1) A brief 🧵on Avulsion Fractures

Always keep on the radar 🚨 in any adolescent presenting with acute pelvic pain OR recalcitrant Sx which are not responding to conservative efforts 2) They account for approx 3-5% of adolescent injuries involve the groin (Di Maria et al., 2022). Avulsion fractures typically occur w forceful contraction +/- passive stretching & this is due to secondary ossification centres being weaker than the MTU

1) Vertebral Fragility Fractures

These are the most common 🚩 of the spine. But what are some of the risk factors which ⬆️ likelihood⁉️ 2) Typically affects the thoracolumbar spine (as seen). Be mindful a large % are asymptomatic & picked up incidentally during other investigations (e.g CXR)

Some features
▪️Localised pain & tenderness
▪️Pain supine & sitting hard chair
▪️+’ve percussion
▪️⬇️ ROM

1) Approx. 5-11% of patients undergoing MRI for suspected Cauda Equina Syndrome (CES) will have it confirmed (Metcalfe et al., 2023) 💡

Once differentials are ruled out 🕵️‍♂️
The remaining % are then considered to be ‘Scan-Negative CES’. But what does this actually mean? 2) Scan-Negative CES ‼️

Pt’s have 1+ symptoms suggestive of CES, yet without the radiological evidence of compression. One possible cause is that it may occur secondary to an almost functional neuro disorder 🧠

1) A whistle stop tour of muscle cramps. How can we tell if they are idiopathic vs something more systemic? 2) Thought to be influenced by both the PNS (weighted more heavily) and the CNS. Majority of them are benign

1) A very simple way of trying to differentiate between peripheral nerve palsies in the upper limb 💡 2) The Kumar sign

1) A brief look at reflexes! 2) What are we looking at?

1) A brief look at the Straight Leg Raise, or the Lasegues sign. Named after Charles Lasegue from the 1800’s 2) A test used to stress the mechanosensitivity of neural and somatic tissues. Previously thought to identify the specific level of compression / LDH (we now know this is unlikely)

1) A brief look at BSI’s & what are some of their clinical features? 2) We can view them on a continuum ranging from reaction (mild) - complete fracture (end stage).

They are almost always due to training error & will be influenced by other factors

1) A look at red flags of the spine 🚩 2) How reliable are our subjective checklist of Q’s?

1) A series of slides (more patient friendly) looking briefly at the diagnostic triage of low back pain 💡 2) What are our three main subtypes?

1) A whistle stop tour looking at the prognosis of some of the common spinal conditions we encounter.

*Note this will vary considerably & is dependent on so many factors* 2) LBP

1) An overview of Deep Vein Thrombosis 2) Case study scenario

1) A 🧵 looking peripheral arterial disease (PAD’s). An important differential to consider for those presenting with leg pain 2) PADs is a vascular pathology whereby an inadequate amount of oxygenated blood is transported to the LL due to atherosclerosis & stenosis/occlusion of arterials supplying the tissue

1) If anything has deterred attempting to teach my giraffe body how to ski it was a recent patient of mine 🦒🎿

Mini case reflection 2) 60yo M, otherwise fit & well presented 3/7 post ? Hyperextension injury to the knee +/- extreme dorsiflexion of the ankle after getting their ski stuck. Drove home to 🇬🇧

Able to FWB, marked oedema/bruising of the calf. Knee - NAD, able to heel raise and Simmonds Triad -‘ve

Inspired by @JLTHphysio

Thought I’d have a stab at how I go about explaining common back pain themes. This made me realise I’m actually pretty lowsy at doing this with a lot of room to improve. Apologies if they aren’t your ☕️ 2) Back pain & it’s types

1) A brief dive into Lumbar Spinal Stenosis (LSS), looking at; a) what happens, b) who it tends to affect, c) it’s clinical features & d) how we can potentially treat it 2) A look at what it is and it’s 3 varying phenotypes

1) A brief 🧵looking at common peroneal neuropathy (CPN) & how to differentiate from more proximal lesions, plexopathies or radiculopathies. 2) It is the 3rd most common entrapment neuropathy in the body & the most prevalent for the LL.

It is formed by ventral rami of L4-S2. It wraps around the fibular neck and bifurcates into deep (DPN) & superficial nerves (SPN) around the proximal shin (Baima et al., 2008).

1) Two examples of rare but there pathologies involving the sciatic nerve. A brief 🧵 2) Endometriosis & Sciatica

ncbi.nlm.nih.gov/pmc/articles/P…

1) Keeping with the recent change in NICE guidelines & overall buzz on socials. I have compiled some slides looking at prevalence, features of hip OA & some of the differentials 2) We know that it is an age-related, degenerative disorder. This looks briefly at some of the pathophysiology

1) A 🧵 looking at meniscal root tears (MRT) of the knee. 2) A MRT is defined as a radial tear within 1cm of the tibial attachment of menisci OR an avulsion of the attachment (LaPrade et al., 2014).

1) A short 🧵 looking at median nerve palsy (MNP) and some useful tips to help differentiate the site of its lesion. 2) In terms of its anatomy. It is composed of two sections, the lateral cord (C5-7) which innervates proximal muscles and provides sensory innervation to thenar eminence and the radial 3.5 digits. The medial cord (C8-T1) is purely motor.