According to the Centers for Disease Control, as many as 476,000 people in the U.S. contract Lyme disease every year. Climate change and human encroachment into wilderness areas means ticks and the disease-causing bacteria they carry are becoming more common. Dr. Linden Hu, an immunology professor and co-director of the Lyme Disease Initiative at Tufts University, joins John Yang to discuss.
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Educational video describing the condition of rat bite fever.
Rat-bite fever is an illness caused from bacteria transmitted by rodents. The condition goes by many names but it is typically transmitted by a rat. The disease can be passed from the urine or feces of an infected rodent but it is typically caused due to the animal’s bite. The bacteria responsible for rat-bite fever is found in the mouth, nose and respiratory tract of many rats and sometimes infection from the bite can be fatal. It is rare disease typically spread by infected rodents however pets such as dogs or cats that are exposed to these animals can also carry the disease and infect humans.
There are two types of gram-negative bacteria that can cause the infection: streptobacillosis moniliformis and spirillum minus.
Symptoms occur 3-10 days after exposure, however they can be delayed up to several weeks. Symptoms include: chills/fever, headache, muscle aches, vomiting, painful swelling of the joints (polyarthralgia), fatigue, rash. Symptoms are nonspecific and can be confused with other diseases. It is a difficult diagnosis and the diagnosis could be delayed. Here is a patient MRI of the right side shoulder. The patient had documented infection of the right shoulder proven to be caused by rat-bite fever. The patient had incision and drainage of the right shoulder.
Treatment is usually penicillin or its derivative. A good prevention program to avoid exposure to infected animals. The mortality rate is about 13% if not treated.
The CDC states that those at higher risk of contracting the illness are people with pet rats or those who work with rats in laboratories, pet stores or people who live in rat-infested buildings. People who handle rodents or clean up after them should wash their hands regularly, as well as wear protective gloves and avoid placing their hands to the mouth after being in contact with rodents. All rodents are potential carriers of the bacteria. Children under the age of 5, pregnant women and people with weakened immune systems should consider not having a rat as a pet.
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Background music provided as a free download from YouTube Audio Library.
Song Title: Every Step Video Rating: / 5
Dr. Ebraheim’s educational animated video describing the anatomy and associated injuries of the knee joint.
Disrupted quadriceps
•Patient is unable to actively extend the knee.
The most common cause of ACL ruptures:
•Traumatic force being applied during twisting motion.
•Side stepping or landing from a jump.
Patient complains of:
•Immediate pain
•Knee giving way
•Swelling
Aspiration of the knee
•If aspiration of the knee joint shows evidence of blood within the joint there is 75-80% chance of ACL and meniscal injury.
Lachamn’s test- ACL knee exam
•Knee is flexed at 30 degrees.
•ACL tear of the knee is identified by pulling on the tibia and examining the frontward motion of the lower leg in comparison to the upper leg.
Radiological exam – ACL
•MRI of the knee joint shows bone lesions or bruising associated with tears of the ACL. Injury is found in the typical location; middle of the femoral condyle and posterior part of the tibia laterally.
Posterior cruciate ligament tear (PCL)
•Common cause of injury is a bent knee hitting a dashboard in a car accident.
Tibial Sag Test –PCL knee exam
Quadriceps active test-PCL knee exam
•The examiner stabilizes the leg of the patient and then the patient is asked to actively contract the quadriceps muscle.
•The tibia is seen actively reduced from the posterior subluxed position.
Lachman’s test-PCL knee exam
•Knee is bent 20-30 degrees.
•The posterior drawer test is carried out while the patient is in a supine position and the knee is flexed to 90 degrees.
•The amount of translation of the tibia relative to the femur is observed.
The dial test is performed while the patient is in the supine or prone position and both knees are in 90 and 30 degrees of flexion. More than 10 degrees of external rotation indicates significant injury.
Common meniscal tears
Symptoms include
•Knee pain
•Pain with straightening the knee
•Swelling
•Locking
•Weakness Video Rating: / 5
