Aa
pott spine/ spine tb
my son nikhil jindal aged 20 years had neck pain and stiffness abt a month back followed by fever (100 to 101.6) after 3-4 days of neck pain started.
on 26 mar he was put on topcef 200mg 2 tabs a day for 3 days all medicines were given to patient
on 27 mar his blood was tested and report was as under
TLC 12,600,
DLC- NEUTROPHILS 69.2, LYMPHOCYTES 21.3, MONOCYTES 7.8, EOSINOPHILS 1.1, BASOPHILS 0.6
ESR(WESTREGEN'S) 102
S.G.P.T.(A.L.T.) 31.23
WIDAL TEST WAS NEGATIVE
BASED ON ABOVE TESTS DOCTOR SUGGESTED FOR CHEST X RAY
0n 29 mar he was put on topcef 200mg tab mobizox for another 3 days all medicine wr given to patient
x ray report of chest was normal
but still fever (99 to 101) and pain continues
doctor suggested x ray cervical spine on 29 mar
report was as under
straightening of spine is seen with loss of normal curvature suggestive of muscle spasm
irregularity of articular surface of c5 seen
prevertebral soft tissue thickening is seen
cystic lesion seen anteriorly at body of c6
disc spaces are normal
no cervical rib is seen
ADVISED - MRI CERVICAL SPINE
DOCTOR REFERRED THE PATIENT TO ORTHOPEDIC BASED ON ABOVE REPORT
ortho doc put on the following treatment
inj monocef 1gm I.V - BD
inj Acenac MR 1 BD
these injections were injected for 5 days
doctor suggested for MRI cervical spine
report dated 05 apr his test report was as under
there is straightening of cervical spine
cervicodorsal vertebral bodies from c2 to d4 level reveal focal or diffuse marrow signal intensity alterations hypointense on T1W1 and hyperintense on STIR images, suggestive of marrow edema/inflation. marrow edema is most marked in c6 vertabral bodies.
large prevertabral abscess is seen in cirvicodosral region displaying hypo to isointense signals on T2W1. abscess is predominantly seen on the left side of midline involving preverbtal muscles with mild extensions on right side in right preverbtal muscles.
cranially it is extending upto c2 verteba and caudally till d4 in posterior aspect of superior mediastium. abscess is also seen to extending into left c5-6 and c6-7 neural foramina with mild posterolateral wall of oropharynx and upper esophagus.
CSF shows normal signal intensity. cord shows normal morphology and signal.
CV junction is normal.
IMPRESSION - MR imaging features aree suggeastive of infective spondylitis with large pre vertebal abscess from c2 to d4 and mild epidural extension at c6 level.
Etiology - likely tubercular
his blood test report dated 06 apr was as under
TLC 10,600
DLC- NEUTROPHILS 68.4, LYMPHOCYTES 22.1, MONOCYTES 7.6, EOSINOPHILS 1.4, BASOPHILS 0.5
ESR(WESTREGEN'S) 110
S.G.P.T.(A.L.T.) 48.57
TSH- 2.020
BASED ON ABOVE INVESTIGATIONS and his continue temp (99 to 100) and neck pain
doctor put him on
AKT 4 1 kit in morning
oflaxin 1 OD 400 mg
tab liv 52 2tabs BD
a second opinion was taken and it was suggested that patient is suffering from pott spine( cervical spine)
and he put on
AKT 4 daily for 1 month
tab pyridoxine 10 mg daily for 1 month
philadiflion collar(MGRM)
also complete bed rest was advised
the patient started taking AKT4 and pyridoxine from 06 apr as par above suggestion
another opinion was taken and it was suggested
to start phase I
rest in bed for 22 hrs for 1 and half month
tab Rcinex 300+600 mg daily in morning
tab oflox 400 mg daily in morning
shelcal-1
cobadex-1
ciplection 1
all above for 5 monthes
somi brace to be worn by pateint
kindly suggest if it is 100% sure that my son is infected with pott spine
or any other test is reqd to be done for confirmation
i want to give treatment after only 100% confirmation of the disease and not in doubt pls
how can it be confirmed
3 doctors have suggested 3 types of treatment although all 3 diagnosed same disease and other one suggested for COTS
sir, i m in total confusion
kindly advice which medicine is the best in india for pott spine
an advice from an expert doctor like u will be a real help to humankind
regards
10 apr 10
pawanj
on 26 mar he was put on topcef 200mg 2 tabs a day for 3 days all medicines were given to patient
