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The International Journal of Lower... Mar 2023Necrotizing fasciitis, commonly known as "flesh-eating disease," is an aggressive soft tissue infection that destroys the fascia, subcutaneous tissue, and skin. Specific... (Review)
Review
Necrotizing fasciitis, commonly known as "flesh-eating disease," is an aggressive soft tissue infection that destroys the fascia, subcutaneous tissue, and skin. Specific clinical features (crepitus or radiologic features of gas in tissues) either appear late or are of poor sensitivity. Thus, a high index of clinical suspicion is required for early diagnosis and prompt treatment, which are the best methods of minimizing its high associated morbidity and mortality. We present 3 cases to demonstrate diagnostic difficulties and challenges in management and highlight the feature of pain on muscular activity.
Topics: Humans; Fasciitis, Necrotizing; Myalgia; Skin; Soft Tissue Infections; Debridement
PubMed: 32940112
DOI: 10.1177/1534734620958605 -
International Journal of Environmental... Apr 2020In patients with neuromuscular disorder, only little data of myalgia frequency and characterization exists. To date, only a weak correlation between pain intensity and...
BACKGROUND
In patients with neuromuscular disorder, only little data of myalgia frequency and characterization exists. To date, only a weak correlation between pain intensity and pressure pain threshold has been found, and it remains enigmatic whether high pain intensity levels are equivalent to high pain sensitivity levels in neuromuscular disorders.
METHODS
30 sequential patients with suspected neuromuscular disorder and myalgia were analyzed with regard to myalgia characteristics and clinical findings, including symptoms of depression and anxiety and pain- threshold.
RESULTS
A neuromuscular disorder was diagnosed in 14/30 patients. Muscular pain fasciculation syndrome (MPFS) without evidence for myopathy or myositis was diagnosed in 10/30 patients and 6/30 patients were diagnosed with pure myalgia without evidence for a neuromuscular disorder (e.g., myopathy, myositis, MPFS, polymyalgia rheumatica). Highest median pain scores were found in patients with pure myalgia and polymyalgia rheumatica. Pressure pain threshold measurement showed a significant difference between patients and controls in the biceps brachii muscle.
CONCLUSION
Only a weak correlation between pain intensity and pressure pain threshold has been suggested, which is concordant with our results. The hypothesis that high pain intensity levels are equivalent to high pain sensitivity levels was not demonstrated.
Topics: Adult; Anoctamins; Female; Humans; Male; Middle Aged; Muscle, Skeletal; Muscular Diseases; Myalgia; Myositis; Pain Threshold; Young Adult
PubMed: 32268560
DOI: 10.3390/ijerph17072502 -
European Journal of Applied Physiology Aug 2021Cryotherapy is utilized as a physical intervention in the treatment of injury and exercise recovery. Traditionally, ice is used in the treatment of musculoskeletal... (Review)
Review
Cryotherapy is utilized as a physical intervention in the treatment of injury and exercise recovery. Traditionally, ice is used in the treatment of musculoskeletal injury while cold water immersion or whole-body cryotherapy is used for recovery from exercise. In humans, the primary benefit of traditional cryotherapy is reduced pain following injury or soreness following exercise. Cryotherapy-induced reductions in metabolism, inflammation, and tissue damage have been demonstrated in animal models of muscle injury; however, comparable evidence in humans is lacking. This absence is likely due to the inadequate duration of application of traditional cryotherapy modalities. Traditional cryotherapy application must be repeated to overcome this limitation. Recently, the novel application of cooling with 15 °C phase change material (PCM), has been administered for 3-6 h with success following exercise. Although evidence suggests that chronic use of cryotherapy during resistance training blunts the anabolic training effect, recovery using PCM does not compromise acute adaptation. Therefore, following exercise, cryotherapy is indicated when rapid recovery is required between exercise bouts, as opposed to after routine training. Ultimately, the effectiveness of cryotherapy as a recovery modality is dependent upon its ability to maintain a reduction in muscle temperature and on the timing of treatment with respect to when the injury occurred, or the exercise ceased. Therefore, to limit the proliferation of secondary tissue damage that occurs in the hours after an injury or a strenuous exercise bout, it is imperative that cryotherapy be applied in abundance within the first few hours of structural damage.
