By Parminder J Singh, Catherine Swales
A 24-year-old lady attends rheumatology outpatients with an eight-week historical past of painful palms. On exam she is tearful and skinny. you're the medic on duty...
100 instances in Orthopaedics and Rheumatology provides a hundred eventualities regularly visible via scientific scholars and junior medical professionals in orthopaedic and rheumatology clinics, or within the emergency division. A succinct precis of the patient's historical past, exam and preliminary investigations, with medical and/or imaging photos, is by way of questions about the analysis and administration of every case. the reply contains a distinct dialogue on every one subject, with extra representation the place applicable, supplying a vital revision relief in addition to a pragmatic consultant for college kids and junior medical professionals.
Making scientific judgements and selecting the easiest plan of action is without doubt one of the so much difficult and hard elements of educating to turn into a physician. those instances will educate scholars and junior medical professionals to acknowledge vital signs and symptoms and, the place applicable, their dating to different health conditions, and to boost their diagnostic and administration talents.
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A 24-year-old girl attends rheumatology outpatients with an eight-week background of painful arms. On exam she is tearful and skinny. you're the medic on responsibility. .. a hundred circumstances in Orthopaedics and Rheumatology provides a hundred eventualities more often than not noticeable through clinical scholars and junior medical professionals in orthopaedic and rheumatology clinics, or within the emergency division.
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Additional resources for 100 Cases in Orthopaedics and Rheumatology
The most common high-energy mechanism of injury is a road trafﬁc accident (RTA), and the most common low-energy mechanism is a fall. Depending on the mechanism of injury, radiographic evaluation of distal femur fractures may include orthogonal plain radiographs of the entire length of the femur to avoid missing ipsilateral femoral neck or shaft fractures. True knee radiographs are required to screen for intra-articular extension of fracture lines. If intra-articular extension is suspected – particularly coronal plane fractures which can be difﬁcult to see on plain X-rays – a CT scan may be helpful in planning treatment.
Muscle attachments when a fracture occurs produce deforming forces. • Treatment options include conservative, open reduction and internal fixation and hemiarthroplasty. 22 Orthopaedics CASE 8: A BOY WITH A PAINFUL ELBOW History A 7-year-old boy fell from his bicycle and described landing on his outstretched right arm in abduction with the elbow in extension. He complained immediately of severe pain around the right elbow, but no other parts of his body were painful. He has presented to the emergency department.
An arthrogram assesses the size of the cartilaginous fragment and the degree of articular displacement which can help in decision-making in difﬁcult cases. Fragment stabilization is most frequently performed using two percutaneously placed smooth Kirschner wires (k-wires). If the fracture is grossly unstable, open reduction and stabilization with wires may be necessary. Care must be taken during the exposure to avoid denuding the blood supply to the lateral condyle from the posterior soft-tissue structure.