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Spine & Upper Limb (Lumbar spine (Sciatica (Treatment (Analgesia,…

- - - - Poor lifting technique
      - Obesity
      - Poor posture
      - Osteoarthritis
      - Spondylosis
    - - Analgesia
      - No bed rest
      - Physiotherapy
      - Spinal stabilisation surgery
        
        Only if one vertebral level affected
  - - - Analgesia
      - Physiotherapy
      - Discectomy
  - - - Bilateral leg pain
      - Saddle anaesthesia
      - Uncontrolled defaecation/ urination
    - - PR exam
      - MRI
    - - Colostomy
      - Urinary rediversion
      - Nerve decompression
- - - - Tendonitis
      - Sub acromial bursitis
      - Acromioclavicular osteoarthritis
      - Rotator cuff tear
    - - NSAIDs
      - Analgesia
      - Physiotherapy
      - Subacromial steroid injection
      - Surgical decompression
  - - - Weakness of initiation of abduction = supraspinatus
      - Weakness of internal rotation = infraspinatus
      - Weakness of external rotation = subscapularis
      - MRi
    - - Physiotherapy
      - Steroid injection
      - Surgical repair
      - Tendon decompression
  - - - Anterior dislocation
        
        Requires reduction
        
        80%/20% redislocation rate in <20/>30 year olds
        
        May cause Bankart's lesions
        
        Surgical stabilisation in recurrent dislocations
    - - Commoner in ligamentous laxity/ Marfan's/ Ehlers-Danlos
      - Inferior/ posterior dislocation
- - - - Colles fracture
      - Diabetes
      - Rheumatoid arthritis
      - Idiopathic
      - Pregnancy
      - Renal failure
      - Hypothyroidism
    - - Loss of sensation over thumb & radial 2.5 digits
      - Worse at night
      - Weakness/ clumsiness
      - Muscle wasting over thenar eminence
    - - Wrist splinting
      - Steroid injection
      - Carpal tunnel decompression
- - - - MCPs, PIPs and DIPs affected
      - Heberden's nodes over DIPs
      - Bouchard's nodes over PIPs
      - Squaring of thumb
      - Treatment
        
        Arthrodesis
        
        Removal of osteophytes
    - - Sparing of DIPs
      - Presentation
        
        Volar MCPJ subluxation
        
        Ulnar deviation
        
        Swan-neck deformity
        
        Boutonierre's deformity
        
        Z-shaped thumb
      - Treatment
        
        Tenosynovectomy
        
        Contracture release
        
        Joint replacement