on 27 mar his blood was tested and report was as under
TLC 12,600,
DLC- NEUTROPHILS 69.2, LYMPHOCYTES 21.3, MONOCYTES 7.8, EOSINOPHILS 1.1, BASOPHILS 0.6
ESR(WESTREGEN'S) 102
S.G.P.T.(A.L.T.) 31.23
WIDAL TEST WAS NEGATIVE
BASED ON ABOVE TESTS DOCTOR SUGGESTED FOR CHEST X RAY
0n 29 mar he was put on topcef 200mg tab mobizox for another 3 days all medicine wr given to patient
x ray report of chest was normal
but still fever (99 to 101) and pain continues
doctor suggested x ray cervical spine on 29 mar
report was as under
straightening of spine is seen with loss of normal curvature suggestive of muscle spasm
irregularity of articular surface of c5 seen
prevertebral soft tissue thickening is seen
cystic lesion seen anteriorly at body of c6
disc spaces are normal
no cervical rib is seen
ADVISED - MRI CERVICAL SPINE
DOCTOR REFERRED THE PATIENT TO ORTHOPEDIC BASED ON ABOVE REPORT
ortho doc put on the following treatment
inj monocef 1gm I.V - BD
inj Acenac MR 1 BD
these injections were injected for 5 days
doctor suggested for MRI cervical spine
report dated 05 apr his test report was as under
there is straightening of cervical spine
cervicodorsal vertebral bodies from c2 to d4 level reveal focal or diffuse marrow signal intensity alterations hypointense on T1W1 and hyperintense on STIR images, suggestive of marrow edema/inflation. marrow edema is most marked in c6 vertabral bodies.
large prevertabral abscess is seen in cirvicodosral region displaying hypo to isointense signals on T2W1. abscess is predominantly seen on the left side of midline involving preverbtal muscles with mild extensions on right side in right preverbtal muscles.
cranially it is extending upto c2 verteba and caudally till d4 in posterior aspect of superior mediastium. abscess is also seen to extending into left c5-6 and c6-7 neural foramina with mild posterolateral wall of oropharynx and upper esophagus.
CSF shows normal signal intensity. cord shows normal morphology and signal.
CV junction is normal.
IMPRESSION - MR imaging features aree suggeastive of infective spondylitis with large pre vertebal abscess from c2 to d4 and mild epidural extension at c6 level.
Etiology - likely tubercular
his blood test report dated 06 apr was as under
TLC 10,600
DLC- NEUTROPHILS 68.4, LYMPHOCYTES 22.1, MONOCYTES 7.6, EOSINOPHILS 1.4, BASOPHILS 0.5
ESR(WESTREGEN'S) 110
S.G.P.T.(A.L.T.) 48.57
TSH- 2.020
BASED ON ABOVE INVESTIGATIONS and his continue temp (99 to 100) and neck pain
doctor put him on
AKT 4 1 kit in morning
oflaxin 1 OD 400 mg
tab liv 52 2tabs BD
a second opinion was taken and it was suggested that patient is suffering from pott spine( cervical spine)
and he put on
AKT 4 daily for 1 month
tab pyridoxine 10 mg daily for 1 month
philadiflion collar(MGRM)
also complete bed rest was advised
the patient started taking AKT4 and pyridoxine from 06 apr as par above suggestion
another opinion was taken and it was suggested
to start phase I
rest in bed for 22 hrs for 1 and half month
tab Rcinex 300+600 mg daily in morning
tab oflox 400 mg daily in morning
shelcal-1
cobadex-1
ciplection 1
all above for 5 monthes
somi brace to be worn by pateint
kindly suggest if it is 100% sure that my son is infected with pott spine
or any other test is reqd to be done for confirmation
i want to give treatment after only 100% confirmation of the disease and not in doubt pls
how can it be confirmed
3 doctors have suggested 3 types of treatment although all 3 diagnosed same disease and other one suggested for COTS
sir, i m in total confusion
kindly advice which medicine is the best in india for pott spine
an advice from an expert doctor like u will be a real help to humankind
regards
10 apr 10
pawanj
MEDICAL PROFESSIONAL
Hello!
AKT 4 is same as the present medications, only some dose adjustments. I already confirmed to you that he needs 4 drugs isoniazid, rifampicin, ethambutol and pyrazinamide for 2 months and followed by isoniazid and rifampicin for further 6 months for his Tuberculosis.
