signs

Hypocalcaemia

Signs

 

Fall in level promotes tetanus

 

Chvostek sign

- tapping masseter muscle induces spasm

 

Trousseau Sign

-  flexion of thumb & wrist with extension of fingers

 

Carpopedal Spasm

 

ECG

 

Prolonged QT interval on ECG

 

Causes

 

1. Vit D Deficiency

Congenital Vertical Talus

Definition

 

Rockerbottom foot / Persian Slipper Foot

 

Epidemiology

 

Uncommon

 

50% bilateral

 

Doesn't delay walking

- may present in toddler with callus under talus head

 

Associations

 

Congenital anomalies

- CNS disorders

- spina bifida & diastematomyelia ~10%

- arthrogryposis

- neurofibromatosis 

CRPS

Definition

 

Chronic Regional Pain Syndrome

 

CRPS 1

 

Sympathetically mediated pain syndrome

- excessive or exaggerated response of extremity to injury, surgery or disease

 

Manifested by

- intense or unduly prolonged pain

- vasomotor disturbances

- trophic changes

- delayed functional recovery

 

CRPS 2

 

Management

Incidence

 

Knee > Hip

- superficial position

- limited cover of well vascularised muscle 

- watershed area of skin blood supply anterior to the skin incision 

- much increased in fully constrained prosthesis 

 

Ideal < 1%

 

Risk Factors

 

Increased with

- revision

- prior infection

- RA / Psoriatic arthropathy

- DM

Metatarsus Adductus

Definition

 

Metatarsus varus

- adduction of the forefoot at the TMTJ

 

Intrauterine positional deformity / packaging defect

 

Epidemiology

 

1:1000

- M = F 

- bilateral in 50%

- 10% have CDH

 

Aetiology

 

Unclear

 

Theories

- intrauterine positioning defect

- prone nursing

 

Lumbar Scheuermann

Definition

 

Different entity to thoracic Scheuermann's

- end plate abnormal but no kyphosis or wedging

 

Natural History

 

Self - limiting condition

 

Epidemiology

 

Young athlete / labourer

 

Symptoms

 

Adolescent who presents with low grade levels of low back pain

- more pain than thoracic

 

Signs

 

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