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Tuberculosis This is discussed in Chapters 6 and 43 . Tuberculosis This is discussed in Chapters 6 and 43 . Tuberculosis This is discussed in Chapters 6 and 43 .

modern imaging and equipment? The key to good surgery in all disciplines is a surgeon who is dedicated to the care of his or her patient, who takes a good history and examination and then o ff ers the best treatment that is available under the circumstances. I...

surgery There have been dramatic advances in spinal surgery owing to modern imaging, modern instruments and implants, and advanced spinal cord monitoring equipment. The widespread availability of MRI in high-income countries such as the USA, the UK and most o...

Acquired abnormalities History Patients usually associate the onset of their symptoms with an unusual event (trauma or excessive activity) even though the causation may not be as clear as the patient thinks. Even so, the onset (sudden or gradual) and duration...

Arthritis of the elbow Rheumatoid arthritis Surgery may be required, especially in end-stage disease ( Figure 38.29 ). Arthroscopic or open radial head excision and synovectomy are e ff ective for painful, restricted pronation and supination. Elbow arthroplasty...

Arthritis of the shoulder Rheumatoid arthritis The glenohumeral joint is commonly involved in rheumatoid - arthritis ( Figure 38.14 ). As is typical of this condition, there is osteoporosis, destruction of the articular cartilage and synovial proliferation w...

Arthritis Rheumatoid arthritis Rheumatoid arthritis presents with classic symptoms: morning sti ff ness, symmetrical arthritis, hand deformities and rheuma - toid nodules. Diagnostic criteria include seropositive rheu - matoid factor and radiographic changes ( ...

Avascular necrosis of carpal bones Idiopathic avascular necrosis of the lunate (Kienböck’s disease; Figure 38.57 ) or scaphoid (Preiser’s disease) can occur. The clinical presentation is of wrist pain and the diagnosis can be Robert Kienböck , 1871–1953, Prof...

Classification of glenohumeral instability /uni25CF Traumatic : unidirectional; involuntary; surgery is usu - ally successful. /uni25CF Atraumatic : multidirectional, painful; involuntary; re - sponds to surgery . /uni25CF Habitual : voluntary , with ligament l...

Clinical history and physical examination History Asking about the patient’s occupation, hobbies (sport, musical instruments, fine art) and hand dominance are important when taking a history . In considering the problem concerned there are a number of symptoms...

Compressive neuropathies Median nerve (carpal tunnel syndrome) The majority of cases of carpal tunnel syndrome are idiopathic. It is, however, associated with diabetes, thyroid disorders, alcoholism, amyloidosis, inflammatory arthritis, pregnancy and obesity . ...

Congenital abnormalities Sprengel’s shoulder The commonest congenital abnormality is due to abnormal scapular descent from its embryonic midcervical position. The typical presentation is a high, small, rotated scapula that remains connected to the cervical spi...

Congenital malformations There are many congenital malformations of the upper limb and these are discussed in Chapter 44 . A classification summarising the main congenital defects and based on aetiology appears as Table 38.2 . (b) Figure 38.59 Volar wrist gang...

DISORDERS OF THE ELBOW Anatomy and function The elbow joint allows flexion and extension through the ulnohumeral articulation as well as rotation of the radial head, which articulates with both the capitellum of the distal humerus (radiocapitellar joint) and ...

De Quervain’s disease De Quervain’s disease is caused by tenosynovitis of the abductor pollicis longus (APL) and extensor pollicis brevis (EPB) in the first dorsal wrist extensor compartment (1st EC). It is predom - inantly seen in middle-aged females and is as...

Dislocation of the shoulder and instability of the glenohumeral joint Three broad groups of shoulder instability exist.

Dislocation of the shoulder and instability of the glenohumeral joint Three broad groups of shoulder instability exist. Dislocation of the shoulder and instability of the glenohumeral joint Three broad groups of shoulder instability exist.

Dupuytren’s contracture Dupuytren’s contracture is most often characterised as an autosomal dominant condition, common in northern Europe, predominantly in men in the fifth to seventh decades of life. Four out of seven cases occur in those with a family histo...