Regular follow up and protein diet has already been discussed with you.
Follow your senior physician's advice and believe in his diagnosis and treatment and give some time. If it is tuberculosis it will respond for sure!
Take care!
AKT 4 is same as the present medications, only some dose adjustments. I already confirmed to you that he needs 4 drugs isoniazid, rifampicin, ethambutol and pyrazinamide for 2 months and followed by isoniazid and rifampicin for further 6 months for his Tuberculosis.
Regular follow up and protein diet has already been discussed with you.
Follow your senior physician's advice and believe in his diagnosis and treatment and give some time. If it is tuberculosis it will respond for sure!
Take care!
dear dr vinod
how r u
as advised by u i got the tests repeat on 28 apr i am forwarding you the reports of my son nikhil
before the start of treatment of AKT4, live 52, pyridoxine 10 mg and after 3 weeks of treatment
pls study these reports and give ur valuable advice
reports dtd 06 apr 2010 before AKT4
HAEMATOLOGY
Haematology performed on Fully Automatic 5 part differential COULTER Haematology Analyzer
Investigation Result Unit Reference Range
Haemogram
Haemoglobin. : 13.1 g/dl M : 13 - 18 g/dl
F : 11.5 - 16.5 g/dl
TLC . : 10,600 /c.mm. A : 4000 - 11000 /c.mm.
DLC.
Neutrophils : 68.4 % A : 50 - 80 %
Lymphocytes : 22.1 % A : 25 - 50 %
Monocytes : 7.6 % A : 2 - 10 %
Eosinophils : 1.4 % A : < 6 %
Basophils : 0.5 % A : < 2 %
E.S.R. (Westregen's) : 110 mm/1st Hr F : < 20 mm/1st Hr
M : < 15 mm/1st Hr
R.B.C. Count. : 4.66 mil./cmm M : 4.5 - 6.5 mil./cmm
F : 3.8 - 5.8 mil. /cmm
Packed Cell Volume : 40.2 % M : 40 - 54 %
F : 37 - 47 %
Platelets Count. : 343 thousand/cmm A : 150 - 450 thousand/cmm
M.C.V : 86 fl A : 76 - 96 fl
M.C.H : 28.2 pg. A : 27 - 32 pg.
M.C.H.C : 32.7 % A : 30 - 35 %
RDW : 11.6 % A : 11.6 - 14 %
Peripheral Blood Smear :
RBCs are normocytic normochromic. No significant anisopoikilocytosis is seen.
WBC series is normal in number & distribution. Platelets are adequate. No
haemo-parasite is seen. No abnormal / immature cell is seen
BIO-CHEMISTRY REPORT
Biochemistry tests performed on Fully Automatic ROCHE COBAS 400 INTEGRA & HITACHI 902 / Semi Auto RA-50
/ AVL 9180 / D-10
Investigation Result Unit Reference Range
B. Glucose Fasting. : 78.69 mg/dl A : 70 - 110 mg/dl
Liver Function Test
S. Bilirubin (Total) : 0.32 mg/dL A : < 1 mg/dL
---------------------------------------------------------------------------------------------------
S. Bilirubin (Conjugated) : 0.12 mg/dL A : < 0.6 mg/dL
S. Bilirubin (Unconjugated) : 0.20 mg/dL A : 0.1 - 1 mg/dL
S.G.O.T.(A.S.T) : 20.41 U/L
S.G.P.T.(A.L.T ) : 48.57 U/L
S. Alkaline Phosphatase : 74.77 U/L
S. Protein. : 8.60 gm/dL A : 6.6 - 8.7 gm/dL
S. Albumin : 4.01 gm/dL A : 3.5 - 5.2 gm/dL
S. Globulin : 4.59 gm/dl
A/G. Ratio : 0.87 : 1
HORMONES ANALYSIS REPORT
HORMONE ANALYSIS DONE ON COBAS e411 ELECTRO CHEMILUMINESCENCE & ABBOTT AXSYM SYSTEMS
Investigation Result Unit Reference Range
S. TSH : 2.020 uIU/ml A : 0.27 - 4.2 uIU/ml
reports dtd 28 apr 2010 after 3 weeks of treatment
HAEMATOLOGY
Haematology performed on Fully Automatic 5 part differential COULTER Haematology Analyzer
Investigation Result Unit Reference Range
Haemogram
Haemoglobin. : 14.7 g/dl M : 13 - 18 g/dl
F : 11.5 - 16.5 g/dl
TLC . : 8,300 /c.mm. A : 4000 - 11000 /c.mm.
