Bone Marrow (Trephine Biopsy) Tips

Metabolic Bone Disease is a term used for various conditions of the bones that can be caused by a number of different disorders. Most of these disorders are developed due to nutritional deficiencies, defects in the bone metabolism procedure or due to hereditary defects in the skeletal structure. Conditions that fall under the category are osteoporosis, osteomalacia, rickets, Paget's disease, parathyroid conditions, chemotherapy induced bone loss and menopause induced bone loss.

Causes of Metabolic Bone Diseases:

1. Imbalance in the level of calcium : Too much calcium or too little calcium can cause bone diseases. While the overabundance of calcium (hypercalcemia) in the body will lead to calculi formation, which can be harmful for the body, the lack of calcium (hypocalcemia) causes weakness, bone pain and restricted growth. 
2. Deficiency of phosphorus: Low phosphorus in blood (hypophosphatemia) leads to softening of the bone tissue and bone loss. Osteomalacia is commonly caused by phosphorus deficiencies.
3. Deficiency of Vitamin D: Vitamin D is essential for the body to absorb calcium. Cells called osteoblasts need vitamin D in order to absorb calcium and secrete the bone tissue proteins. A deficiency of vitamin D can lead to a number of metabolic bone diseases like rickets and osteoporosis.
4. Over or under secretion of the parathyroid hormone:The parathyroid hormone (PTH) stimulates the secretion of an enzyme, which converts the inactive circulatory form of vitamin D into its active usable form. The hormone can also increase the circulation of free or ionized calcium (Ca2+), which is not attached to proteins. Both underproduction and overproduction of the hormone causes skeletal problems.

Symptoms of Metabolic Bone Diseases:

The symptoms of most of the Metabolic Bone Diseases are similar, such as 

1. A dull, throbbing pain in the bones is the most common symptom. The pain is frequent and lasts for a long amount of time, but unlike muscular pain, the exact region of bone pain cannot be specified.
2. Severe joint pains accompanied by stiffness and swelling of the joints. The patient experience pain during regular physical activities, especially during cold weather conditions.
3. Frequent fractures are caused by most bone diseases because the bone mineral density decreases drastically. Severe bone injury may be caused by mild trauma.
4. Defects in the bones can cause bowed out legs and a bent backbone.
5. A general feeling of exhaustion is often caused by bone diseases.
6. Kidney stones are an associated complication of metabolic bone diseases.

Metabolic Bone Disease is a term used for various conditions of the bones that can be caused by a number of different disorders. Most of these disorders are developed due to nutritional deficiencies, defects in the bone metabolism procedure or due to hereditary defects in the skeletal structure. Conditions that fall under the category are osteoporosis, osteomalacia, rickets, Paget's disease, parathyroid conditions, chemotherapy induced bone loss and menopause induced bone loss.

Causes of Metabolic Bone Diseases:

1. Imbalance in the level of calcium : Too much calcium or too little calcium can cause bone diseases. While the overabundance of calcium (hypercalcemia) in the body will lead to calculi formation, which can be harmful for the body, the lack of calcium (hypocalcemia) causes weakness, bone pain and restricted growth. 
2. Deficiency of phosphorus: Low phosphorus in blood (hypophosphatemia) leads to softening of the bone tissue and bone loss. Osteomalacia is commonly caused by phosphorus deficiencies.
3. Deficiency of Vitamin D: Vitamin D is essential for the body to absorb calcium. Cells called osteoblasts need vitamin D in order to absorb calcium and secrete the bone tissue proteins. A deficiency of vitamin D can lead to a number of metabolic bone diseases like rickets and osteoporosis.
4. Over or under secretion of the parathyroid hormone:The parathyroid hormone (PTH) stimulates the secretion of an enzyme, which converts the inactive circulatory form of vitamin D into its active usable form. The hormone can also increase the circulation of free or ionized calcium (Ca2+), which is not attached to proteins. Both underproduction and overproduction of the hormone causes skeletal problems.

Symptoms of Metabolic Bone Diseases:

The symptoms of most of the Metabolic Bone Diseases are similar, such as 

1. A dull, throbbing pain in the bones is the most common symptom. The pain is frequent and lasts for a long amount of time, but unlike muscular pain, the exact region of bone pain cannot be specified.
2. Severe joint pains accompanied by stiffness and swelling of the joints. The patient experience pain during regular physical activities, especially during cold weather conditions.
3. Frequent fractures are caused by most bone diseases because the bone mineral density decreases drastically. Severe bone injury may be caused by mild trauma.
4. Defects in the bones can cause bowed out legs and a bent backbone.
5. A general feeling of exhaustion is often caused by bone diseases.
6. Kidney stones are an associated complication of metabolic bone diseases. If you wish to discuss about any specific problem, you can consult an Orthopedist.

