US-guided Baker’s cyst aspiration today. Always switch Doppler/power to confirm it’s not an aneurysm. Know your anatomy,,avoid nerves. #MSKUltrasound #SportsMedicine

💥Fascinating examples of neuro-immune connection! Top picture shows remission of psoriasis in the right hand after a posterior dislocation of the right shoulder with brachial plexus lesion. Bottom picture: the reappearance of psoriasis in the right hand during early stages of recovery - 4 months following his accident. Photogrpahs from reference. The paper has 23 more such case reports.

OA is a clinical diagnosis not a radiographic one stop diagnosing OA from an X-ray 👇 Effects of X-ray-based diagnosis and explanation of knee osteoarthritis on patient beliefs about osteoarthritis management: A randomised clinical trial

Climber’s Pulley Injuries This chapter focuses on pulley injuries in rock climbers, a common injury resulting from repetitive strain during specific climbing grips, particularly the crimp grip. Diagnosis typically involves a thorough history and physical examination, including the characteristic "bowstringing" sign observed during resisted finger flexion. Ultrasound is the preferred imaging modality for confirming the diagnosis and assessing injury severity, superior to CT or MRI due to its dynamic assessment capabilities and lack of ionizing radiation. The chapter details the anatomy of the flexor tendon sheath and pulleys, highlighting the A2 pulley of the ring finger as the most frequently affected site. Management strategies depend on injury severity. Partial injuries, without the bowstringing sign, respond well to conservative treatment with a thermoplastic splint, immobilizing the affected finger for a significant period. However, complete ruptures, confirmed by both clinical findings and imaging, usually necessitate surgical repair using an extensor retinaculum graft. Early intervention is crucial for optimal outcomes. Surgical repair aims to reconstruct the annular structure, effectively holding the flexor tendon in place, facilitating functional recovery. The chapter emphasizes the importance of avoiding repetitive high-force movements and emphasizes the need for adequate rest and appropriate rehabilitation after both surgical and conservative treatments. Prevention strategies, including proper warm-up, hydration, and avoiding overuse, are key to reducing the incidence of these injuries in climbers.

Cervical Myelopathy: Know the clinical signs ☝️ 1️⃣ Hoffmans sign - Flick middle finger distal phalanx. A positive sign is reflex flexion of the thumb and/or index finger. 2️⃣ Hyperreflexia - brisk tendon reflexes. Can be seen in upper or lower limb. 3️⃣ Fine Motor Skill loss/Dexterity Issues - note the inaccuracy in the the pts ability to point at the pens, especially with greater velocity. 4️⃣ Balance Issues - This can be tested in many different ways. Here I have just asked the patient to close his eyes and observe for postural sway. A more comprehensive (and more time consuming) test is the Rhombergs test: Good description here:🔗 5️⃣ Imaging - A definite diagnosis of cervical myelopathy can only be made with imaging. The MRI shows a C3/4 Disc osteophyte causing canal stenosis and cord compression with increased focal T2 signal. What's next for this patient? This patient has now been listed for decompressive surgery. Chronic cord compression can lead to irreversible neurological changes. So early detection is 🗝️ for timely Intervention. Know the signs ☝️ --------------------- Note - This client consented to the posting of these scan results on social media for educational purposes. Please comment respectfully and professionally 🙏