Mysterious syndrome likely genetic

Dear Dr. Roach:I’d like information about a rare condition called MayerRokitansky-Kuster-Hauser syndrome. The person I am asking about was born in 1958 without a uterus or vagina, and has one kidney. Were there any medicines or pills given at this time to pregnant women that could cause this condition?

D.D.

Answer: Mayer-Rokitansky-Kuster-Hauser syndrome, also called Mullerian agenesis, is not as rare a condition as you might suppose (1 in 5,000 births).

Researchers originally thought that this condition was caused by maternal exposure to medication or infection. Thalidomide (1954) and diethylstilbestrol (1938) are drugs given around the same time that caused the potential for serious harm to the developing fetus, but the current thinking is that MRKH is a genetic condition. No link between an environmental cause and the condition has been found.

You can read more about it at tinyurl.com/MRKH syndrome.

Dear Dr. Roach:Will

hyaluronic acid injections in the knees increase the risk for stroke in a person with a stroke history? I had strokes about 20 years ago and have been on blood thinning meds (first aspirin, then Aggrenox) since then. The suspected stroke cause was vasculitis, although this was never definitively determined.

Recently, I have had severe knee pain. After I tried physical therapy with no success and cortisone injections with limited success, the orthopedist has suggested that I try hyaluronic acid injections. Is this safe? Can such injections increase my risk for another stroke? If hyaluronic acid would not be appropriate for me, I would appreciate any other nonsurgical suggestions you might have.

M.H.

Answer: Stroke risk should not be affected by knee injection of any kind. If the treatment is effective, there may be benefit.

If regular medicines such as Tylenol or anti-inflammatory drugs have been no help, and you get no relief from injections or physical therapy, it may be time to consider joint replacement.