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Archive for December 2011

Christmas and Ralph Waldo Emerson

As I sit here after a fantastic Christmas Day and I think of all the things I’m grateful for in this last 12 months, I write to thank you all for your continued commitment to excellence and learning. I thank you for the opportunity to teach and for the time you give to read the…

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Supracondylar Fracture

Hi everyone. I wanted to spend a few moments on supracondylar fractures in children as this is one fracture that seems to be missed, when it’s not obvious and when first reading the Xray. It’s actually a pretty straightforward view of the elbow joint. The only catch is that the elbow must be at right…

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The Slam Dunk ECG!

Hi all. This is a case from a few days ago. I loved it, as it was one of those slam dunk diagnosis, even when everything looked normal, thanks to the ECG. A 63 year old woman presents with sudden onset of shortness of breath. It began, whilst she was in the supermarket, shopping. The…

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Where’s the lesion?

Good clinical examination is so important in what we do. I say, just have a look, sometimes you’ll be surprised what you pick up. In this month’s NEJM‘s image challenge, this image was presented. Where is the lesion? Is it: (a) Left facial nerve (b) Left glossopharyngeal nerve (c) Left hypoglossal nerve (d) Right glossopharyngeal…

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Left Ventricular Hypertrophy

Left Ventricular Hypertrophy(LVH) can cause all sorts of problems in terms of ECG diagnosis. There is a straightforward and simple approach to diagnosing it. Here is the ECG in 20 Seconds Approach. The criteria for diagnosing LVH are very specific(>90%) but not sensitive(50%). That means that if the criteria are met, it’s probably there. If…

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