Differential Leucocyte count
Neutrophils : 57.7 % A : 50 - 80 %
Lymphocytes : 31.7 % A : 25 - 50 %
Monocytes : 7.0 % A : 2 - 10 %
Eosinophils : 3.0 % A : < 6 %
Basophils : 0.6 % A : < 2 %
E.S.R. (Westregen's) : 45 mm/1st Hr
RBC Count 5.29
Packed Cell Volume (Hematocrit) : 42.7 %
Platelets Count. : 217 thousand/cmm A : 150 - 450 thousand/cmm
M.C.V : 81 fl A : 76 - 96 fl
M.C.H : 27.9 pg. A : 27 - 32 pg.
M.C.H.C : 34.5 % A : 30 - 35 %
RDW : 13.9 % A : 11.6 - 14 %
Peripheral Blood Smear :
RBCs are normocytic normochromic. No significant anisopoikilocytosis is seen.
BIO-CHEMISTRY REPORT
Biochemistry tests performed on Fully Automatic ROCHE COBAS 400 INTEGRA & HITACHI 902 / Semi Auto RA-50
/ AVL 9180 / D-10
Investigation Result Unit Reference Range
B. Glucose Fasting. : 75.46 mg/dl A : 70 - 110 mg/dl
Liver Function Test
S. Bilirubin (Total) : 0.22 mg/dL A : < 1 mg/dL
S. Bilirubin (Conjugated) : 0.10 mg/dL A : < 0.6 mg/dL
S. Bilirubin (Unconjugated) : 0.12 mg/dL A : 0.1 - 1 mg/dL
S.G.O.T.(A.S.T) : 32.47 U/L M : < 40 U/L
S.G.P.T.(A.L.T ) : 75.94 U/L M : < 41 U/L
S. Alkaline Phosphatase : 72.14 U/L M : 40 - 129 U/L
S. Protein. : 8.40 gm/dL A : 6.6 - 8.7 gm/dL
S. Albumin : 4.74 gm/dL A : 3.5 - 5.2 gm/dL
S. Globulin : 3.65 gm/dl
A/G. Ratio : 1.30 : 1
Investigation Result
S. TSH : 3.520
regards
rajni jindal 9811035568
how r u
as advised by u i got the tests repeat on 28 apr i am forwarding you the reports of my son nikhil
before the start of treatment of AKT4, live 52, pyridoxine 10 mg and after 3 weeks of treatment
pls study these reports and give ur valuable advice
reports dtd 06 apr 2010 before AKT4
HAEMATOLOGY
Haematology performed on Fully Automatic 5 part differential COULTER Haematology Analyzer
Investigation Result Unit Reference Range
Haemogram
Haemoglobin. : 13.1 g/dl M : 13 - 18 g/dl
F : 11.5 - 16.5 g/dl
TLC . : 10,600 /c.mm. A : 4000 - 11000 /c.mm.
DLC.
Neutrophils : 68.4 % A : 50 - 80 %
Lymphocytes : 22.1 % A : 25 - 50 %
Monocytes : 7.6 % A : 2 - 10 %
Eosinophils : 1.4 % A : < 6 %
Basophils : 0.5 % A : < 2 %
E.S.R. (Westregen's) : 110 mm/1st Hr F : < 20 mm/1st Hr
M : < 15 mm/1st Hr
R.B.C. Count. : 4.66 mil./cmm M : 4.5 - 6.5 mil./cmm
F : 3.8 - 5.8 mil. /cmm
Packed Cell Volume : 40.2 % M : 40 - 54 %
F : 37 - 47 %
Platelets Count. : 343 thousand/cmm A : 150 - 450 thousand/cmm
M.C.V : 86 fl A : 76 - 96 fl
M.C.H : 28.2 pg. A : 27 - 32 pg.
M.C.H.C : 32.7 % A : 30 - 35 %
RDW : 11.6 % A : 11.6 - 14 %
Peripheral Blood Smear :
RBCs are normocytic normochromic. No significant anisopoikilocytosis is seen.
