The HEALTH : November 2018 | Page 23

NOVEMBER, 2018 | THE HEALTH iron men Sports induced shoulder instability Orchitis caused by infection S HOULDER instability affects the younger age group as they are more inclined towards sports. Kelana Jaya Medical Centre Consul- tant Orthopaedics & Traumatology Dr Mohd Ikraam Ibrahim explained that shoulder instability can be divided into two groups - one that is acquired which is usually caused by trauma while the other which is congenital meaning that the patient has generalised ligament laxity. “We need to ascertain whether this is purely due to trauma which is more common or if the patient is actually born with ligament laxity. If it is caused by trauma, it is not always treated with surgery.” “Despite that, we always tell patients that 70 per cent would have chances of recurrence, because the tissue (the labrum) does not heal properly. The labrum refers to the capsule or the tissue which is usually torn. So, unhealed tissue will cause instability in the dislocated area. However, in generalised laxity, the pre-existing capsule of the patient is already loosened, hence treatment is different.” In trauma cases, he said that patients are advised to do a stabilisation surgery if it recurs for the second time. This can be done through a keyhole surgery or an ultrascopic repair. As for patients with generalised laxity, they are sent for physiotherapy to strengthen the muscle. “This is done so the muscle will hold the shoulder. Although it is repaired, the 23 ORCHITIS is an inflamma- tion of one or both testicles that usually stems from an infection. What causes orchitis? Anterior instability accounts for 95 per cent of acute traumatic dislocations. thing when the shoulder is pushed up as the tissue is good,” he said. Symptoms recurrence rate is high as the own tissue is lax.” Diagnosing shoulder instability Mohd Ikraam revealed that diagnosis would begin with physical examination. “This is when patients would be appre- hensive – where when aggravated – the patient would stop the surgeon from doing so. In a normal patient, they won’t feel a Among the common indication of shoulder instability include limited overhead activ- ity —extension and external rotation— as this is where the shoulder is weak. Meanwhile, the chances for those 40 years and above to suffer from shoulder instability are slim as they aren’t as active in sports compared to younger persons. Even if it should get dislocated at the age of 45 years old, the chances of recurrence is only 10 per cent as compared to younger patients. Gleneagles Kota Kinabalu Consultant Urologist Dr Wong Teck Boon described orchitis as the result of either a viral or bacterial infection. “The most common virus that causes the condition is mumps. It often occurs in boys after puberty. Orchitis tends to develop four to six days after the mumps begin to appear.” “As for bacterial infec- tion, this can come in the form of urinary tract infections and sexually transmitted infections such as gonorrhoea, chlamydia and epididymitis.” Symptoms According to Wong, patients with orchitis may exhibit symptoms such as testicular swelling, redness, pain and tenderness, fever and chills, nausea, malaise and fatigue, headache, body aches and pain during passing of urine.