If you are experiencing joint stiffness in your hip along with pain and tenderness, you could be suffering from hip arthritis or osteoarthritis. Osteoarthritis accounts for being the most common form of arthritis. It is referred to as degenerative joint disease and old-age arthritis and usually, occurs because of age-related issues. The condition occurs when injury and inflammation of a joint lead to the breakdown of the cartilage tissue, causing pain, swelling, and deformity.

How hip arthritis affects the hip joint?
People who are affected by osteoarthritis of the hip may have difficulty in walking properly. Diagnosis in the early stage is difficult as pain may occur in various locations such as the thigh, groin, knee or buttocks.

The underlying causes
The factors responsible for osteoarthritis include increasing age, joint injury and excess body weight. Some other factors may also be responsible. They are as follows:

1. When the joints have formed improperly.
2. In case of inherited defects in the cartilage.
3. When a person puts excess stress on the hip joint because of being overweight or due to certain activities and motions.

How it can be detected?
The different symptoms of hip arthritis or osteoarthritis are as follows:

1. Joint stiffness, especially after waking up in the morning.
2. Joint stiffness after sitting for a long period.
3. Swelling, pain, and tenderness in the hip joint.
4. A crunching feeling or sound of bones rubbing against one another.
5. The inability to move the hip for carrying out daily activities.

Treatment
The aim of osteoarthritis treatment is to improve the patient’s ability to move about so that his regular life is less affected. The function of the hip and pain management are other targets of treatment for this condition. The different treatment plans are as follows:

1. Proper joint care and rest
2. Using a cane while walking for taking weight off your hip
3. Losing excessive weight
4. Non-drug pain relief measures for controlling pain
5. Regular exercise
6. Several medicines, including NSAIDS and other prescribed pain medication
7. Surgery
8. Alternative therapies

Hip replacement surgery
This is a surgical procedure used for osteoarthritis treatment when all other treatment plans fail. The damaged ball of the hip joint is replaced with a metal ball in this surgical procedure. The hip socket is resurfaced by using a plastic liner and metal shell.

 Apart from the mentioned treatment procedures, hip resurfacing is another surgical option for osteoarthritis treatment, which helps in giving relief when a hip replacement surgery is delayed. In this procedure, the affected hip joint surfaces are surgically removed and are replaced with metal. 

Heel bone spur is a form of calcium deposit that causes a bony protrusion under the heel bone. An X-ray can reveal up to a half inch elongation under the hill. Without image report, this condition is commonly known as heel spur syndrome. Heel spurs are mostly painless but reports of pain in not uncommon. They are often related to plantar fasciitis. The latter is an inflammation of the connective tissue that stretches through the foot bottom connecting the heel bone and the football.

What causes heel spurs?
Heel spurs are a result of prolonged calcium deposit. This condition can result from the heavy strain on the muscle of the foot and ligament, stretching of fascia and wear and tear of the heel bone membrane. These injuries are frequently observed among athletes who are involved with activities such as jumping and running. 

What are the risk factors?
1. Walking abnormalities that involve putting more than normal stress on the bone, nerve and ligament in and around the heel.
2. Running on surfaces that are hard in nature
3. Shoes lacking arch support
4. More than normal body weight 
5. Spending too much time on the feet
6. Too flat or too high arches
7. A person suffering from diabetes
8. In case the protective pad of the heel is fading away due to old age or other bone disorder

Non-Surgical treatment
Unlike common belief, only rest may not be the best way to treat heel bone spurs. On the contrary, a patient might feel sharp pain immediately after sleep. This happens when he tries to walk and the plantar fascia elongates all of a sudden. The pain decreases with more walking. Some treatment methods that work for 90 percent of the sufferers includes wearing the right shoe, stretching exercises, wearing orthotic devices inside the shoes and physical therapy. Over the counter medicine such as Aleve, Tylenol and Advil can be consumed to reduce the pain and for improving the overall condition. Corticosteroid injection also tends to give relief from the inflammation.

Surgical treatment
If heel spurs persist for more than 8-9 months, surgical options should be explored by the patient. There are two angles on which a doctor works, either removing the spur or release the plantar fascia. Pre-surgical exams are necessary to ensure that a person is eligible for surgery and all non-surgical avenues are explored. Post-surgical activities are equally important for the process of healing. Usage of bandages, crutches, splints and surgical shoes is a mandate to avoid complications such as infection, numbness, and scarring. Possible side effects should be discussed with the surgeon well before the surgery. The estimated healing time from this procedure is close to 8-12 weeks.

