43

Venus Williams case /El caso de Venus Williams

Embed Size (px)

DESCRIPTION

Rheumatological approach to Venus Williams Case and Sjogrens Syndrome . A work presented by students to Dr Carlo V Caballero Uribe

Citation preview

Page 1: Venus Williams case /El caso de Venus Williams
Page 2: Venus Williams case /El caso de Venus Williams

Introduction

Many times throughout our lives we have idols, people you admire and put on a pedestal, so the untouchable and we believe that nothing can happen, but when something happens that we are ordinary people, flesh and blood, and so are we.

Page 3: Venus Williams case /El caso de Venus Williams

General Information

Page 4: Venus Williams case /El caso de Venus Williams
Page 5: Venus Williams case /El caso de Venus Williams
Page 6: Venus Williams case /El caso de Venus Williams

Performance

Page 7: Venus Williams case /El caso de Venus Williams

Venus came into this U.S. Open ranked 2011 as the number 36, that in terms of ranking, so we had to play first round that normally do not play top-ranked players.

Page 8: Venus Williams case /El caso de Venus Williams
Page 9: Venus Williams case /El caso de Venus Williams

Recent titles won by Venus have been to Dubai in 2009 and Acapulco in 2010, tournaments that are highly relevant and competitive sports.

Page 11: Venus Williams case /El caso de Venus Williams

Symptoms reported by Venus

Page 12: Venus Williams case /El caso de Venus Williams

No matter how hard I trained, I never had stamina

http://www.youtube.com/watch?v=IrVknOd581A

Page 13: Venus Williams case /El caso de Venus Williams

I can not get in shape

http://www.youtube.com/watch?v=rT6GSnBOo80

Page 14: Venus Williams case /El caso de Venus Williams

four years ago, I felt like I was not getting enough air but I was diagnosed with exercise-induced astma

http://www.youtube.com/watch?v=wZQjrYHrMAY

Page 15: Venus Williams case /El caso de Venus Williams

Joints pain, my hands started swelling, my joints started to kinda change shape

http://www.youtube.com/watch?v=lhG2TC0xNXc

Page 16: Venus Williams case /El caso de Venus Williams

I had some of the classic symptoms, dry eyes and dry mouth.

http://www.youtube.com/watch?v=EYVd5mSVzHM

Page 17: Venus Williams case /El caso de Venus Williams

I lost a lot of feel. Like, I would miss shots by feet and I just couldn’t feel my hands, and my hands would hurt when I was playing. http://www.youtube.com/watch?v=knCsOtjOMNM

Page 18: Venus Williams case /El caso de Venus Williams

I had swelling and numbness

http://www.youtube.com/watch?v=ZP1qMvyDJ5k

Page 19: Venus Williams case /El caso de Venus Williams

then fatigue which is really debilitating.

http://www.youtube.com/watch?v=oMpXo4b9rlQ

Page 20: Venus Williams case /El caso de Venus Williams

It's not that you have no energy – you just feel beat up

http://www.youtube.com/watch?v=wPQNzB3CbgM

Page 21: Venus Williams case /El caso de Venus Williams

I had a tough practice, I was just sitting there and it was taking an effort just to lift my arms

http://www.youtube.com/watch?v=fV_1wjxlvcI

Page 22: Venus Williams case /El caso de Venus Williams

if you wake every morning and feel you have a cold but you do not have one

http://www.youtube.com/watch?v=KVEL_eZoHqU

Page 23: Venus Williams case /El caso de Venus Williams

• 1. Shortness of breath (4 years ago)

• 2. Joint pain in hands associated with swelling, inflammation and deformity

• 3. Weakness to lift arms• 4. Fatigue, tiredness, and refers

‘she feel like she had a cold’ • 5. Sjogren's classic symptoms:

mouth and dry eyes

Page 26: Venus Williams case /El caso de Venus Williams

Are the respiratory problems of Venus associated with pulmonary fibrosis secondary to Sjogren?

