By Parminder J Singh, Catherine Swales
A 24-year-old lady attends rheumatology outpatients with an eight-week background of painful arms. On exam she is tearful and skinny. you're the medic on duty...
100 circumstances in Orthopaedics and Rheumatology offers a hundred eventualities typically noticeable via clinical scholars and junior medical professionals in orthopaedic and rheumatology clinics, or within the emergency division. A succinct precis of the patient's heritage, exam and preliminary investigations, with medical and/or imaging photos, is by means of questions about the analysis and administration of every case. the reply encompasses a precise dialogue on each one subject, with additional representation the place acceptable, supplying a necessary revision relief in addition to a pragmatic consultant for college students and junior medical professionals.
Making medical judgements and selecting the simplest plan of action is without doubt one of the so much tough and hard components of educating to develop into a physician. those situations will educate scholars and junior medical professionals to acknowledge vital signs and symptoms and, the place applicable, their courting to different health conditions, and to increase their diagnostic and administration abilities.
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Additional info for 100 Cases in Orthopaedics and Rheumatology
The psoas and iliacus attach to the lesser trochanter and ﬂex the proximal fragment – as in this case. The adductors pull the distal fragment medially. Intramedullary nails are emerging as the treatment of choice for subtrochanteric femur fractures. For some fractures with extension above the lesser trochanter, a ﬁxed-angle device such as a blade-plate or dynamic condylar screw can be considered as surgical options. In the presence of pathological fractures, prophylactic stabilization of the entire femur may be indicated to prevent problems with multiple metastases in the same bone.
2. 2 Questions • What is the diagnosis? • Describe how you would assess this injury clinically and radiologically. • Describe the classification system for this type of injury and the associated injuries. • Describe the principles of management. 49 100 Cases in Orthopaedics and Rheumatology ANSWER 17 The diagnosis is a fracture of the tibial plateau. This fracture disrupts the articular surface of the proximal tibia and causes a haemarthosis and immediate swelling of the knee. The peak incidence occurs in men in their fourth decade and in women in their seventh decade.
The diagnosis is thus a distal radius fracture. These injuries were ﬁrst described by an Irish surgeon, Abraham Colles, in 1814, and are commonly called Colles’ fractures. His description was based on clinical examination alone because X-rays had not been invented. Distal radius fractures are the most common fractures. Colles’ fractures account for over 90 per cent of distal radius fractures. Any injury to the median nerve can produce paraesthesia in the thumb, index ﬁnger, and middle and radial border of the ring ﬁnger – as in this case.