Stomach Pains

Posted on April 23, 2012 by admin

Stomach pains is a common problem that often causes people to go to the doctor.  Stomach pains can actually be due to conditions other than problems of the stomach.  Structures such as the pancreas, gallbladder, intestines, and many other structures are in the vicinity of the stomach and can cause similar pains and problems.  It is important to keep this in mind since the treatment of these conditions can be very different.

Most of the time, only a trained physician can narrow down the cause of your stomach pain.  Although stomach ulcers, gastritis or inflammation of the stomach lining and heart burn can cause stomach pains, more serious conditions such as cancer or problems of other nearby organs can also be the root cause.

Some of the common causes include pancreatitis which is an inflammation of the pancreas.  This most commonly occurs because of drinking too much alcohol or gallbladder stones blocking the tube that goes from the gallbladder to the intestine and pancreas.  Your doctor will order special blood tests to diagnose this condition which can potentially be life threatening.

Gallbladder stones can sometimes be a cause of pain in the region of the stomach.  The stones can block your gallbladder and cause intermittent pain or inflammation of the gallbladder wall.  If your gallbladder stones are causing you problems, you will likely need it removed.

Inflammation of the stomach lining or gastritis can also cause pain in this region.  Ulcers, reflux of stomach acid into the the esophagus can also cause pain in this region.  Often these conditions are further investigated with endoscopy by a gastrointestinal specialist.  Blood tests are often done to exclude pancreatitis and other inflammatory conditions.  Imaging such as ultrasound is done to look for gallbladder stones and other inflammatory conditions of the abdomen.  As always, only your doctor can properly diagnose your condition.  An early diagnosis will lead to a better outcome so see your doctor.

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Lump Behind The Knee

Posted on March 4, 2012 by admin

A lump behind the knee can be due to many causes.  One of the most common is a bakers cyst or collection of fluid behind the knee.  Other less common causes can include a variety of growths or tumors, aneurysms of the popliteal artery and abnormalities of the muscles and growths of the bones to name a few.  It is important to have your doctor examine the area since some of the conditions have typical findings.

In cases when it is not clear, your doctor may send you for an ultrasound of MRI.  These tests can more precisely show what the cause of the lump behind your knee is.  An ultrasound is best at showing that the lump is due to a bakers cyst.  An ultrasound is not as good for distinguishing other possibilities.  MRI is a test that can better show what the cause of a lump behind the knee is.

If you have had an injury, then a collection of blood may be the cause of a lump.  There is a major artery called the popliteal artery behind the knee which can develop an aneurysm.  An abnormal widening of the artery which can be dangerous.   Both benign and malignant growths can occur behind the knee.  If you have cancer, then spread from another site is can occur.  Primary tumors can also form behind the knee over time.  An MRI is best at showing these tumors.  It is important to see your physician immediately after discovering a lump since an early diagnosis can lead to better outcome and more treatment options.

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Testicle Lump

Posted on March 4, 2012 by admin

Testicular lumps are commonly found by either you or your doctor.  Testicular lumps are an important finding that can signify testicular cancer.  There are however other causes of lumps in and around the testicle which can be benign or harmless.  Sometimes your doctor may suspect that the lump is benign by the way it feels or it is located around the testicle.  In some cases you may get a test called an ultrasound.

A testicular ultrasound can localize a lump to the testicle or structures around it.  Lumps located next to the testicle are most commonly cysts in the epididymis.  These are typically benign cysts.  Cysts can also occur inside the testicle but are more rare.  Solid non cystic lumps inside the testicle are more concerning and can represent cancer.  In these cases, you will be referred to a specialist urologist.  He will then make a decision as to treatment which may include removal of the testicle.

Sometimes fluid can collect around your testicle and also cause a fullness or lump sensation.  This is called a hydrocele and can form due to a variety of causes.  Trauma, infection, inflammation are some of the causes.  In some cases, a hernia can protrude into the scrotum and cause a lump.  Your doctor will examine you and potentially make this diagnosis.  In some cases you may need a cat scan.

