What is Kaplan’s lesion? Metacarpophalangeal (MCP) joint dislocation: Complex (Irreducible) Dorsal Mechanism of injury: Hyperextension injury Involvement: Usually occurs on border digits (Index > Little finger) Characteristic position of index finger: Hyperextended at MCP rests on dorsum of metacarpal Deviated towards middle finger Slightly flexed middle & distal phalanx with…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Novel Coronavirus Disease (CoViD-19) – “An Old Family with a New Disease”
Coronaviridae, one of the families of viruses which are known to cause diseases in mammals and birds ranging from the common cold to Severe Acute Respiratory Syndrome. A new species which belongs to this family emerged recently causing an outbreak of a respiratory disease in the eastern part of Asia….
Emergency Medicine
LRINEC score for Necrotizing fascitis – Mnemonic
The LRINEC (Laboratory Risk Indicator for Necrotizing Fasciitis) score is a tool to distinguish ordinary skin infections from necrotizing fasciitis. Mnemonic: NeC WASH Na level: <135 mmol/L: 2 points Creatinine: >1.6 mg/dl: 2 points WBC: <15,000/cu.mm: 0 points 15,000-25000/cu.mm: 1 point >25,000/cu.mm: 2 points Acute phase reactant (CRP): >/= 150:…
Clinical Skills and Approaches
Cellulitis vs Early Osteomyelitis – Clinical features
Often, one may find difficulty differentiating cellulitis from osteomyelitis in a patient presenting with signs of inflammation localized to an extremity. There are few points that must be kept in the back of head, that will help us to differentiate these two entities. 1. Overlying skin findings: In osteomyelitis, the…
Clinical Skills and Approaches
Finger test for Necrotizing Fascitis
Synonyms: Finger sweep test Finger test can be performed under Local anesthesia or General anesthesia in: Emergency department Bedside in wards Operation theaters Procedure: Area is infiltrated with local anesthetic A 2 cm test incision down to fascia is made in the suspected area The tissues are visually examined for:…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Skeletal Traction – Pin Insertion Sites
Site Point of insertion Direction Indications Olecranon (K-wire) 1.25 inches (3 cm) distal to olecranon tip – deep to subcutaneous border of upper ulna (avoids ulnar joint and open epiphysis) Medial to Lateral – At right angles to longitudinal axis of ulna (Avoids ulnar nerve) Supracondylar or Distal humerus fractures…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Heart Sounds – Murmurs
Murmur is a low, indistinct sound. In terms of medicine, it is the sound produced due to turbulent flow within the heart and great vessels. They are described and named in relation to the normal heart sounds, location, and quality. Please go through these articles before reading further: Heart Sounds…
PGMEE, MRCS, USMLE, MBBS, MD/MS
Appendix, Appendicitis and Appendicectomy
Inflammation of the Appendix is one of the most common causes of Pain Abdomen presenting in the Emergency Room. Since its first description in the texts, there has been a lot of improvement in the quality of management due to the availability of resources and technology. Appendix, in the initial…