Madelungs deformity is usually characterized by malformed wrists and wrist bones and is often associated with Léri-Weill dyschondrosteosis. It can be bilateral (in both wrists) or just in the one wrist. It has only been recognized within the past hundred years. Named after Otto Wilhelm Madelung (1846–1926), a German surgeon, who described it in detail, it was noted by others. Guillaume Dupuytren mentioned it in 1834, Auguste Nélaton in 1847, and Joseph-François Malgaigne in 1855. Signs and symptoms
It is a congenital subluxation or dislocation of the ulnas distal end, due to malformation of the bones. Sometimes, minor abnormalities of other bone structures, often caused by disease or injury, such as a fracture of the distal end of the radius with upward displacement of the distal fragment. The deformity varies in degree from a slight protrusion of the lower end of the ulna, to complete dislocation of the inferior radio-ulnar joint with marked ulnar deviation of the hand. Severe deformities are associated with congenital absence or hypoplasia of the radius.The male:female rate of this disorder is 1:4. The incidence is unknown, and there is no described racial predominance. Even though Madelungs Deformity is considered a congenital disorder, symptoms sometimes arent seen until adulthood. In most cases, symptoms find their onset during midchildhood. At this age, the relatively slower growth of the ulnar and palmar part of the radius, leads to an increasingly progressive deformity. Pain and deformity are the main symptoms patients present with.
Extrapulmonary tuberculosis is tuberculosis (TB) within a location in the body other than the lungs. It accounts for an increasing fraction of active cases, from 20 to 40% according to published reports, and causes other kinds of TB. These are collectively denoted as "extrapulmonary tuberculosis". Extrapulmonary TB occurs more commonly in immunosuppressed persons and young children. In those with HIV, this occurs in more than 50% of cases. Notable extrapulmonary infection sites include the pleura (in tuberculous pleurisy), the central nervous system (in tuberculous meningitis), the lymphatic system (in scrofula of the neck), the genitourinary system (in urogenital tuberculosis), and the bones and joints (in Pott disease of the spine), among others. Infection of the lymph nodes, known as tubercular lymphadenitis, is the most common extrapulmonary form of tuberculosis. An ulcer originating from nearby infected lymph nodes may occur and is painless. It typically enlarges slowly and has an appearance of "wash leather". When it spreads to the bones, it is known as skeletal tuberculosis, a form of osteomyelitis. Tuberculosis has been present in humans since ancient times.Central nervous system infections include tuberculous meningitis, intracranial tuberculomas, and spinal tuberculous arachnoiditis.Abdominal infections include gastrointestinal tuberculosis (which is important to distinguish from Crohns disease, since immunosuppressive therapy used for the latter can lead to dissemination), tuberculous peritonitis, and genitourinary tuberculosis.A potentially more serious, widespread form of TB is called "disseminated tuberculosis", also known as miliary tuberculosis. Miliary TB currently makes up about 10% of extrapulmonary cases.