•As described above it is possible to say that though Venus Williams comments that she was presenting respiratory difficulty, we do not believe that it is because a pulmonary fibrosis secundary to Sjogren, since the course of the disease has not been so chronic in her, we think that it is possible it is beacuse of the asthma induced by exercise, which was diagnosed 4 years ago, of course,we affirm this with the little information we have about the case, because of that information we can`t say she really has asthma. So it would be necessary to perform more complex tests to reject the presence fibrosis, that maybe is making a debut as atypical form

Page 27: Venus Williams case /El caso de Venus Williams

Differential diagnoses

• Evolution time (> 6 weeks), pain, inflammation and swelling in his hands anddeformity.

• Although there is no serological results • View ACR criteria for RA according to 2010

INFORMATION LINK

Rheumatoid arthritis

Page 28: Venus Williams case /El caso de Venus Williams

Chronic Fatigue Syndrome. • A person with fatigue of more than six months of duration,

but that has not suffered it for the whole life, does not associate it with the exercise, does not get better with the rest, has produced a substantial reduction to him or her in his/her daily activities and it is not possible to make clear for medical or psychiatric known reasons and that presents in addition four or any more of the following symptoms or signs:

• 1. Disorders of the memory or of the concentration • 2.Odinophagia• 3. Axilar or cervical adenophaties• 4.Osteomuscular pain.• 5. Articular pain.• 6.Headache of recent appearance.• 7. Not repairer sleep• 8. Post-exercise aches

Page 29: Venus Williams case /El caso de Venus Williams

• Of which Venus has presented substantial reduction in her daily activities and can not be explained by known medical or psychiatric causes, osteomuscular pains, articular pains, not repairer sleep and post- exercise aches.

INFORMATION LINK

Page 30: Venus Williams case /El caso de Venus Williams

Fibromyalgia•

Fibromyalgia is a common disease characterized by widespread musculoskeletal pain, stiffness, paresthesias, sleep disturbances and fatigue, painful sites and numerous large and symmetrical distribution. It is more common in women than in men, with a ratio of 9 to 1. The disease exists in almost all countries, the majority of ethnic groups and in all weather. Its prevalence in the general population of an American community under the 1990 classification criteria of the American College of Rheumatology is 3.4% in women and in men 0.55. Most patients are between 30 and 50 years of age.

Page 31: Venus Williams case /El caso de Venus Williams

• Clinical: Symptoms are characterized by widespread musculoskeletal pain, stiffness and fatigue. Patient sometimes complains of joint pain and joint swelling seen, but on physical examination abnormalities are not observed. The stiffness is almost always in the morning when you wake up and improve over the course of hours but in some cases persists throughout the day. Many patients complain of numbness in hands and feet and many are tired and exhausted since they are awake. In many cases, anxiety, or depression

INFORMATION LINK

Page 32: Venus Williams case /El caso de Venus Williams

• The symptoms reported by Venus Williams are related to fibromyalgia include:

• musculoskeletal pain• Fatigue• joint pain• Hand Numbness• anxiety

INFORMATION LINK

Page 33: Venus Williams case /El caso de Venus Williams

Polymyositis

• The polymyositis is a connective tissue disease characterized by the presence of muscular weakness of predominance proximal, in the escapular waist and pelvic, the respiratory muscles, of the swallowing and the myocardium.

Page 34: Venus Williams case /El caso de Venus Williams

• With regard to Venus we observe that she presents the muscular weakness, which we it see reflected in that she cannot lift the arms.

• Also she presents artralgias.• Although she also feels pain, and dry

eyes and dry mouth, these are not characteristic of the disease.

INFORMATION LINK

Page 35: Venus Williams case /El caso de Venus Williams

¿Se debió retirar Venus del Tenis?

Page 36: Venus Williams case /El caso de Venus Williams

¿Regresará Venus al Tenis?