Topics: Cryotherapy; Exercise; Humans; Musculoskeletal System; Myalgia; Sprains and Strains
PubMed: 33877402
DOI: 10.1007/s00421-021-04683-8 -
Rheumatology International Jan 2021Protracted febrile myalgia syndrome (PFMS) is one of the rare conditions characterized by long standing severe myalgia and fever in familial Mediterranean fever (FMF)... (Review)
Review
Protracted febrile myalgia syndrome (PFMS) is one of the rare conditions characterized by long standing severe myalgia and fever in familial Mediterranean fever (FMF) patients. Laboratory studies show elevated values of inflammatory markers and normal creatinine phosphokinase (CPK) levels. Rarely, PFMS may be the first manifestation of FMF and this makes the diagnosis of FMF and PFMS challenging. The aim of this report was to describe case series of PFMS patients without previous diagnosis of FMF and discuss with other pediatric PFMS cases described in the literature. Six patients with PFMS as the first manifestation of FMF from two Pediatric Rheumatology clinics were presented. The male: female ratio was 1:1. The median (min-max) age at diagnosis was 7.05 (5.5-15.5) years. All patients had severe myalgia. No fever was detected in two patients. Only one patient had rash. Markedly elevated acute phase reactants were observed in all patients. CPK levels were normal in all patients. Also, we searched the PubMed/MEDLINE, Google Scholar, Web of Science and Scopus databases from inception to May 2020, using the keywords 'familial Mediterranean fever, protracted febrile myalgia, child' and 52 pediatric PFMS were found. In the literature, three patients did not have fever, and nineteen patients were not previously diagnosed with FMF as our patients. As a conclusion, PFMS may be the first manifestation of FMF. It should be suspected in cases with prolonged severe myalgia with or without fever, and high acute phase reactants.
Topics: Adolescent; Child; Child, Preschool; Diagnosis, Differential; Familial Mediterranean Fever; Female; Fever; Humans; Male; Myalgia
PubMed: 32895731
DOI: 10.1007/s00296-020-04696-0 -
Current Sports Medicine Reports 2016Calf pain is a common complaint among runners of all ages but is most frequent in masters athletes. This article focuses on injuries to the triceps surae or true 'calf... (Review)
Review
Calf pain is a common complaint among runners of all ages but is most frequent in masters athletes. This article focuses on injuries to the triceps surae or true 'calf muscles.' The most common calf injury is a tear of the medial gastrocnemius muscle (Tennis Leg) but other structures including the lateral gastrocnemius, plantaris and soleus also may be the cause of muscular pain. This article looks at the presentation, evaluation, and treatment of these injuries. We also highlight some examples of musculoskeletal ultrasound which is a valuable tool for rapid diagnosis of the cause and extent of injury.
Topics: Athletic Injuries; Combined Modality Therapy; Compression Bandages; Cumulative Trauma Disorders; Diagnosis, Differential; Humans; Hypothermia, Induced; Leg Injuries; Muscle, Skeletal; Myalgia; Return to Sport; Running
PubMed: 27618240
DOI: 10.1249/JSR.0000000000000292 -
Zeitschrift Fur Rheumatologie Aug 2015
Topics: Humans; Myalgia; Myositis; Rheumatic Diseases; Rheumatology
PubMed: 26169746
DOI: 10.1007/s00393-014-1545-2 -
Current Sports Medicine Reports Jul 2021Passive recovery techniques are popular and offer a diverse spectrum of options for athletes and the clinicians providing care for them. These techniques are intended to... (Review)
Review
Passive recovery techniques are popular and offer a diverse spectrum of options for athletes and the clinicians providing care for them. These techniques are intended to minimize the negative effects of training or competition, thus enabling the athlete a quicker return to peak performance. Current evidence demonstrates improved athlete recovery with compression garments, cold water immersion, partial body cryotherapy, hyperbaric oxygen, and vibratory therapies. Other popular modalities, such as compression devices, whole body cryotherapy, percussive gun-assisted therapy, neuromuscular electrical stimulation, and pulsed electromagnetic therapy lack convincing evidence concerning athlete recovery. This article seeks to review the current literature and offer the reader an updated understanding of the mechanisms for each modality and the evidence regarding each modality's potential benefit in an athlete's recovery strategy.
