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…
Tag: Orthopedics
Section Editor: Dr. Sulabh Kumar Shrestha, MBBS, PGY1 Orthopedics
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…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Boutonniere and Swan neck Deformity – Pathophysiology
Understanding of the Boutonniere and Swan neck deformity requires clear concept of the finger extensor apparatus, which has been discussed here. The extrinsic extensor tendons trifurcate giving a central slip which attaches to the middle phalanx base and two lateral slips which join with lateral band (formed by intrinsic muscles…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Juvenile Idiopathic Arthritis (JIA) : Mnemonic Approach
Synonym: Juvenile Rheumatoid Arthritis (JIA) Diagnosis of JIA Mnemonic: One Six Sixteen (1, 6, 16) 1: Inflammation of atleast 1 joint (joint involvement: knee > wrist/hand > ankle > hip > c-spine) 6: Lasting for atleast 6 weeks 16: Onset before 16 years age In order to confirm the diagnosis,…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Singh Index for Osteoporosis – Simplified
Pattern of bone loss in Osteoporosis Trabecular bone responds faster to metabolic changes due to greater surface are compared to cortical bone. Non-weight bearing (secondary trabeculae) are lost first. Weight bearing (primary trabeculae) may appear prominent due to loss of other trabeculae and may also become thickened due to compensatory…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Flexor Tendon Rehabilitation : Simplified
Immobilization Protocol Dorsal blocking orthosis Early stage (0-3/4 weeks) Intermediate stage (4-6 weeks) Late stage (6-8 weeks) Wrist: 20-30 degrees flexionMCP: 40-60 degrees flexionIP: Neutral ROM of elbow and shoulder Increase wrist extension (towards neutral) within splint Tendon gliding exercises (hold each position 3 seconds, repeat 10 times, do 3…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Achondroplasia Mnemonic
A: Autosomal dominant C: “Champange glass” pelvis in X-rays H: Hypotonia O: Ossification affected (Enchondral > Appositional) N: Nasal bridge small D: Disproportionate Dwarfism R: Rhizomelic (proximal i.e. humerus and femur shortening) O: Out knees (varus deformity) P: Proliferative zone quantitative defect L: Little phalanx (brachydactyly) and metacarpals with Leister…