Overview Shoulder impingement syndrome, now more commonly referred to as subacromial pain syndrome (SAPS), is one of the most frequent causes of shoulder pain. It accounts for ~40–65% of shoulder complaints in primary care and sports medicine settings. It occurs due to mechanical compression of the rotator cuff tendons (most commonly supraspinatus) and subacromial bursa […]

Overview Scaphoid fracture is the most common carpal bone fracture, accounting for ~60–70% of all carpal fractures. It occurs most frequently in young adults (15–40 years) following a fall on the outstretched hand (FOOSH). The scaphoid’s tenuous blood supply predisposes to non-union and avascular necrosis, especially in proximal fractures. Early recognition is essential as delayed […]

Overview Chronic compartment syndrome (also known as chronic exertional compartment syndrome or exercise induced compartment syndrome) is an exertional condition in which repetitive activity causes transiently elevated pressure within a closed myofascial compartment, leading to ischemic pain, tightness, and sometimes neurologic symptoms that predictably begin with exercise and abate with rest. It most often affects […]

Overview Anterior cruciate ligament (ACL) tear is one of the most common knee injuries, particularly in young athletes involved in pivoting sports (soccer, basketball, skiing). ACL injuries account for ~50% of all knee ligament injuries, with an incidence of ~68 per 100,000 annually, more common in females due to anatomical and biomechanical risk factors. ACL […]

Overview Achilles tendinopathy & rupture are common causes of posterior ankle pain and disability, particularly in active adults. Tendinopathy presents with chronic pain, stiffness, and impaired function, while rupture is an acute injury characterised by a sudden “pop” and loss of plantarflexion power. Achilles tendon injuries are increasingly prevalent due to sports participation, with rupture […]

Overview Toxic Multinodular Goitre (TMNG) is the second most common cause of hyperthyroidism caused by a long-standing goitre and/or iodine deficiency which results in an increased risk of mutation and consequent TSH-independent autonomic function of thyroid nodules to produce excess thyroid hormones. Common clinical manifestations include hyperthyroidism and a painless thyroid goitre with palpable nodules. […]

Overview Cryoglobulinaemic vasculitis is an immune complex–mediated small to medium vessel vasculitis caused by circulating cryoglobulins—immunoglobulins that precipitate below 37 °C and redissolve on warming. These immune complexes deposit in vessel walls, activate complement (typically with marked C4 consumption), and drive leukocytoclastic vasculitis. “Mixed” CV (types II and III) is most often linked to hepatitis […]

Overview Post‑splenectomy immunodeficiency refers to the increased susceptibility to infection following removal (or functional loss) of the spleen. The spleen plays a critical role in filtering bloodborne pathogens, especially encapsulated bacteria, and in mounting both innate and adaptive immune responses. Loss of splenic function leads to impaired opsonisation, reduced IgM production, and defective clearance of […]

Overview Sarcoidosis is a multisystem granulomatous disease of unknown cause, characterised by the formation of non‑caseating granulomas in affected organs. Pulmonary involvement occurs in ~90% of patients, making it the most common manifestation. Global prevalence varies widely (e.g., 3.7/100,000 in Japan vs. 28.2/100,000 in Finland), with higher rates in Black Americans and Northern Europeans. Peak […]

Overview Chronic lower limb ischemia can be classified using the Fontaine classification: Grades III and IV are classified as Critical Limb Ischemia. Intermittent claudication is a type of chronic lower limb ischemia that presents with muscle pain on exercise and is relieved on rest2. It affects 4% of people over 55, mostly men1. Up to […]

Overview Acute limb ischaemia refers to any sudden decrease in limb perfusion that causes a potential threat to viability. It is associated with pain, motor and sensory loss, and cold sensation. It affects one in about 6000 of the population1 and is more common in the lower limb, with less than 17% of cases affecting […]

Overview Rheumatoid pleural effusion (RPE) is an uncommon extra‑articular manifestation of rheumatoid arthritis (RA), occurring in ~2–5% of patients, more often in middle‑aged men with high rheumatoid factor (RF) titres, despite RA being more common in women. It typically presents during active disease or in patients with rheumatoid nodules, but can occasionally precede joint symptoms. […]

