Check S4-5 S4-5: Perianal area <1 cm lateral to the mucocutaneous junction (taken as one level) 1. Sensory (-) and Motor (-): AIS A (Complete)i.e. N-0-0-0-0-N sign (No sacral sparing) 2. Sensory (+) and Motor (-): AIS Bi.e. Sensory (+) means any sensation present in S4/S5 or anal sensation Motor…
Tag: Orthopedics
Section Editor: Dr. Sulabh Kumar Shrestha, MBBS, PGY1 Orthopedics
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Elbow ligaments : Simplified Anatomy
Lateral collateral ligament complex Restraint to varus and posterolateral rotatory instability. Anatomy is more variable. LCL arises from lateral humeral condyle at a point through which the axis of rotation passes – it maintains a uniform tension throughout the arc of motion. Annular ligament is a “U” shaped ligament that…
Emergency Medicine 
Pulled elbow reduction
Synonyms: Nursemaid’s elbow, Radial head subuluxation, Elbow subluxation Age: Commonly 1-4 years After 5 years of age, the attachment of the annular ligament to the neck of the radius strengthens Enlargement of the proximal radial epiphysis with growth may also improve stability Presentation: History of pull may be absent in…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
6 Ps and 3 As of Compartment Syndrome
Clinical features A. Adolescents and Adults Mnemonic: 6 Ps (by Hargens and Mubarak) Pain (may be absent in cases of nerve damage): Pain out of proportion to other physical findings (requiring increasing analgesic requirement) *: Earliest symptom Pain on passive stretch of the muscles in concerned compartment * Low sensitivity…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
General Principles – Pediatric Fracture Management
Children are not just mini-adults • Higher head to torso ratio: Head injury & Upper C-spine fractures • Light weight – projectile when struck • BSA to Wt. ratio – higher (rapid hypothermia) • Large cardiopulmonary reserves – normal SBP in significant hypovolemia Growth contribution by Proximal & Distal Physes…
Emergency Medicine 
Kaplan’s Lesion : Complex Dorsal MCP joint dislocation
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…
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…