Ulnar drift or deviation of fingers Normal anatomical factors contributing to ulnar drift of fingers at MCP joint: Normal mechanical advantage of ulnar intrinsic muscles Asymmetry and ulnar slope of metacarpal heads of index and middle fingers Greater ulnar deviation permitted by radial collateral ligament when MCP joint is flexed…
PGMEE, MRCS, USMLE, MBBS, MD/MS
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Gout : Mnemonics
Urate Lowering Therapy (ULT) Mnemonic: 1, 2, 3, 4, 5, 6 Start Urate Lowering Therapy if: ≥1 subcutaneous tophi ≥2 flares per year ≥3 stage CKD with Serum uric acid (SUA) ≥ 9 mg/dl Other indications: Urate renal stone, Evidence of joint destruction in X-ray 4. ≥4 weeks to be…
PGMEE, MRCS, USMLE, MBBS, MD/MS
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Edward Syndrome : Mnemonic
Mnemonic: EDWARDS 1. Eighteen trisomy, Elongated skull 2. Digit overlapping with clenched fist 3. Webbing of 2nd and 3rd toes 4. Absent radii, Arthrogryposis 5. Rocker-bottom feet 6. Dysplastic ears, Disability (intellectual), Diseased heart (VSD) 7. Small lower jaw
Clinical Skills and Approaches
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Romberg test
Tests the function of: Posterior or Dorsal column which may be impaired in: Subacute combined degeneration (SCD) of spinal cord (Vitamin B12 deficiency) Posterior cord syndrome (Posterior spinal artery infarction) Hemisection of spinal cord (Brown Sequard syndrome) Pathophysiologic basis: When the patient is standing with the eyes open, visual, proprioceptive,…
Clinical Skills and Approaches
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Deep tendon reflexes
Deep tendon reflexes are monosynaptic reflexes integrated at lamina IX of the spinal cord. Deep tendon reflexes may be interpreted as: Normal Diminished or absent (hyporeflexia): Lower motor neuron lesions Exaggerated or clonus (hyper-reflexia): Upper motor neuron lesions Inverted or paradoxical: Damaged afferent pathway Name Spinal level Peripheral nerve Location…
Clinical Skills and Approaches
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Beevor’s sign
Named after: Charles Edward Beevor Definition: Upward (Cephalad) movement of the umbilicus in a supine patient attempting either to flex the head onto the chest against resistance or performing a sit-up. It is not a pathologic reflex, but a sign resulting from imbalance in muscle strength between the upper and…
Surgical Skills
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Percutaneous Achilles Tenotomy for CTEV
Indications Cavus, Adductus and Varus are fully corrected but ankle dorsiflexion remains <10 degrees above neutral Adequate abduction: Best sign: Ability to palpate anterior process of the calcaneus as it abducts out from beneath the talus Abduction of approximately 60 degrees Neutral or slight valgus of os calcis Technique 1….
Clinical Skills and Approaches
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Heel Pain : Mnemonic
Mnemonic: HEEL PAINS 1. Heel pad syndrome 2. Enthesopathy 3. Entrapment 4. Ligaments 5. Plantar fasciitis 6. Posterior tibial tendinopathy/tenosynovitis 7. Peroneal tendinopathy/tenosynovitis 8. Arthritis 9. Impingement 10. Neuroma 11. Spurs 12. Stress fracture 13. Sinus tarsi syndrome 14. Sever’s disease 15. S1 radiculopathy Condition Description Site of heel pain…