Overview Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) is a serious extra-articular manifestation of RA, affecting up to 10% of RA patients clinically, though subclinical involvement may be present in up to 60% on HRCT. It typically presents in the 5th–6th decade, with a male predominance and is a leading cause of RA-related mortality. The most […]

Overview Sjögren’s-associated interstitial lung disease (Sjögren’s-ILD) is a significant extra-glandular manifestation of primary Sjögren’s disease (pSS), occurring in ~9–20% of patients clinically, with subclinical involvement detectable in up to 50% on HRCT. It may precede sicca symptoms or develop late in the disease course. The most common ILD pattern is nonspecific interstitial pneumonia (NSIP), followed […]

Overview Systemic sclerosis–associated interstitial lung disease (SSc-ILD) is one of the most common and severe internal organ manifestations of systemic sclerosis (SSc), occurring in up to 50–60% of patients on HRCT, with clinically significant disease in ~25–30%. It is a major cause of SSc-related mortality. The most frequent histopathological pattern is nonspecific interstitial pneumonia (NSIP), […]

Overview X-linked agammaglobulinaemia (XLA) is a rare primary immunodeficiency caused by mutations in the Bruton’s tyrosine kinase (BTK) gene, leading to failure of B-cell maturation. It results in profound hypogammaglobulinaemia and susceptibility to recurrent bacterial infections, particularly with encapsulated organisms. It usually presents after 6 months of age (once maternal IgG wanes). Prevalence is ~1 […]

Overview Hyperemesis gravidarum (HG) exists on a spectrum of nausea and vomiting in pregnancy (NVP). NVP refers to symptoms of nausea, vomiting or dry retching commencing in the first trimester, with no other cause identified.1 HG refers to severe, persistent vomiting that may result in malnutrition, dehydration, weight loss and debility due to illness. HG […]

Overview Critical limb ischaemia (CLI) represents grade III and IV chronic limb ischaemia (based on the Fontaine classification). It presents with rest pain, breakdown of skin and inability to heal an injury, which can lead to infection or gangrene. If left untreated it may be necessary to amputate the affected limb. CLI develops in 1% […]

Overview Chronic upper limb ischaemia is a form of peripheral arterial disease that results in a symptomatic reduced blood supply to the upper limb. The common symptoms are weakness, cramps, pain, and digital ischaemia/gangrene. Upper limb ischaemia occurs less frequently than lower limb ischaemia.  Anatomy/ Physiology Parent Artery Major Branches Aortic arch  Left subclavian artery […]

Overview Wiskott–Aldrich syndrome is a rare X-linked recessive primary immunodeficiency caused by mutations in the WAS gene, leading to defective actin cytoskeleton regulation in hematopoietic cells. It presents with the triad of eczema, recurrent infections, and thrombocytopenia with small platelets. Patients are prone to autoimmunity and malignancy. Incidence is ~1 in 100,000 live male births. […]

Overview Severe combined immunodeficiency (SCID) is the most severe form of primary immunodeficiency, characterised by profound defects in both humoral (B-cell) and cellular (T-cell) immunity. It presents in infancy with recurrent, severe, and opportunistic infections, chronic diarrhoea, and failure to thrive. Without curative therapy, most infants die within the first year of life. Incidence is […]

Overview Selective IgA deficiency is the most common primary immunodeficiency, defined by very low or absent serum IgA levels with normal levels of other immunoglobulins (IgG, IgM). Many patients are asymptomatic, but some develop recurrent mucosal infections, allergic disease, or autoimmune disorders. Prevalence is estimated at 1:300 to 1:700 in Caucasian populations. Diagnosis is often […]

Overview Leukocyte adhesion deficiency (LAD) is a rare primary immunodeficiency characterised by recurrent bacterial and fungal infections, impaired wound healing, and absence of pus formation due to defective leukocyte adhesion and migration. It results from genetic defects in leukocyte integrins or signalling pathways, preventing neutrophil extravasation from blood vessels into tissues. LAD has an estimated […]

Overview Hyper-IgE syndrome (HIES) is a rare primary immunodeficiency characterised by markedly elevated serum IgE, recurrent staphylococcal skin and lung infections, eczema, and connective tissue/ skeletal abnormalities. Most commonly caused by autosomal dominant mutations in STAT3, it results in impaired Th17 cell differentiation and defective neutrophil chemotaxis. Autosomal recessive forms (DOCK8, TYK2 mutations) present with […]