Metabolic Bone Disease is a term used for various conditions of the bones that can be caused by a number of different disorders. Most of these disorders are developed due to nutritional deficiencies, defects in the bone metabolism procedure or due to hereditary defects in the skeletal structure. Conditions that fall under the category are osteoporosis, osteomalacia, rickets, Paget's disease, parathyroid conditions, chemotherapy induced bone loss and menopauseinduced bone loss.

Causes of Metabolic Bone Diseases:

1. Imbalance in the level of calcium : Too much calcium or too little calcium can cause bone diseases. While the overabundance of calcium (hypercalcemia) in the body will lead to calculi formation, which can be harmful for the body, the lack of calcium (hypocalcemia) causes weakness, bone pain and restricted growth. 
2. Deficiency of phosphorus: Low phosphorus in blood (hypophosphatemia) leads to softening of the bone tissue and bone loss. Osteomalacia is commonly caused by phosphorus deficiencies.
3. Deficiency of Vitamin D: Vitamin D is essential for the body to absorb calcium. Cells called osteoblasts need vitamin D in order to absorb calcium and secrete the bone tissue proteins. A deficiency of vitamin D can lead to a number of metabolic bone diseases like rickets and osteoporosis.
4. Over or under secretion of the parathyroid hormone:The parathyroid hormone (PTH) stimulates the secretion of an enzyme, which converts the inactive circulatory form of vitamin D into its active usable form. The hormone can also increase the circulation of free or ionized calcium (Ca2+), which is not attached to proteins. Both underproduction and overproduction of the hormone causes skeletal problems.

Symptoms of Metabolic Bone Diseases:

The symptoms of most of the Metabolic Bone Diseases are similar, such as 

1. A dull, throbbing pain in the bones is the most common symptom. The pain is frequent and lasts for a long amount of time, but unlike muscular pain, the exact region of bone pain cannot be specified.
2. Severe joint pains accompanied by stiffness and swelling of the joints. The patient experience pain during regular physical activities, especially during cold weather conditions.
3. Frequent fractures are caused by most bone diseases because the bone mineral density decreases drastically. Severe bone injury may be caused by mild trauma.
4. Defects in the bones can cause bowed out legs and a bent backbone.
5. A general feeling of exhaustion is often caused by bone diseases.
6. Kidney stones are an associated complication of metabolic bone diseases.

If you are experiencing joint stiffness in your hip along with pain and tenderness, you could be suffering from hip arthritis or osteoarthritis. Osteoarthritis accounts for being the most common form of arthritis. It is referred to as degenerative joint disease and old-age arthritis and usually, occurs because of age-related issues. The condition occurs when injury and inflammation of a joint lead to the breakdown of the cartilage tissue, causing pain, swelling, and deformity.

How hip arthritis affects the hip joint?
People who are affected by osteoarthritis of the hip may have difficulty in walking properly. Diagnosis in the early stage is difficult as pain may occur in various locations such as the thigh, groin, knee or buttocks.

The underlying causes
The factors responsible for osteoarthritis include increasing age, joint injury and excess body weight. Some other factors may also be responsible. They are as follows:

1. When the joints have formed improperly.
2. In case of inherited defects in the cartilage.
3. When a person puts excess stress on the hip joint because of being overweight or due to certain activities and motions.

How it can be detected?
The different symptoms of hip arthritis or osteoarthritis are as follows:

1. Joint stiffness, especially after waking up in the morning.
2. Joint stiffness after sitting for a long period.
3. Swelling, pain, and tenderness in the hip joint.
4. A crunching feeling or sound of bones rubbing against one another.
5. The inability to move the hip for carrying out daily activities.

Treatment
The aim of osteoarthritis treatment is to improve the patient’s ability to move about so that his regular life is less affected. The function of the hip and pain management are other targets of treatment for this condition. The different treatment plans are as follows:

1. Proper joint care and rest
2. Using a cane while walking for taking weight off your hip
3. Losing excessive weight
4. Non-drug pain relief measures for controlling pain
5. Regular exercise
6. Several medicines, including NSAIDS and other prescribed pain medication
7. Surgery
8. Alternative therapies

Hip replacement surgery
This is a surgical procedure used for osteoarthritis treatment when all other treatment plans fail. The damaged ball of the hip joint is replaced with a metal ball in this surgical procedure. The hip socket is resurfaced by using a plastic liner and metal shell. Apart from the mentioned treatment procedures, hip resurfacing is another surgical option for osteoarthritis treatment, which helps in giving relief when a hip replacement surgery is delayed. In this procedure, the affected hip joint surfaces are surgically removed and are replaced with metal. If you wish to discuss about any specific problem, you can consult an orthopedist.

