Monocytosis ICD-10, Symptoms, Causes, Treatment

Monocytosis is defined as an increase in peripheral blood monocytes greater than 0.8 X 109 / L and is predominantly associated with inflammatory and immune disorders. It is difficult to connect elevated levels of monocytosis with some specific diseases, unlike neutrophils. One of the classical monocytosis associations is tuberculosis infection.

However, other infections such as subacute bacterial endocarditis, salmonellosis, listeriosis, syphilis, leprosy and brucellosis may also be associated with monocytosis. The monocytosis often occurs during the recovery phase of acute infection or after removal of the bone marrow. Monocytosis may also be associated with haematological malignancies such as myelodysplastic syndrome and certain types of acute and chronic leukemias. Interestingly, 25% of patients with Hodgkin's disease have been reported to have monocytosis.

Monocytosis may also accompany many non-hematopoietic malignancies and some vascular diseases of collagen. Thus, the detection of a monocytosis is relatively non-specific and can be associated with various haematological disorders that might be benign or malignant in natures. The mononuclear phagocytic system is also the major cell system affected in several storage disorders. These storage disorders are usually inherited disorders or enzyme deficiencies that are necessary for the storage and processing of lipids. Macrophages become the most obvious morphological anomalies in these diseases as they are filled with lipid materials that can not  be further digested.

Monocytosis ICD-10, Symptoms, Causes, Treatment

Monocytosis Symptoms

Monocytosis  is associated with inflammatory response in case of any infection, pathological disorder or autoimmune disease. Symptoms are not so obvious to distinguish it clearly from other disorders. However, some commonly reported symptoms are swelling around body especially in extremities, joints pain due to inflammatory response, fever like condition. These symptoms may vary from patient to patient depending upon the underlying cause.

Monocytosis Causes

Monocytosis is an unusual finding in children. Infection with intracellular micro-organisms or parasites is the most common cause of monocytosis. Infections include malaria, trypanosomiasis, Rickettsia disease and Listeria monacytogertes. Persistent monocytosis with unusual forms may precede various lymphoproliferative disorders and histopathological disorders such as hodgkin's disease and juvenile myelomonocytic leukemia. Some other possible causes include ulcerative colitis, regional neuritis, lipid storage disorders, neutrophil suppression, collagen vascular disease etc.

Monocytosis Treatment

Monocytosis itself does not require any treatment because it is always a manifestation of disease. So, it is important to rule underlying cause of monocytosis before treatment. If monocytosis is associated is with infection like brucellosis or tuberculosis then antibacterial therapy is much effective to bring this condition at normal level. However, if it is associated with auto immune disorder then steroidal therapy and immunosuppressant might be required.

Monocytosis ICD-10

Following code is used for monocytosis in ICD-10

D72.821--Monocytosis (symptomatic)--billable
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Pseudarthrosis ICD-10, Symptoms, Causes, Treatment

Pseudarthrosis ( non-union) of the tibia results from a pathological fracture that may occur before or after birth. It can be preceded by the anterolateral bend of the tibia and sometimes associated with neurofibromatosis. The pseudarthrosis encounter in the distal tibial diaphysis can be assessed by severity.

When pseudarthrosis develop, it is not necessary to require a surgical correction. pseudarthrosis can not be considered as the main cause of ongoing symptoms. In fact, many pseudarthrosis are asymptomatic and in some degenerative conditions, the preferred treatment is observation. However, in cases where the inability to achieve a stable anhrodesis can lead to the development of deformation, consider surgery, even in the absence of pain.

Progression of kyphosis and the development of osteophytes neurocompressive led to reports of isolated cases at the end of paraparesis and even torn aortic pseudo-aneurysm. When pseudarthrosis is accompanied by pain or other symptoms, a careful reassessment of the patient should be performed to establish a causal relationship between the pseudarthrosis and the symptoms. In general, symptomatic lumbar pseudarthrosis causes back pain as the most important feature. Pain is usually close to the level of the pseudarthrosis and is axial in one place.

Indications for surgical repair of pseudarthroses include myelopathy, structural instability, deformity or irreversible back pain. Surgical repairs of pseudarthroses might be helpful in improving overall clinical outcome. However, patients and physicians should be aware that for symptomatic pseudarthrosis repeated surgery is associated with higher rates of recurrent pseudanhrosis and clinical failure.

Pseudarthrosis ICD-10, Symptoms, Causes, Treatment

Pseudarthrosis Symptoms

Many patients with pseudarthrosis show no special symptoms, and for these patients additional treatment and evaluation are not always needed. If necessary, x-rays and computer tomography of the spine can be used to determine whether there is a spinal fusion occurred or not. Moreover, precise physical examination provides valuable information to rule out pseudarthrosis suspect.

Pseudarthrosis Causes

The exact underlying cause of pseudarthrosis is still not fully understood but many researchers believed that genetic predisposition is very important in this disease. Some other factors that might have some correlation with this disease are

  • Hyperthyroidism
  • Bone Demineralization
  • Distraction
  • Infection
  • Skeletal muscle rupture
  • Nutritional deficiency
  • Bone fragility

Pseudarthrosis Treatment

Treatment of pseudarthroses in asymptomatic individuals is non-operative, and up to 30% does not  require surgical intervention. Surgical treatment is required for people with unstable or defective structure and suitable for those patients who remain symptomatic despite conservative measures. Treatment of the back pseudarthroses can be complicated in the context of pre-decompression because there is an increased risk of accidental durotomy during surgical dissection. In these cases, anterior cervical fusion is preferred.

A non-surgical treatment can be considered as management for delayed fusion in the absence of neurological compromise or progression of deformity. Treatment strategies include bracing, restricted activity, and careful monitoring. When non surgical treatment does not provide adequate response then surgical intervention will be required.

Pseudarthrosis ICD-10

Following code is used for pseudarthrosis in ICD-10

M96.0--Pseudarthrosis after fusion or arthrodesis--billable
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