WBC series is normal in number & distribution. Platelets are adequate. No
haemo-parasite is seen. No abnormal / immature cell is seen
BIO-CHEMISTRY REPORT
Biochemistry tests performed on Fully Automatic ROCHE COBAS 400 INTEGRA & HITACHI 902 / Semi Auto RA-50
/ AVL 9180 / D-10
Investigation Result Unit Reference Range
B. Glucose Fasting. : 78.69 mg/dl A : 70 - 110 mg/dl
Liver Function Test
S. Bilirubin (Total) : 0.32 mg/dL A : < 1 mg/dL
---------------------------------------------------------------------------------------------------
S. Bilirubin (Conjugated) : 0.12 mg/dL A : < 0.6 mg/dL
S. Bilirubin (Unconjugated) : 0.20 mg/dL A : 0.1 - 1 mg/dL
S.G.O.T.(A.S.T) : 20.41 U/L
S.G.P.T.(A.L.T ) : 48.57 U/L
S. Alkaline Phosphatase : 74.77 U/L
S. Protein. : 8.60 gm/dL A : 6.6 - 8.7 gm/dL
S. Albumin : 4.01 gm/dL A : 3.5 - 5.2 gm/dL
S. Globulin : 4.59 gm/dl
A/G. Ratio : 0.87 : 1
HORMONES ANALYSIS REPORT
HORMONE ANALYSIS DONE ON COBAS e411 ELECTRO CHEMILUMINESCENCE & ABBOTT AXSYM SYSTEMS
Investigation Result Unit Reference Range
S. TSH : 2.020 uIU/ml A : 0.27 - 4.2 uIU/ml
reports dtd 28 apr 2010 after 3 weeks of treatment
HAEMATOLOGY
Haematology performed on Fully Automatic 5 part differential COULTER Haematology Analyzer
Investigation Result Unit Reference Range
Haemogram
Haemoglobin. : 14.7 g/dl M : 13 - 18 g/dl
F : 11.5 - 16.5 g/dl
TLC . : 8,300 /c.mm. A : 4000 - 11000 /c.mm.
Differential Leucocyte count
Neutrophils : 57.7 % A : 50 - 80 %
Lymphocytes : 31.7 % A : 25 - 50 %
Monocytes : 7.0 % A : 2 - 10 %
Eosinophils : 3.0 % A : < 6 %
Basophils : 0.6 % A : < 2 %
E.S.R. (Westregen's) : 45 mm/1st Hr
RBC Count 5.29
Packed Cell Volume (Hematocrit) : 42.7 %
Platelets Count. : 217 thousand/cmm A : 150 - 450 thousand/cmm
M.C.V : 81 fl A : 76 - 96 fl
M.C.H : 27.9 pg. A : 27 - 32 pg.
M.C.H.C : 34.5 % A : 30 - 35 %
RDW : 13.9 % A : 11.6 - 14 %
Peripheral Blood Smear :
RBCs are normocytic normochromic. No significant anisopoikilocytosis is seen.
BIO-CHEMISTRY REPORT
Biochemistry tests performed on Fully Automatic ROCHE COBAS 400 INTEGRA & HITACHI 902 / Semi Auto RA-50
/ AVL 9180 / D-10
Investigation Result Unit Reference Range
B. Glucose Fasting. : 75.46 mg/dl A : 70 - 110 mg/dl
Liver Function Test
S. Bilirubin (Total) : 0.22 mg/dL A : < 1 mg/dL
S. Bilirubin (Conjugated) : 0.10 mg/dL A : < 0.6 mg/dL
S. Bilirubin (Unconjugated) : 0.12 mg/dL A : 0.1 - 1 mg/dL
S.G.O.T.(A.S.T) : 32.47 U/L M : < 40 U/L
S.G.P.T.(A.L.T ) : 75.94 U/L M : < 41 U/L
S. Alkaline Phosphatase : 72.14 U/L M : 40 - 129 U/L
S. Protein. : 8.40 gm/dL A : 6.6 - 8.7 gm/dL
S. Albumin : 4.74 gm/dL A : 3.5 - 5.2 gm/dL
S. Globulin : 3.65 gm/dl
A/G. Ratio : 1.30 : 1
Investigation Result
S. TSH : 3.520
regards
rajni jindal 9811035568
pls also give ur specific advice on raised value of SGPT(ALT)- 75.94
wat are its reasons, repercussions on lever and its remedies
do u suggest any change in medicine due to the raised value
wat are its reasons, repercussions on lever and its remedies
do u suggest any change in medicine due to the raised value
MEDICAL PROFESSIONAL
Hello!