Heel bone spur is a form of calcium deposit that causes a bony protrusion under the heel bone. An X-ray can reveal up to a half inch elongation under the hill. Without image report, this condition is commonly known as heel spur syndrome. Heel spurs are mostly painless but reports of pain in not uncommon. They are often related to plantar fasciitis. The latter is an inflammation of the connective tissue that stretches through the foot bottom connecting the heel bone and the football.

What causes heel spurs?
Heel spurs are a result of prolonged calcium deposit. This condition can result from the heavy strain on the muscle of the foot and ligament, stretching of fascia and wear and tear of the heel bone membrane. These injuries are frequently observed among athletes who are involved with activities such as jumping and running. 

What are the risk factors?
1. Walking abnormalities that involve putting more than normal stress on the bone, nerve and ligament in and around the heel.
2. Running on surfaces that are hard in nature
3. Shoes lacking arch support
4. More than normal body weight 
5. Spending too much time on the feet
6. Too flat or too high arches
7. A person suffering from diabetes
8. In case the protective pad of the heel is fading away due to old age or other bone disorder

Non-Surgical treatment
Unlike common belief, only rest may not be the best way to treat heel bone spurs. On the contrary, a patient might feel sharp pain immediately after sleep. This happens when he tries to walk and the plantar fascia elongates all of a sudden. The pain decreases with more walking. Some treatment methods that work for 90 percent of the sufferers includes wearing the right shoe, stretching exercises, wearing orthotic devices inside the shoes and physical therapy. Over the counter medicine such as Aleve, Tylenol and Advil can be consumed to reduce the pain and for improving the overall condition. Corticosteroid injection also tends to give relief from the inflammation.

Surgical treatment
If heel spurs persist for more than 8-9 months, surgical options should be explored by the patient. There are two angles on which a doctor works, either removing the spur or release the plantar fascia. Pre-surgical exams are necessary to ensure that a person is eligible for surgery and all non-surgical avenues are explored. Post-surgical activities are equally important for the process of healing. Usage of bandages, crutches, splints and surgical shoes is a mandate to avoid complications such as infection, numbness, and scarring. Possible side effects should be discussed with the surgeon well before the surgery. The estimated healing time from this procedure is close to 8-12 weeks. If you wish to discuss about any specific problem, you can consult an orthopedist.

Staying healthy involves a wholesome state of being where the mind and body are in perfect sync. A less than properly functioning body can leave you in a state of potential depression after a certain point of time, while a depressive mind can leave you feeling less than stellar where you end up imagining and experiencing pain. The health of your bones and joints is one such area that requires even more care as you start growing older. Wear and tear is just one of the reasons for degeneration while fractures and injuries can lead to a sudden halt of normal functioning of the bones and joints too.

So how can you ensure bone and joint health in the long run?

Follow our tips!

1. Eating Right: Pick calcium rich food like dairy products that have a low fat content, including milk and yogurt. Also, have a daily dose of green, leafy vegetables and plenty of citrus fruit and juices for your fill of calcium. Further, food like eggs and soya beans which have lots of vitamin D can also help in retaining good bone and joint health. Vitamin C rich fruit like watermelon, oranges, squash and tomatoes also help in natural tissue and cartilage repair. And finally, get plenty of Vitamin K to retain good bone density for a prolonged period with ingredients like leafy green vegetables, eggs and cheese.
2. Exercise: This is the key to good bone and joint health. Much like machinery and tools, the bones and joints of your body can also wither with disuse and prolonged inactivity. Make sure that you indulge in exercises like long walks and muscle strengthening exercises which will give your joints and bones good amount of strength as well. Remember to speak with your doctor before you start a new exercise regime so that you avoid anything that may be harmful in case you have any other ailment. Low impact exercises will strengthen the spine, while fat burning and weight loss exercises will ensure that there is less pressure on the knees and lumbar area. Swimming and resistance building exercises can also be practised for these purposes.
3. Abstinence: A major factor in promoting better bone and joint health is abstinence from all those things that can create problems in the long run, like smoking, drinking excessively and even too much consumption of caffeine and fatty food. All these things can create depletion of the natural bone mass. Also, switching to a lower heel for everyday wear footwear and changing your position during your time at your work station are a few things that will go a long way.

Take care of your bones and joints the right way today, for a healthier tomorrow.