Topics: Athletes; Athletic Performance; Clothing; Cryotherapy; Electric Stimulation Therapy; Exercise; Humans; Hyperbaric Oxygenation; Immersion; Magnetic Field Therapy; Massage; Myalgia; Recovery of Function; Vibration
PubMed: 34234090
DOI: 10.1249/JSR.0000000000000859 -
Nutrients Mar 2018Given its pivotal role in fatty acid oxidation and energy metabolism, l-carnitine has been investigated as ergogenic aid for enhancing exercise capacity in the healthy... (Review)
Review
Given its pivotal role in fatty acid oxidation and energy metabolism, l-carnitine has been investigated as ergogenic aid for enhancing exercise capacity in the healthy athletic population. Early research indicates its beneficial effects on acute physical performance, such as increased maximum oxygen consumption and higher power output. Later studies point to the positive impact of dietary supplementation with l-carnitine on the recovery process after exercise. It is demonstrated that l-carnitine alleviates muscle injury and reduces markers of cellular damage and free radical formation accompanied by attenuation of muscle soreness. The supplementation-based increase in serum and muscle l-carnitine contents is suggested to enhance blood flow and oxygen supply to the muscle tissue via improved endothelial function thereby reducing hypoxia-induced cellular and biochemical disruptions. Studies in older adults further showed that l-carnitine intake can lead to increased muscle mass accompanied by a decrease in body weight and reduced physical and mental fatigue. Based on current animal studies, a role of l-carnitine in the prevention of age-associated muscle protein degradation and regulation of mitochondrial homeostasis is suggested.
Topics: Adult; Aged; Antioxidants; Carnitine; Dietary Supplements; Elder Nutritional Physiological Phenomena; Evidence-Based Medicine; Exercise; Humans; Muscle, Skeletal; Myalgia; Oxidative Stress; Performance-Enhancing Substances; Sarcopenia; Sports Nutritional Physiological Phenomena
PubMed: 29534031
DOI: 10.3390/nu10030349 -
Rheumatology International Jan 2019Protracted febrile myalgia syndrome (PFMS) in familial Mediterranean fever (FMF) patients is a vasculitic condition characterized by severe myalgia, fever, abdominal... (Review)
Review
Protracted febrile myalgia syndrome (PFMS) in familial Mediterranean fever (FMF) patients is a vasculitic condition characterized by severe myalgia, fever, abdominal pain, diarrhea, and arthralgia/arthritis episodes lasting 4-6 weeks. Symptoms typically resolve with corticosteroid treatment. However, in recent years, corticosteroid-resistant PFMS patients have been reported. We herein report five pediatric FMF patients complicated with PFMS. In addition, demographic findings, Mediterranean fever (MEFV) gene analysis, symptoms at disease onset, time interval between the diagnoses of FMF and PFMS, co-existent diseases, and treatment responses were evaluated. Resolution of all PFMS symptoms was accepted as complete response, while decreased symptoms without full recovery as partial response. We searched PubMed using the keywords 'protracted febrile myalgia' and 'anakinra', and reviewed the literature. There were three male and two female patients. Median age at the diagnosis of FMF was 6 (3-10) years. The time from diagnosis of FMF to the development of PFMS was changed from 0 to 8 (median: 2) years. All of the patients, except one, had homozygous M694V mutation. All patients were treated with corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDs) first. Two out of five patients were exhibited partial response, while others exhibited complete response. Patients with partial response to the conventional therapies were treated with anakinra, and achieved a great response after the first dose. Anti-interleukin-1 (IL-1) therapy may be a beneficial and a reasonable treatment option, when there is insufficient response to NSAID and corticosteroid therapies in pediatric PFMS patients.
Topics: Adolescent; Antirheumatic Agents; Child; Familial Mediterranean Fever; Female; Humans; Interleukin 1 Receptor Antagonist Protein; Male; Myalgia; Treatment Outcome
PubMed: 30293156
DOI: 10.1007/s00296-018-4163-5 -
Archives of Disease in Childhood Aug 2015Episodic myalgia is a common complaint in children and young adults. While many cases remain idiopathic even after extensive investigation, myalgia can be the first... (Review)
Review
Episodic myalgia is a common complaint in children and young adults. While many cases remain idiopathic even after extensive investigation, myalgia can be the first symptom of an underlying serious neuromuscular condition, and can be associated with an increased risk of such serious complications as rhabdomyolysis and malignant hyperthermia. We review and highlight the metabolic myopathies and other increasingly recognised muscle disorders that may present to paediatricians with episodic myalgia or isolated episodes of rhabdomyolysis, and propose a diagnostic algorithm for investigation of these complaints.
Topics: AMP Deaminase; Algorithms; Child; Energy Metabolism; Glycogen Storage Disease; Humans; Lipidoses; Muscle, Skeletal; Myalgia; Purine-Pyrimidine Metabolism, Inborn Errors; Recurrence; Rhabdomyolysis
PubMed: 25633066
DOI: 10.1136/archdischild-2014-307663