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What Causes Severe Pain Between The Arm And Shoulders?
Question: Hi Doctor, last time I had pain between left arm and shoulder at back and was ok for few days but today again while I was walking through stairs, it has come back, pls advise. I am uploading my spine BMD for 2015 and 14 also for refrence
wanted to know also, what should be Z score and T Score for me as it is varying from year to year, 2014, 15 and 16, pls scroll down page, first page is blank and what is mean "IMPRESSION: Overall study shows osteoporosis. Osteoporosis seen in Wards triangle"
wanted to know also, what should be Z score and T Score for me as it is varying from year to year, 2014, 15 and 16, pls scroll down page, first page is blank and what is mean "IMPRESSION: Overall study shows osteoporosis. Osteoporosis seen in Wards triangle"
Brief Answer:
Answers about T and Z scores
Detailed Answer:
Hi XXXXXXX
Normal T score should be between higher than - 1
Osteopenia is - 1 to - 2.5
Osteoporosis is lesser than - 2.5 (for example - 3) at spine or femur neck.
T score compares the bone density in your bones like the femur neck, to that of the femur in normal healthy males.
Z score is the number of standard deviations of the BMD measurements above or below that of he quotes of the same age and sex. A Z-score of -2 or below should trigger investigations for underlying disease to exclude other causes of bone mineral loss.
That means, your T and Z scores should normally be higher than - 1, that is for example - 0.8 for example.
You do have Osteoporosis because your T and Z scores are more than - 2 (Osteopenia or weak bones) or more than - 2.5 (Osteoporosis or severe weak bones).
Answers about T and Z scores
Detailed Answer:
Hi XXXXXXX
Normal T score should be between higher than - 1
Osteopenia is - 1 to - 2.5
Osteoporosis is lesser than - 2.5 (for example - 3) at spine or femur neck.
T score compares the bone density in your bones like the femur neck, to that of the femur in normal healthy males.
Z score is the number of standard deviations of the BMD measurements above or below that of he quotes of the same age and sex. A Z-score of -2 or below should trigger investigations for underlying disease to exclude other causes of bone mineral loss.
That means, your T and Z scores should normally be higher than - 1, that is for example - 0.8 for example.
You do have Osteoporosis because your T and Z scores are more than - 2 (Osteopenia or weak bones) or more than - 2.5 (Osteoporosis or severe weak bones).
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
is that reason for pain between shoulder and arm and is @-3 T/Z score is at very low or risky?
what investigation I should do to know exact cause of bone mineral loss and what I should do to avoid further deterioration and strengthen bones
Rgds
what investigation I should do to know exact cause of bone mineral loss and what I should do to avoid further deterioration and strengthen bones
Rgds
Brief Answer:
Vitamin D deficiency
Detailed Answer:
The pain in that region could be attributed to stress, Cervical spondylosis or even low Vitamin D.
You can get tested for Serum Vitamin D3 levels, Serum Electrolytes.
Do get physiotherapy in the form of TENS therapy in the interscapular region and shoulder strengthening exercises.
It you have pain radiating from the back of the neck to the shoulder blades then it is possible you have Cervical spondylosis. Avoid using a think pillow under your head. Apply hot packs to the affected region.
Go for daily brisk walking for 45 minutes, wearing a sunscreen of SPF50 at 3:00PM everyday. This will help to increase your Vitamin D levels that are needed to increase your bone mineral density and strength.
Do upload your Vitamin D3 levels for my review so that I can suggest further management accordingly.
Vitamin D deficiency
Detailed Answer:
The pain in that region could be attributed to stress, Cervical spondylosis or even low Vitamin D.
You can get tested for Serum Vitamin D3 levels, Serum Electrolytes.
Do get physiotherapy in the form of TENS therapy in the interscapular region and shoulder strengthening exercises.
It you have pain radiating from the back of the neck to the shoulder blades then it is possible you have Cervical spondylosis. Avoid using a think pillow under your head. Apply hot packs to the affected region.
Go for daily brisk walking for 45 minutes, wearing a sunscreen of SPF50 at 3:00PM everyday. This will help to increase your Vitamin D levels that are needed to increase your bone mineral density and strength.
Do upload your Vitamin D3 levels for my review so that I can suggest further management accordingly.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Thanks Dr. Pls check my profile, I had Vit D test last year in May 16, and had about 42.23ng/ml. Pls advise.
Rgds
is Vit D and Serum Vit D3 are different test?
what is serum electrolytes test?
Rgds
is Vit D and Serum Vit D3 are different test?
what is serum electrolytes test?
Brief Answer:
Answers
Detailed Answer:
Thanks for the reply
Your Vitamin D level seems normal. Vitamin D3 is 1-2,5 dihydrochocecalciferol which is the most active form of Vitamin D.