Whenever you feel a lump in the testicle, it is very important to see your doctor right away.  The lump will likely not go away with time.  Making a diagnosis early will always lead to a better prognosis, especially if it turns out to be cancer.

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Breast Lump

Posted on February 29, 2012 by admin

A breast lump that you or your doctor may feel is always concerning.  You should always see your doctor as soon as you can if you discover a breast lump.  While breast lumps can be due to harmless causes, cancer of the breast must be excluded anytime a breast lump is discovered.  When you see your doctor, he will examine you and obtain a detailed history.

You will likely be sent for additional testing to include mammograms, ultrasound and possibly MRI.  Depending on the results of the testing, you may need a biopsy to get a precise diagnosis.  At times, the imaging may not reveal the cause or it can be inconclusive.  Sometimes, the imaging does not even show the lump.  This can be due to normal breast tissue covering the lump.

If a lump is discovered as a cyst, then this is a harmless condition.  A cyst is full of fluid.  If it causes pain, than it can be drained.  Other causes of lumps can also be harmless such as a benign tumor called a fibroadenoma.  This is a common cause of benign lumps.  Of course the most important cause of a lump is cancer.  This will need to be diagnosed with a needle biopsy.

If you are diagnosed with cancer, you will often have to see a surgeon and an oncologist.  They will work together to determine and appropriate treatment plan for you.  The earlier a lump is diagnosed as cancer the better.  The more it grows and time goes by, the greater the chance for spread.  Always see your doctor as soon as you can for any lumps you have in the breast.  This goes for men and women.

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What Are Some Causes Of A Lump?

Posted on February 28, 2012 by admin

A lump is often found by you or your doctor.  Your doctor is best trained to determine what a lump may be based on the exam they do and the history they get from you.  There are many causes for a lump.  Enlarged lymph nodes or glands, cysts, fatty growths, cancerous growths amongst many other causes are possibilities.  So a lump is not something to take lightly.  This is especially true if it is changing rapidly, hurts, or you have had cancer in the past.

The best thing is to see your doctor as soon as possible.  Your doctor will examine you, get a good history, and then tell you what they think it may be.  It is also important where the lump is.  For a women, a lump in the breast can be very concerning.  This is especially true if it new.  You will need a mammogram and possible ultrasound to determine its nature.  Lumps in other parts of the body and skin can also occur almost anywhere.

For other parts of the body other than the breast, your doctor may order additional testing.  An ultrasound is a test commonly done as a first step.  Ultrasound is real good at showing cysts.  Cysts are lumps filled with water and in many cases harmless.  Some cysts have features which are not harmless, but an ultrasound will often show this.  An ultrasound is not so good at distinguishing amongst the many other causes of a mass.

Other tests for evaluating lumps include cat scans and MRI.  MRI is the better choice and may allow a confident diagnosis.  If this is not the cases, than a lump may need to be biopsied or removed by a surgeon.  If your doctor think the cause is an enlarged gland, than waiting for a short period of time like a month may be an option to see if the gland is enlarged because of an infection or inflammation you have.

In all cases, it is important to see your doctor right away.  Lumps can be harmless or they can be very dangerous and cancerous.  The earlier they are treated, the better your prognosis may be.  Not all dangerous lumps grow fast or change.  Some dangerous or cancerous lumps can grow slowly.  Lumps can also press on arteries and nerves and cause damage.

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Ultrasound For A Lump

Posted on February 28, 2012 by admin

Ultrasound is quick, non invasive, and good at showing what a lump may be in the body.  Your doctor may order an ultrasound for a lump in the body that either you discovered or the doctor found during an exam.  Often your doctor may have an idea of what a lump may be simply by examining it but wants to confirm his suspicion.

Some causes for a lump include a cyst or a mass filled with water.  A lipoma is another common cause of a benign mass.   A lipoma is a mass made up of benign fat.  Other more aggressive or dangerous causes of masses can be cancerous.  Ultrasound is very good at showing a benign cyst.  It is not great at distinguishing other causes of lumps.  So if an ultrasound fails to show something is a cyst, then you will likely need further testing.

