Let’s talk about bum abscess! 🍑 📌 Anorectal abscess refers to a collection of pus in the anal or rectal region 📌It can be caused by blockage of anal glands which can lead to infection. It may also be due to infection of anal fissure or sexually transmitted infection (STI). 📌 Most patients are between the ages of 20 to 60 with a mean age of 40. Male>Female. 📌The abscess can happen in 4 different areas (as shown by the diagram above) 👉🏽Perianal (most common) 👉🏽Ischiorectal 👉🏽Intersphincteric 👉🏽Supralevator Risk factors that increase your chances of getting the abscess: 📍Diabetes 📍Inflammatory bowel disease 📍Immunosuppressed patients Signs and symptoms: 🔥Discharge of pus from the rectum 🔥Painful and hardened tissue/lump around the anus 🔥Fever 🔥Constipation 🔥Pain is usually worse when sitting down, cough and when you poo Treatment 🏥Surgery to drain the abscess under local or general anaesthetics, the wound is normally left open (no stitches) and is packed with special dressing until it is healed. However, some may spontaneously drain by themselves and not need any surgery. 🏥Pain relief 🏥Stool softener 🏥Antibiotics - usually not needed unless if you have diabetes or have problem fighting off infection (immunosuppressed patients) Complications 👉🏽Anorectal abscess can lead to formation of fistula (small tunnel that develops between the end of the bowel and the skin near the anus (where poo leaves the body)) in up to 30% of patients 👉🏽Recurrence 👉🏽Scarring 👉🏽Systemic infection - infection in the bloodstream

The Knee - menisci - they need to move properly when we flex/extend our knees A patient took a MRI and consulted 2 orthopaedic specialists after a fall, which revealed horizontal tear of medial meniscus, fissure of retro-patellar cartilage. Operation done and it was found to have something that surprised the specialist - a quite crucial loosening of the anterior horn of lateral meniscus undetected by the MRI was found during operation, which if left unrepaired, would render the patient functional problem e.g. walking, despite the repair of medial meniscus be done. Menisci are shock absorbers, friction preventers of the knee, they protect the cartilage and improve knee joint stability. It moves posteriorly whenever the knee flexes, with medial meniscus slides back from 5 to 6mm while lateral meniscus slides back from 10 to 12mm. Before taking the MRI, patient came for a treatment. I found the medial meniscus was pretty good in movement while the lateral meniscus stuck and did not move to the front in assessment. MRI results and orthopaedists’ comments both focused on the medial meniscus and I was convinced that I was wrong in the assessment. It was until the operation was done and the surgeon found out that the lateral meniscus was functionally more problematic than the medial one, that it was in dysfunction despite a pretty ok structure. MRI can only showed something in static motion that has structural problems. Problems arise during movement (motor dysfunction) cannot be picked up by MRI. Defective kinetics do not depend on a structural lesion or misalignment of the meniscus or joint. “Osteopathy matters most is NOT a joint components position but rather its capacity for movement” (Barral JP & Croibier A, 2011) While MRI is not sensitive enough to pick up some conditions, it doesn’t mean the patient’s sufferings is psychological or that they can be denied. To be able to help patients, we cannot only study, but to train our hands to be able to pick up the problems of the patient, to understand the lesion, and to facilitate the joint to restore proper movement. To do this, you have to understand where the problems lie.

"Living In a Forgotten Fissure I," acrylic and colored pencil on paper, 2014. . #illustration #illustratorsoninstagram #traditionalart #acrylicpainting #trannguyen #pleats #monochromatic