Your Vitamin F levels seem adequate.
Serum Electrolytes will measure Serum Calcium and phosphorus. Also get tested for Parathyroid HORMONE (PTH) levels as well. This can reflect abnormal bone turnover.
Answers
Detailed Answer:
Thanks for the reply
Your Vitamin D level seems normal. Vitamin D3 is 1-2,5 dihydrochocecalciferol which is the most active form of Vitamin D.
Your Vitamin F levels seem adequate.
Serum Electrolytes will measure Serum Calcium and phosphorus. Also get tested for Parathyroid HORMONE (PTH) levels as well. This can reflect abnormal bone turnover.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Hello Doctor, I had PTH also tested same time, and value was 86.9 pg/ml, report is there in profile
Hello Doctor,
I had tested for PTH, Phosphorus, Cal and Alkaline Phosphorus in May 2016, and values are as below, all reports are attached in profile
PTH - 86.9 pg/ml
Serum Inorganic Phosphorus - 3.37 mg/dl
Total Cal - 9.79 mg/dl
Alkaline Phosphorus - 83.40
2 years before also, I had tested for Vit D and value was 11 and last year improved to 42 and PTH improved from 110 to 86.9 pg/ml
now you pls review and advise reason for osteoporosis
Rgds
Hello Doctor,
I had tested for PTH, Phosphorus, Cal and Alkaline Phosphorus in May 2016, and values are as below, all reports are attached in profile
PTH - 86.9 pg/ml
Serum Inorganic Phosphorus - 3.37 mg/dl
Total Cal - 9.79 mg/dl
Alkaline Phosphorus - 83.40
2 years before also, I had tested for Vit D and value was 11 and last year improved to 42 and PTH improved from 110 to 86.9 pg/ml
now you pls review and advise reason for osteoporosis
Rgds
Brief Answer:
No reports available
Detailed Answer:
I'm sorry, but no such report is available other than just your BMD Report.
Please upload all your concerned reports. I need to see your lab values normal range too, to understand your problem.
No reports available
Detailed Answer:
I'm sorry, but no such report is available other than just your BMD Report.
Please upload all your concerned reports. I need to see your lab values normal range too, to understand your problem.
Above answer was peer-reviewed by :
Dr. Prasad
Hello Doctor
I have uploaded reports and old reports, I don't have with me right now but values were as below
2 years before, I had tested for Vit D was 11 and and PTH was at 110 to 86.9 pg/ml
Rgds
Hello Doctor
I have uploaded reports and old reports, I don't have with me right now but values were as below
2 years before, I had tested for Vit D was 11 and and PTH was at 110 pg/ml
Rgds
I have uploaded reports and old reports, I don't have with me right now but values were as below
2 years before, I had tested for Vit D was 11 and and PTH was at 110 to 86.9 pg/ml
Rgds
Hello Doctor
I have uploaded reports and old reports, I don't have with me right now but values were as below
2 years before, I had tested for Vit D was 11 and and PTH was at 110 pg/ml
Rgds
Brief Answer:
Good sign
Detailed Answer:
Since the PTH is reducing to nearly normal level, it indicates that the disease is being treated well.
Usually high PTH indicates that the none is losing calcium. But when PTH is coming to normal range means that the bone is getting back its calcium.
This is a good sign.
Good sign
Detailed Answer:
Since the PTH is reducing to nearly normal level, it indicates that the disease is being treated well.
Usually high PTH indicates that the none is losing calcium. But when PTH is coming to normal range means that the bone is getting back its calcium.
This is a good sign.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
but what could be cause for high PTH sir, better to know do's and don't to take care of PTH and calcium and Vit D
Brief Answer:
Sestamibi scan
Detailed Answer:
Usually PTH can rise when you have Vitamin D deficiency.
It cash also rise due to overactivity of the Parathyroid glands in your neck.
I suggest you get 6 weekly testing of PTH. If it is normal, not to worry. Otherwise get a Sestamibi scan of the Parathyroid glands to find the reason for it's overactivity.
Sestamibi scan
Detailed Answer:
Usually PTH can rise when you have Vitamin D deficiency.
It cash also rise due to overactivity of the Parathyroid glands in your neck.
I suggest you get 6 weekly testing of PTH. If it is normal, not to worry. Otherwise get a Sestamibi scan of the Parathyroid glands to find the reason for it's overactivity.
Above answer was peer-reviewed by :
Dr. Nagamani Ng
6 weekly testing of PTH, what it mean? r u saying every week testing for 6 week?
Rgds
Rgds
Brief Answer:
Once every 6 weeks
Detailed Answer:
Test PTH once every 6 weeks.
Once every 6 weeks
Detailed Answer:
Test PTH once every 6 weeks.
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Remy Koshy
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