Step 1: Arthralgia vs Arthritis Arthralgia Arthritis Symptom Diagnosis Joint pain without inflammation Joint pain with inflammation (swelling, redness, tenderness) Articular or Non-articular Articular Articular Non-articular Pain with all joint ROMs Pain with only some joint ROMs Most painful at the limit of joint ROM May not be most painful…
Tag: Orthopedics
Section Editor: Dr. Sulabh Kumar Shrestha, MBBS, PGY1 Orthopedics
Clinical Skills and Approaches 
Ely’s test
Rectus femoris is the only Quadriceps muscle that cross the hip joint and act as a hip flexor and knee extensor. When the rectus femoris is shortened/tightened, it tends to pull the pelvis forward into anterior pelvic tilt and also forces the knee into hyperextension. Ely’s test: Patient is positioned…
Emergency Medicine 
Bier Block
Named after: German Surgeon August Bier (first introduced the block in 1908) Definition: It is a peripheral intravenous local anesthetic block (IVRA; Intravenous Regional Anesthesia) of the upper limb using a pneumatic cuff technique Mechanism of action: Local anesthesia diffuses into the small veins surrounding the nerves and then into…
Surgical Skills 
Orthopedic Screw Insertion Mnemonic
Don’t Marry Too Soon DRILL Choose the correct drill bit Insert the drill bit correctly in the chuck Tighten the chuck sufficiently Start the drill home perpendicular to the surface Maintain adequate pressure Maintain the proper direction Irrigation with normal saline should be commenced simultaneously with drilling Keep the drill…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Pedicle Screw Insertion Simplified
Anatomy of Vertebral Pedicle Width (narrowest transverse diameter): Narrowest at T4-T5 (4-5 mm) Above and below this level, the width gradually increases to almost double at T1 and T11 (8 mm) Narrowest for lumbar at L2 (two for tiny; 2 X 3 = 6 mm) Increases gradually to L5 (5…
Clinical Skills and Approaches 
Ober’s Test
Tensor fascial latae (TFL) originates from the anterior superior iliac spine (ASIS) outer surface, outer lip of anterior iliac crest and deep surface of fascia latae, continues down in thigh as Iliotibial band (ITB) and inserts to the ipsilateral Gerdy’s tubercle. TFL plays role in flexion, medial rotation and abduction…
Clinical Skills and Approaches 
Thomas Test and Staheli Test
Thomas test Synonym: Hip flexion contracture test, Iliacus test, Iliopsoas test Fixed flexion deformity of the hip and anterior pelvic tilt leads to a compensatory hyperlordosis of the lumbar spine to restore the body’s center of gravity. Compensatory hyperlordosis can mask the fixed flexion deformity of hip. Thomas test: With…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Nerve Conduction Study (NCS) and Electromyography (EMG) : Mnemonic Approach
Nerve Conduction Study (NCS) In the Nerve conduction study, assessment must be done for ABCDEFGH. Action potential Amplitude Measures the height of response in millivolts (mV) for motor nerve and microvolts (μV) for sensory nerve Indicates quantity of axons contributing to action potential Block of conduction CMAP on proximal stimulation…