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  Discussion on "Unfriendly" cortisone
Author Message
Member:
Vickiann

Posted on Wednesday, Nov 2, 2005 - 10:13 am:

Dr. O -- RE: cortisone shot/infection: Interesting article in the Orlando newspaper today. After 3 years of misdiagnosis, being ill and losing weight, a correct diagnosis was finally made after analyzing bone chips from the pelvic bone of Gator football player Jarvis Moss. He had a staph infection feasting on his body for almost 3 years after a cortisone shot to the hip. He had been misdiagnosed with everything from gastritis to a hernia, urinary tract infection, and just being lazy before the truth was finally found. 6 weeks of IV antibiotics plus nutrients made him well again. Just wanted to post this in case there are horses out there that could be similarly affected.
Member:
Corinne

Posted on Wednesday, Nov 2, 2005 - 10:32 am:

Vicki,
I have found your post most interesting. I am working on therapeutic modalities in my grad school studies of sports medicine at the United States Sports Academy. Do you mind if I bring your finding up in class? It should yield a terrific discussion.

v/r
Corinne
Member:
Vickiann

Posted on Wednesday, Nov 2, 2005 - 2:24 pm:

Of course -- I am all for sharing information that helps others. More than likely you could pull up the entire article on this on the internet at OrlandoSentinel.com --- It is on Page D 1 (Sports) in the November 2, 2005 paper. "Moss making up for lost time."
Moderator:
DrO

Posted on Thursday, Nov 3, 2005 - 8:14 am:

An interesting case for sure but not really useful as a diagnostic example for members. More of an example of what NOT to do I would say. When faced with a diagnostic challenge you should NOT start with a list of diseases in your head and then try to make the clinical signs you see "fit one". You start with the clinical signs and then try to discover the pathological process producing them. Once the pathology is accurately defined, then is the step where you confidently work on a diagnosis.

Perhaps the same backward process described above is what delayed the correct diagnosis of the Gator. They took a set of clinical signs, did not find the pathology, and tried to make it fit a disease. It was not until the pathology was found that the correct diagnosis could be made.
DrO
Member:
Vickiann

Posted on Thursday, Nov 3, 2005 - 10:43 am:

My point is that if a cortisone shot has been given and the patient is in worse pain and suffering after it, with increased and new signs of illness that continues, the possibility of such an infection should at least be considered. Unfortunately, this malady was allowed to progress to the point of complete and painful physical collapse with this young man unable to stand, straighten up or even get dressed. The doctors (who I am sure are GREAT doctors) blew it on this one, and team doctors even thought he "was just complaining a lot." Coach Meyer intervened and had four doctors run tests to find the cause. What you say about how to make a diagnosis is correct. Too many medical diagnoses are made in a rapid try this, try that, hit or miss manner, (without looking at all the facts) and too often symptoms are treated without addressing the actual pathology, which continues, grows and destroys. And in some cases, the creed of "do no harm" is violated.
Moderator:
DrO

Posted on Friday, Nov 4, 2005 - 9:15 am:

We do not know enough of the specifics of the above case to make the conclusions you draw Vicki. I often find newspaper reports terribly inaccurate. You are making a diagnosis (the doctors blew this one) without knowing all the facts. As presented it does represent an example of how not to practice medicine. When treatment is given and illness worsens, reevaluation should be done. But I am not ready to condemn the doctors or the therapy given or use it as a diagnostic/therapeutic basis for cases in the future.
DrO
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