Epidemiology and Clinical features Mnemonic: LMNOP Lower extremity predilection (proximal femur > tibial diaphysis) Male predilection (2:1 to 3:1) Night pain relieved by NSAIDs (absent in osteoblastoma) Osteogenic benign tumor Prostaglandins (PGE2) and Cyclooxygenase (COX1 and 2) release by nidus (explains night pain and response to NSAIDs) 3 Concentric layers…
Tag: Orthopedics
Section Editor: Dr. Sulabh Kumar Shrestha, MBBS, PGY1 Orthopedics
Emergency Medicine 
Conus Medullaris Syndrome vs Cauda Equina Syndrome : Anatomical basis and Mnemonic
Definitions Condition Vertebral level of injury Neurological level of injury ISNCI level of injury Conus Medullaris Syndrome (CMS) T12-L2 T12-S5 T11 Cauda Equina Syndrome (CES) L3-L5 L3-S5 L2 Anatomy The spinal cord ends as a tapered structure called the conus medullaris at the level of L2–L3 disc in the neonate…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Pirani Score and Dimeglio Classification for Clubfoot Assessment
Pirani socre Pirani score for assessment of clubfoot (CTEV) consists of 6 parameters (3 each in midfoot and hindfoot) which is scored as 0, 0.5 or 1 with a maximum possible score of 6. The parameters can be remembered using the mnemonic: PER TOM Posterior crease Empty heel Rigid equinus…
Surgical Skills 
Krackow Suture Technique
The Krackow technique is a continuous locking loop suture technique commonly used in tendon repair. The classic Krackow stitch involves 3 or more locking loops placed along each side of the ligament or tendon. Starting point: 1 cm from the tendon end Suture pitch: 5 mm (space the loops 5…
Surgical Skills 
DIY Vac Dressing for Wounds
Pre-requisites for Vac Dressing Components of Vac Dressing 1. Pump for Negative Pressure: In a study, 3 closed suction drainage systems were studied – Davol Reliavac 400 Evacuator, Jackson-Pratt Closed Wound Suction Drainage System, and Snyder Hemovac 400. In all three systems, maximal negative pressures (-71 to -175 mm Hg)…
Clinical Skills and Approaches 
Mnemonic Based Approach to Joint Pain
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…
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…