LIHAKSEN/JÄNTEEN KIINNITYSKOHDAN TULEHDUS

[Bb]

Lähettäjä: Soijuv Lähetetty: 6.5.2004 21:00

Lihaksen/jänteen kiinnityskohdan tulehdus saattaa olla useasti syynä borrelioosia sairastavien "omituisiin" kipuihin esim. kyynärpäässä, polvissa, akilles jänteessä. Tätä asiaa ei kuitenkaan tunneta hyvin, joten monet saavat erilaisiin lihas-luustokipuihinsa hoidoksi kortisonia vaikka oireen aiheuttaja borrelioosia sairastavilla saattaa olla esim. juuri edellä mainittu tulehdus. Seuraavassa yhden lääkärin kertomus asiasta:


"The tissue that is the transition from muscle to tendon is called the enthesium. We find the most important clinical enthesium at elbow, knee, occasionally at the coracobrachialis and Achilles tendon insertion. It's a pretty standard series of questions in neurotoxin patients-do you have 'tennis elbow" without overuse, unusual heel cord pain and the like. You'll find a lot of musculoskeletal diagnoses made without question that aren't musculoskeletal at all. I had an orthopedist wife in for her Lyme not too long ago; she had already gotten three cortisone shots for her "extensor epicondylitis" (elbow pain) that was simply Lyme. The orthopod has become a nice referral source since then-when his patients don't get better with his shots, he sends them down for an evaluation. Now, I asked him how come he did the unnecessary procedures-but they weren't unnecessary in his mind until they didn't work.

The enthesium is richly endowed with nerve fibers, including Golgi tendon organs and the like. The brain really wants to know how much stretch there is on tendons. I have always wondered how come other areas of enthesium weren't more important in neurotoxic illness.

So, this most recent biotoxin event for me brought a partial answer. My left hip was killing me. Everytime I straightened my leg or began to move it to the outside, oh boy, what a reminder that something wasn't right. I've got three dead disks in my LS spine-surely, that was it. No, soreness was independent of the range of motion of the back and the pain wasn't radicular. Hip was fine, nothing to suggest a synovitis. It wasn't a trochanteric bursitis, this was something entirely new to me.The soreness was rally bad after flying in one of those shoe horn seats in the commuter jet to Montreal and back.

All the rest of my biotoxin symptoms, and VCS too, were responding to cholestyramine, but this new soreness was bizarre.

Actually the soreness was in the tensor fascia lata. This little muscle sits on the very outside of the upper thigh and leads to the iliotibial band, connective tissue that helps secure the quadriceps muscles. The enthesium here was quite substantial. Sure enough, and thankfully, the soreness disappeared just over night-I just hadn't been patient enough.

Well, this was neat. A new muscle to ask about in my enthesium history. And don't you know, here was the young girl from Florida in yesterday. She had been diagnosed with Lyme, but I think the massive mold contamination in her workplace in Naples is the problem. And there was her tensor fascia lata enthesopathy that had been diagnosed first as a disk problem and then as a bursitis. Nope, it was an enthesopathy. I am certain that I would have missed it if I hadn't had the problem too.

How many other people have I overlooked tensor fascia lata enthesopathy? Anyone else overlook it, too?

Happiness is finding something new right under your nose, right, Dad?

Ritch Shoemaker MD