreated syphilis and neuropathic arthropathy has been primarily a historic point of interest. However, current epidemiologic research suggests a resurgence of syphilis in the United States, with an increased incidence of patients presenting with manifestations of tertiary syphilis from unidentified and untreated primary infections. Treatment options for neuropathic arthropathy of the hip are limited. Arthrodesis has had poor success and treatment with THA has had high complication rates. Conclusions Syphilis is not merely a historic cause of neuropathic arthropathy. Neurosyphilis and Tabes Dorsalis should be considered in the differential diagnosis for patients presenting with rapid joint destruction consistent with Charcot arthropathy and no other apparent cause.