Further testing may include another imaging test such as MRI or possibly a biopsy.  A tissue sample may be needed to know for sure what the lump is if it is not a cyst.  Sometimes cysts can also be suspicious since there may  be other components to them like nodules along the wall or septations.

So basically, an ultrasound is a good first step to determining what a lump may be.  if it is a simple cyst, then you can ignore it or have it aspirated or surgically removed.  If it is not a cyst, then you will likely need further testing.  If your doctor thinks it is something that is infected, than they may watch it or give you a trial of antibiotics.  In all cases, you should discuss your particular case with your doctor who will know the specifics best.

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Should You Get A Screening CT?

Posted on February 28, 2012 by admin

Screening CT can be done to look for disease in its early stages.  Screening CT is often offered by free standing imaging centers.  It is not covered by insurance so cash payment is usually required.  The test has no immediate complications since it is a painless imaging test.   The test is interpreted by a radiologist.  A highly specialized physician trained in imaging interpretation.

There are many problems with screening CT.  For one, the test is usually not done with the intravenous administration of dye.   The dye helps detects more subtle abnormalities in the abdominal organs.  Screening CT may pick up many abnormalities which are not clearly benign.  Say a nodule on your adrenal gland or a spot in the lung.  This may require further follow up or in some cases, an invasive procedure like a biopsy.

When you get a screening CT of your lungs, it is more likely that a spot in your lung will be found which is most likely benign.  But it will not be clear if this is benign from the test itself.  Therefore you may need at least 2 years of follow up and potentially dangerous radiation.  In some cases, a biopsy will be needed for larger nodules greater than 1 cm in size.

Another danger of getting a screening CT is the radiation you get.  Although it is not clearly known how much radiation is needed to induce a cancer, any radiation above background has the potential to increase your risk.  The cost can also run you back hundreds to thousands of dollars.  The potential anxiety of having to live with a finding that needs follow up for years, or an invasive procedure can really ruin the quality of your life.

The screening CT will also not detect many cancers and diseases even if they exist.  One example is colon cancer which is detected with colonoscopy.  Smaller cancers will not be detected in many cases since the test is most frequently done without dye.  So be very careful and think long and hard before you commit to one of these tests.  It may sound good to detect a disease early in its potentially curable phase, but you may end up doing more harm than good.  Discuss your plans with your doctor who knows your medical history best.

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Calcifications In The Pelvis On X Rays

Posted on August 23, 2011 by admin

Calcifications in the pelvis on x rays is a common finding that has many different causes.  Calcifications form from calcium in the soft tissues causing them to harden.  On x rays, the calcification looks like a bright spot of varying size.  The x rays you have are performed by technologists and interpreted by a radiologist physician.  He will often describe in his report what the calcifications may be based on their appearance and location.  Thinking about some of the structures in the pelvis such as the uterus, ovaries, ureters, lymph nodes, prostate, etc. can give an idea where the calcifications can originate from.

Calcifications in the pelvis which look like popcorn can often be seen with uterine fibroids.  These are benign tumors which can cause symptoms due to pressure on other structures in the pelvis or vaginal bleeding.  The prostate gland in men often has small calcifications which are usually found in the lower middle portion of the pelvis.  Tumors of the ovaries can also calcify, particularly dermoid tumors which can actually have teeth in them.

Calcifications in the pelvis can be due to a stone which has passed from the kidney.  Often the stone will obstruct urine flow and the patient will have severe pain.  The calcification will often be on one side of the pelvis and usually smaller than a centimeter.  Often a CT scan is done to further evaluate.  Stones can also form in the urinary bladder.

