27-year-old female with a diagnosis of suspected fibromyalgia. Her history includes long standing widespread musculo – skeletal pain connected to a feeling of general slight illness, as well as a series of accompanying symptoms: frequent migraines, cervicalgia, stomach disorders, chest pain and tachycardia . Therefore, she has carried out various follow-ups that each time detected a different problem for which the relevant therapy was set out.
A 58 years old male. 4 years ago the patient was hospitalized due to acute thrombosis of the right femoral-iliac axis. The patient was treated succesfully with locoregional intra-arterial fibrinolytic therapy. A follow-up arteriography, revealed sub-occlusion of the common iliac, occlusion of the right superficial femoral artery in Hunter’s canal. PTA + stent of the iliac was carried out with excellent final angiographic result.
60-year-old patient was diagnosed with Still's disease. He was treated with high doses of corticosteroids (methylprednisolone, 110 mg daily). The dose was gradually lowered to 4 mg daily. In the last 2 years he had two exacerbations of the disease which were successfully treated by the increased dose of methylprednisolone. The expert recommends different complementary treatments that can be helpful to reduce pain , other symptoms and inflammation, reduce the dose of the drugs needed to control the disease, and improve quality of life.
18 years old male. 4 months ago the patient was hospitalized due to epigastric abdominal pain, lack of appetite and weight loss. He was diagnosed with Crohn’s disease.
Hepatic biopsy, that was performed during this hospitslization, showed evidence of an overlap syndrome picture (cholangitis/hepatitis). He was initially treated with Cortisone and Azathioprine.
47-year-old male presented with un-provoked portal and mesenteric vein thrombosis that caused persistent radiating pains of upper abdominal quadrants. The examinations found heterozygous factor II mutation, and family survey for the factor II mutation was recommended. The patient started anticoagulant therapy. In the expert's opinion, the main risk factors for portal vein thrombosis are: Prothrombotic disorder, abdominal inflammation, cirrhosis, cancer, abdominal intervention and abdominal infection.
65-year-old female that suffers from pain in the left knee underwent examinations that showed femoral-tibial arthrotic manifestations, external degenerative meniscal tear and moderate joint effusion. A diagnosis of external degenerative meniscal tear was established. Further medical tests showed marked degeneration of the meniscal fibrocartilage, diffuse femoral-tibial arthrotic abnormalities, subchondral cysts and edema of the spongious bone, as well as rarefaction of the cartilage matrix, and manifestations of chondropathy.
A 50 years old male with generalized ligamentous laxity and long history of distortions (Sprains) of the ankles. On the right ankle the incidence and severity of the sprains had increased significantly in recent months. On MRI imaging of both ankles: in the right ankle the lateral stabilizing ligaments are damaged and incongruent. On the left ankle the picture is similar with an old fracture of the tip of the medial malleolus which is not united, but not significantly displaced. Right ankle instability was diagnosed and “Brodstrum“ type operation on right ankle has been suggested.
Patient with clinical and laboratory picture compatible with acute infectious mononucleosis with Epstein-Barr Virus (EBV). Although he still feels weak, his condition is slowly improving. There is a gradual disappearance of the fever episodes and rash, in parallel with gradual normalization of the liver enzymes results, and disappearance of atypical lymphocytes. The reactivation of Herpes labialis can be explained by the stress involved in the EBV infection or the Cortisone treatment.