Page 37: Venus Williams case /El caso de Venus Williams

Other testimoniesAt 53 years, Jenny Inga, president of the "Spanish Association of Sjögren Syndrome ', acknowledges that it is a fairly common disorder, although with different manifestations depending on the patient. "It's very prevalent, but not all have the same degree of severity. People who only suffer from impairment in the eyes and mouth are often seen in primary care, the most serious cases are referred to hospital."

Page 38: Venus Williams case /El caso de Venus Williams

• Victòria Espiniella, president of the 'Catalan Association of Sjögren Syndrome', in getting it diagnosed. "The average time to achieve a medical opinion is between six and eight years. In my case, they were eight. It all started one day in which, literally closed my eyes and could not open them. I went to the eye but treatments failed to overcome the problem. Any external agent hurts me. Gradually, the problem got worse until it affects the throat and started the muscle aches, tiredness and fatigue. "

Page 39: Venus Williams case /El caso de Venus Williams

Analyzing the case of Venus Williams, recording each and every one of the symptoms expressed by her, and addressing the study and the relationship of these as described in the literature, we conclude that differential diagnosis and surplus (rheumatoid arthritis, SLE, secondary Sjogren's syndrome, fibromyalgia, polymyositis, chronic fatigue syndrome), but a definitive diagnosis is impossible to give without laboratories and related studies and even more when there is little information about the onset of symptoms presented by Venus. What is clear is that the established approach is sound and that would be by check which of these diagnoses is that which corresponds in this case, all the while possible and we have key data that we analyze, discuss and complete data, which unfortunately are not yet within our reach.

CONCLUSION

Page 40: Venus Williams case /El caso de Venus Williams

Bibliography :

• http://books.google.com.co/books?id=o83v2ocK80IC&pg=PA471&lpg=PA471&dq=sindrome+sjogren+diagnosticos+diferenciales&source=bl&ots=8DAUmzL5Aq&sig=-3Br60B-NxpjfrOhSsl-_KyLXFk&hl=es&ei=omplTo2tMsOztweTq8yqCg&sa=X&oi=book_result&ct=result&resnum=10&ved=0CF4Q6AEwCQ#v=onepage&q&f=false

• http://www.cieph.com.br/site_novo/downloads/Livros/Sindrome%20de%20Sjogren%20en%20espanol.pdf.

• http://www.elmundo.es/elmundosalud/2011/09/01/noticias/1314888547.html• http://www.cieph.com.br/site_novo/downloads/Livros/Sindrome%20de%20Sjogren%2

0en%20espanol.pdf• http://www.niams.nih.gov/Portal_en_espanol/Informacion_de_salud/Sindrome_de_Sjog

ren/default.asp• http://www.encolombia.com/medicina/reumatologia/reuma82-01-manifestacionesis.ht

m• http://www.doctorponce.com/modules.php?name=Sections&op=viewarticle&artid=4

0• http://www.bbc.co.uk/mundo/ultimas_noticias/2011/09/110901_ultnot_eeuu_tenis_ve

nus_williams_en.shtml• aesjogren.org• http://www.revistacolombianadereumatologia.org/Portals/0/Descargas/3-enfermedad

%20quistica%209-2.pdf• http://www.medicalcriteria.com/site/index.php?option=com_content&view=article&id

=211:reusjs&catid=79:rheumatology&Itemid=80&lang=es

Page 41: Venus Williams case /El caso de Venus Williams

Interviews

• http://www.youtube.com/watch?v=fsIfOLuCNRM

• http://www.venustennis.com/interviews/usopen20071.html.  

Page 42: Venus Williams case /El caso de Venus Williams

Topic Information :

• http://www.sjogrens.org/home/about-sjogrens-syndrome

• www.sjogrens-guidebook.comhttp://www.wtatennis.com/page/Player/Stats/0,,12781~90 27,00.html

• http://www.elespectador.com/deportes/tenis/articulo-296239-venus-williams-continuara-su-carrera-pese-extrana-enfermedad

• http://es-us.deportes.yahoo.com/noticias/venus-williams-retira-us-open-182256776.html

http://vimeo.com/16671907

Page 43: Venus Williams case /El caso de Venus Williams