Other locations for calcifications includes lymph nodes.  Lymph nodes often calcify after an infection or inflammatory process has healed. Sometimes treated tumors can develop calcifications in lymph nodes.  Small calcifications can develop in the appendix and are called apendicoliths.  Sometimes these can obstruct the appendix and cause appendicitis.  Calcifications can also form in the region of the buttock from prior injections of medicines.  Calcifications can form in the bones but these are not true calcifications, but appear as such on x rays in some cases.   A CT scan always be performed to evaluate the cause of a calcification if it is not clear based on the x ray.

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Ultrasound For Abnormalities Of The Uterus

Posted on August 23, 2011 by admin

Ultrasound of the pelvis is commonly used to evaluate the pelvic structures including the uterus.  Ultrasound is a commonly done test which uses special sound waves to image the inside of the body.  The test is performed by a specialized technologist and interpreted by a radiologist.  The radiologist then issues a report which will be used by your doctor to determine the best treatment or possible referral to a specialist.  The most common abnormalities include fibroid tumors, cancers, polyps and hyperplasia of the lining of the uterus, and complications related to pregnancy.

Fibroid tumors are commonly identified on ultrasound. Fibroid tumors are masses within the uterus and have a characteristic appearance. Fibroid tumors often cause problems by pushing on structures such as the bladder and rectum which lie in the region of the uterus.  This can cause pressure, pain, urinary urgency amongst other symptoms.  If the fibroid tumor is near the lining or endometrium of the uterus, then vaginal bleeding can occur.  Fibroids can be treated with surgery called myomectomy or hysterectomy which is complete removal of the uterus.  In recent times, specially trained radiologist have been treating fibroids without surgery by stopping blood flow to the fibroids which shrinks them and reduces symptoms.

Cancer of the uterine lining are most common in women who have undergone menopause.   Cancer of the endometrium is often diagnosed when a women develops vaginal bleeding and is post menopausal.  An ultrasound will often be done showing thickening of the endometrium.  This will often prompt a biopsy and diagnosis.  This cancer can spread to other parts of the body so additional imaging tests may be done to look for this spread.   Other abnormalities of the uterine lining include polyps and thickening which can be due to hormonal imbalances.

Complications of pregnancy are additional findings often seen when an ultrasound of the uterus is done.  The full discussion is beyond the scope of this article.  Abnormalities can involve the placenta, fetus, and uterine itself.  In some cases, additional imaging tests such as pelvic MRI will allow an even closer look at the structure of the uterus.  Only your doctor will best know how to treat and work up your condition.  He will best know your history and any testing you have had in the past.

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Posterior Mediastinal Masses

Posted on August 23, 2011 by admin

The mediastinum is the central component of the chest between the lungs.  The mediastinum contains the heart, great vessels, lymph nodes and nerves.  The mediastinum is divided into three compartments anatomically.  The most posterior one being adjacent to the spine. Occasionally, masses or tumors can form in the mediastinum.  Patients often have no symptoms and these tumors are diagnosed because of an x ray or cat scan done for some other reason.  The x ray and cat scan will be read by a specialty trained physician radiologist who will issue a report to your physician.

One of the most common tumors in the posterior mediastinum are related to the nerves.  These are most often nerve sheath, ganglion and paraganglion cell in origin.  Many of these tumors are benign and have no potential to spread.  They cause harm by pressing on important structures such as the spinal cord.   Occasionally, an enlarged thyroid gland can extend into the posterior mediastinum.  This enlargment is usually benign, but can sometimes harbor a neoplasm.

Enlarged lymph nodes can also cause a mass in the posterior mediastinum.  Enlarged lymph nodes can be due to infection, tumor, or spread of tumor from another part of the body.  Many times, tumor will cause lymph nodes to enlarge in other parts of the mediastinum and body.  Abnormalities of the thoracic spine can also cause masses.  This can be due to infections or tumors.  Part of the aorta is also located in the posterior mediastinum, and an aneurysm can cause a mass.  In all cases of a posterior mediastinal mass, it is important to get appropriate follow up care and possible referral to a surgeon or oncologist depending on the diagnosis.  In many cases of a posterior mediastinal mass, a biopsy will be needed for accurate diagnosis. In some cases, you may need chemotherapy and radiation.

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