ESR (Erythrocyte Sedimentation Rate) Usually elevated within 48-72 hours of the infection onset (less reliable in the first 48 hours of infection) Continues to rise for 3-5 days after institution of successful therapy and continuing rise beyond 4th-5th day of treatment can be an indication of treatment failure (not good…
Tag: Orthopedics
Section Editor: Dr. Sulabh Kumar Shrestha, MBBS, PGY1 Orthopedics
Emergency Medicine 
Polytrauma Assessment and Management (ATLS) : Mnemonics
SIEVE triage system Mnemonic: ABC-30-2 Can Do Approach to assessment and initial management Mnemonic: ARM Adjuncts to Primary Survey Reflects the adequacy of resuscitation. Mnemonic: PEA COVER Primary Survey Follow the look, listen, feel approach – Mnemonic: ABCDE 1. Airway and C-spine protection: 2. Breathing: 3. Circulation and control of…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Casting technique related Radiographic indices
Cast index Formula: Inner diameter of cast on lateral view (m) / Inner diameter of cast on AP view (n) Cut-off: 0.7-0.8 Padding index Formula: Dorsal fracture site gap (h) / Maximum interosseous length in AP view (g) Cut-off: 0.3 Cantebury index Formula: Cast index (m/n) + Padding index (h/g)…
Clinical Skills and Approaches 
Radial Tunnel Syndrome (RTS) – Anatomy and Clinical Examination
Synonyms: Radial pronator syndrome, Treatment resistant lateral epicondylitis (tennis elbow) Anatomy of Radial Tunnel The anatomic radial tunnel (~5 cm) extends from the radial head to the inferior border of the supinator muscle. Mnemonic: FREAS Fibrous bands anterior to radiocapitellar joint Radial recurrent vessels (leash of Henry) ECRB medial edge…
Clinical Skills and Approaches 
Femoral Anteversion test (Craig’s test)
Synonym: Trochanteric prominence angle test Patient position: Prone with knee on test side flexed to 90 degrees Test procedure: Examiner palpates the greater trochanter and internally and externally rotates the hip until the greater trochanter lies at the lateral most aspect of the hip (the greater trochanter is parallel to…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Wrist Extensor Compartments
The Extensor Zone VII (wrist) contains 6 extensor compartments comprising of 6 synovial sheath lined tunnels separated from each other by fibrous sheath. These compartments contain tendons of muscles that pass from forearm to hand. The number of tendons passinf thorugh the compartments (radial to ulnar) can be remembered using…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Modified Ficat-Arlet Staging for AVN hip : Mnemonic
Ficat and Arlet first classified avascular necrosis of femoral head (AVN) in 1964 before the advent of MRI which was later modified and published in 1985 to include pre-radiographic stages relying on invasive testing procedures. The classification system later underwent further modifications that include MRI findings, patient symptoms and modifies…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Synovial Fluid Analysis – Made Easy
What investigations to order for synovial fluid sample? Mnemonic: 5 Cs Chemistry (pH, LDH, glucose, protein) Cell counts Cytology Culture Crystals Interpretation of synovial fluid analysis Gross Normal Non-inflammatory Inflammatory Septic Crystal Hemorrhagic Volume (ml) <3.5 >3.5 >3.5 >3.5 >3.5 >3.5 Viscosity High High Low Variable Variable Variable Color Colorless…