– Legg-Calve’-Perthes disease; Findings in M.E.D. not seen in Perthes: short, stunted metacarpals/metatarsals; irregular femoral heads which is bilateral & symmetric, is not assoc w/ metaphyseal cysts, & commonly has early acetabular changes; early hip arthritis is common; bilateral Legg-Calve’-Perthes disease is uncommon; abnormal normal ossification (tibial “slant sign” flattened femoral condyles; T12/L1 notching and deformed … Read more
– See: Synovial F. Exam – ewing’s sarcoma – neuroblastoma – rheumatoid flare – monarticular JRA – knee is less painful, and ROM is > than expected w/ large effusion; – … Read more
Discussion rare type of skeletal dypslasia characterized by extreme short limb dwarfism, with specific hand, foot, and ear abnormalities; micromelic short-limb dwarfism, cauliflower ears, scoliosis, hitchhiker thumbs, and clubfeet. these individuals have extremely short stature, with a mean adult height of 118 cm; condition was originally referred to as diastrophic dwarfism,” which means “crooked or … Read more
Clinical signs Clinical signs are unreliable but should not be ignored Calf tenderness, swelling, fever, and increased pulse rate may be present Work up for DVT arterial blood gas/pulse oximetry coagulation labs (for HCT & platelet count) prothrombin time (PT)/partial thromboplastin time (PTT) fibrinogen CBC EKG and CXR (if PE is suspected) D-dimer level below … Read more
– low mol. wt. dextran; – adjunct in peripheral vascular surgery; – works by expanding plasma volume and decrease blood viscosity; – prophylaxis of DVT and thromboembolism: 10 ml/kg IV on day of surgery followed by 500 ml IV daily for 2-3 days; – then 500ml IV every 2-3 days based on patient risk factors … Read more
– Discussion: – DDH involves displacement of the femoral head from the acetabulum (during the perinatal period) which disrupts the normal development of the hip joint; – DDH is estimated to occur in 1 – 1.5 cases per 1000 live births; – when an agressive screening system is in place (including routine use … Read more
– For Diabetes Insipidus (intranasal & parental); bleeding due to hemophilia A and Type I von Willebrand’s dz (parental); bleeding from esophageal varices; head trauma; – it can transiently correct the bleeding time in most patients with chronic renal failure and other acquired disorders of platelet function; – DI: Intranasally: Adult: 0.1-0.4 mL (10-40 ug) … Read more
– See: Shoulder Abductors – Discussion: – major function of the deltoid muscle is to abduct arm; – it performs this action after scapula[scapula has been fixed by its stabilizing muscles and the humeral head has been snubbed to glenoid by the rotator cuff; … Read more
Medical Intelligence: Current Concepts: Geriatrics: Delirium In The Elderly Patient. Postoperative confusion after anesthesia in elderly patients with femoral neck fractures.
– Discussion: – sacral, ischial, trochanteric, and heel ulcerations are most common; – preventative measures: – turning the patient ever 5 min q 2 hrs of relief may prevent pressure ulceration; – a shift of weight in the wheelchair … Read more