The treatment options for bone cancer depends on the type of cancer one is suffering from, the general health of the patient, the stage of cancer and the general preference of the patient. Different treatment options are designed for different types of cancer, based on the diagnosis. Each treatment responds in a different way. An oncologist decides the treatment options considering all the factors mentioned above. For instance, some cancer is best suited to surgery, while some cancer needs radiotherapy or chemotherapy to curb them. In many cases, all three modes of treatment might be required to tackle the growth of the cancer cells.

Surgery:
The goal of surgery is to eradicate the cancer cells in totality along with some surrounding healthy tissues. This involves special techniques to remove a tumor in one piece. Following are the types of surgeries that are available:

1. Removing the cancer cells sparing the limb: At the very first sight, the surgeon tries to understand whether it is possible to separate cancer cells from the tissues and the nerves. If the same is possible, the surgeon tries to save the limb while getting rid of the cancer cells. For the sake of safety and to ensure that the surgery is effective, the surgeon removes some of the healthy bone from the body and may replace the same with tissue from other parts of the body. To achieve this, a doctor might seek the help from of a bone bank or use a special metal prosthesis.
2. Surgery that does not involve the limbs: If the bone cancer does not involve the legs and the arm, surgeons can remove the affected bone along with some healthy bone from the surrounding areas. Cancer of the ribs and the spine are good examples of this type.
3. Surgery that affects the limb: Bone cancer that has spread to a significant extent and is strategically located in such areas that it is very difficult to remove, requires amputation. While this form of treatment is being increasingly discouraged by the wider medical community, it still does exist. In such cases, patients are fitted with artificial limbs and trained to do their job without the use of natural limbs.

Chemotherapy:
This is a form of drug treatment that uses powerful chemicals to kill cancer cells throughout the body. This medication is mostly given through an IV and the medication kills whatever cancer cells it comes across. 

Radiation therapy:
Radiation therapy involves the use of special X-ray beams that have high power and can kill cancer cells. The patients are required to lie on a table, while a machine moves around the affected area and treats it with high energy X-rays, thereby killing the cancer cells. Radiation therapy is often used in conjunction with chemotherapy to reduce the size of a tumor before operating on it. Also, Brachytherapy is another kind of radiotherapy in which plastic tubes for introducing radioactive sources are placed over tutor bed during surgery, later it is connected with brachytherapy machine to give extra high dose to tutor bed to improve cure rates.

In case you have a concern or query you can always consult an expert & get answers to your questions!

Menopause is a condition that marks the end of the menstrual cycle. It is a normal phenomenon that women experience with age. Menopause affects the bone health adversely. Bone health is directly tied to oestrogen, the hormone responsible for reproductive cycles, pain sensitivity. As a woman moves out of her fertile years there is an internal change in the reproductive system and the consequences can be seen and felt all over the body, including the bones.

The years just preceding menopause, with their hormonal fluctuations can set the stage for later health issues like bone weakening. As the oestrogen level drops, the bone density starts to decline which continues for a long period of time. The bone loss can become significant during perimenopause (the decades making up to menopause) and will speed up in the first few years of menopause.

The oestrogen level directly affects the process known as bone remodelling; the constant breakdown and the remodelling of the bone in the skeleton. With less oestrogen in the body cells called osteoclasts are able to absorb bone at a faster rate than osteoblasts (bone-building cells) are able to regenerate new bone. Thus the bone remodelling equation is no longer equal and the bone density continues to decline.

The osteoporosis risk after menopause is a serious one, yet so many women refuse to pay it much attention. Perhaps it’s because the bone damage isn’t visible, or that bone loss continues so gradually for so many years. While the bone loss cannot be completely halted, there is plenty that can be done to slow it down. Here are some ways to take care of your bone health before or after menopause.

1. Stay active: Adopting an active lifestyle after menopause helps in protecting the bones. It's recommended that adults between 19 to 64 years of age should do moderate to intense activity. This could include activities such as cycling or brisk walking. Sitting for long hours should be avoided. Weight-bearing exercises and resistance exercises are particularly important for improving bone strength and helping to prevent osteoporosis.
2. A balanced healthy diet: A healthy, balanced diet that includes calcium and vitamin D will help maintain healthy bones after the menopause. Good sources of calcium include green, leafy vegetables (but not spinach), nuts, seeds, dried fruit, tinned fish with the bones in, and dairy products like milk, yoghurt and cheese. Good food sources of vitamin D include oily fish, eggs, and fat spreads or breakfast cereals
3. Hormone replacement therapy: HRT can be an effective treatment for common menopausal symptoms like night sweats, sleep disturbance and achy joints. It works by replacing oestrogen, which naturally begins to lower post menopause. HRT can also help to maintain bone density and reduce the risk of osteoporosis.

In case you have a concern or query you can always consult an expert & get answers to your questions!