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Swollen Lymph Nodes and Thorasic Outlet Syndrome and BEXTRA scan
Mar 21, 2006

HIV + 20 years, HAART for 10 years of varying degrees. Currently on Reyataz/Saquinavir Epivir, Viread and Acyclovir. Feel GREAT! After two years of severe arm and hand pain, numbness and tingling, thought to have been brought on by a repetitive motion injury, I have recently had two surgeries in an attempt to resolve. The surgeries, micro-discectomy or disc decompression at C5/C6/C7 L and R, no fusion. Symptoms have improved but not totally resolved. I have never been comfortable that the true source of the problem was ever identified. During the diagnosis process, I had an MRI which revealed multiple swollen lymph nodes in my neck and mandible. Biopsy showed no cancer. At the time, the nodes were not visible but lately I have had two episodes where the nodes have swollen dramtically to the size of golf balls and figuring out why has now become a focus. First time, they responded quickly to Augmentin. I haven't yet been treated for the recent episode. Also, in the past few years, I have noticed that even though I am VERY fit, body fat of 7%, my head/face appears heavy almost slightly distorted to me, especially in the neck area, even the back of my neck (not buffalo hump area, closer to the ears). My question is, could it be that these swollen lymph nodes are causing the nerve compression that lead to the pain in my arms and swollen head all along? Btw, I am not trying to get one over on my neurosurgeon; I know that I have received a very high level of care from him and my PCP, but even with the the advances in MRI and CT scan technology, diagnosing nerve pain is not an easy thing to do. I wonder if I should invest in a BEXTRA scan to determine exactly what it is that is making my face appear larger. I understand this scan will differentiate between bone, fat and other tissues in the body to determine a precise composition. Do you know of it?

Response from Dr. Henry

I am not familiar with a BEXTRA scan. Dexa scans are used to look at the relative distribution of body fat and bone density. Physical examination, careful history taking, nerve conduction studies and EMGs are among the evaluations used to assess the degree of nerve damage and possible site of the problem. KH



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