All the medications he is taking are metabolized in the liver, nothing to worry as his serum bilirubin values are normal.
Give him LIV 52 and Pyridoxine supplements and only go for some rational tests in the future. Monitor his X-rays, ESR which are sufficient.
Take care!
All the medications he is taking are metabolized in the liver, nothing to worry as his serum bilirubin values are normal.
Give him LIV 52 and Pyridoxine supplements and only go for some rational tests in the future. Monitor his X-rays, ESR which are sufficient.
Take care!
thanx a lot sir
i have few more doubts
kindly give ur views
1.isnt sudden fall of ESR to 45 from 110 within three weeks is noticable?
2.or it may happen?
3.what is the relation of ESR to AKT4?
4.in the report before AKT4 started the Lymphocytes was 22.1(less) but in latest report it is 31.7(within limits). is improvement due to AKT4 medicine?
5.now SGPT(ALT) wl come down or it may rise further?
6.what are the future complications on the health of lever after the AKT 4 course is completed?
7.since akt4 was started, 10 ml (2 times a day)of liv 52 and Pyridoxine 10 mg a day is being given to him. do u suggest any change in it?
8.even than akt4 can effect the liver?
9.can we go for MRI in place of X Rays?
10.is MRI more harmful than X Ray? or X Ray is more harmful?
11.what is the periodicity we go for X Rays/MRI and ESR tests?
sir, i really appreciate ur prompt and very correct response. this is really a human service u r doing to the patients
regards
i have few more doubts
kindly give ur views
1.isnt sudden fall of ESR to 45 from 110 within three weeks is noticable?
2.or it may happen?
3.what is the relation of ESR to AKT4?
4.in the report before AKT4 started the Lymphocytes was 22.1(less) but in latest report it is 31.7(within limits). is improvement due to AKT4 medicine?
5.now SGPT(ALT) wl come down or it may rise further?
6.what are the future complications on the health of lever after the AKT 4 course is completed?
7.since akt4 was started, 10 ml (2 times a day)of liv 52 and Pyridoxine 10 mg a day is being given to him. do u suggest any change in it?
8.even than akt4 can effect the liver?
9.can we go for MRI in place of X Rays?
10.is MRI more harmful than X Ray? or X Ray is more harmful?
11.what is the periodicity we go for X Rays/MRI and ESR tests?
sir, i really appreciate ur prompt and very correct response. this is really a human service u r doing to the patients
regards
MEDICAL PROFESSIONAL
Hello!
I will answer only relevant questions for your son.
1) ESR denotes his infection with Tuberculosis, but this is not as specific as X-rays.
3) AKT4 is a 4 drug antibiotic which kills the tuberculosis bacteria so all this improvement.
4) Lymphocyte level coming to normal is a good sign
5) SGPT may stabilize and ultimately come to normal if there are no further complications with respect to his liver.
6) Liver is a highly regenerative organ and it can withstand these antibiotics course and after 2-3 months he will only take isoniazid and rifampicin so the load will decrease.
7) Continue the same dose of LIV52 and Pyridoxine.
9) X-rays are enough and you can go for them every month for initial 2 months and then after 3 months. Furthermore 3 X-rays are enough.
10) Let his doctor suggest if he needs anything extra.
Take care!
I will answer only relevant questions for your son.
1) ESR denotes his infection with Tuberculosis, but this is not as specific as X-rays.
3) AKT4 is a 4 drug antibiotic which kills the tuberculosis bacteria so all this improvement.
4) Lymphocyte level coming to normal is a good sign
5) SGPT may stabilize and ultimately come to normal if there are no further complications with respect to his liver.
6) Liver is a highly regenerative organ and it can withstand these antibiotics course and after 2-3 months he will only take isoniazid and rifampicin so the load will decrease.
7) Continue the same dose of LIV52 and Pyridoxine.
9) X-rays are enough and you can go for them every month for initial 2 months and then after 3 months. Furthermore 3 X-rays are enough.
10) Let his doctor suggest if he needs anything extra.
Take care!
Have an Answer?
You are reading content posted in the Orthopedics Community
Find out if PRP therapy right for you.
Tips for preventing one of the most common types of knee injury.
Tips and moves to ease backaches
How to bounce back fast from an ankle sprain - and stay pain free.
Patellofemoral pain and what to do about it.
A list of national and international resources and hotlines to help connect you to needed health and medical services.
