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Critical Limb Ischaemia

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%…

Systemic Sclerosis (SSc)

Overview Systemic sclerosis (SSc), also known as scleroderma, is a rare chronic autoimmune connective tissue disease characterized by f ibrosis, vasculopathy, and autoimmunity. It primarily affects the skin but can also involve the lungs, GI tract, kidneys, and heart. The estimated prevalence is 50–300 per million, with a female-to-male ratio of ~4:1, and peak onset…

Crystal Arthropathy

Overview Crystal arthropathies are a diverse group of disorders characterized by deposition of various minerals in joints and soft tissues leading to inflammation. Four main types of crystal arthropathies: Gout : The most common of all the crystal arthropathies, caused by monosodium urate crystal precipitation, and its prevalence appears to be increasing. Pseudogout: caused by calcium…

Urinary Tract Infection (Children)

Overview Urinary Tract infections (UTIs) in children are common and usually carry low risk. UTIs are often non-specific and can not be diagnosed on symptoms alone. A clean specimen (urine) is required for the diagnosis of UTI. Any child who is unwell, and most children under 6 months, should be admitted for IV antibiotics. The…

Basic Calcium Phosphate Disease / Milwaukee Shoulder Syndrome

Overview Basic Calcium Phosphate (BCP) disease is a crystal-associated arthropathy characterized by deposition of BCP crystals in periarticular and intra-articular tissues. A severe clinical presentation of BCP disease is Milwaukee Shoulder Syndrome, which typically affects elderly women, leading to rapid joint destruction, massive rotator cuff tears, and non-inflammatory joint effusion. It often involves the shoulder,…

Pseudogout: Calcium Pyrophosphate Deposition Disease

Overview Pseudogout, more accurately known as calcium pyrophosphate deposition disease (CPPD), is a crystal arthropathy characterized by the deposition of calcium pyrophosphate dihydrate crystals in articular cartilage and soft tissues, leading to joint inflammation. It most commonly affects elderly individuals, especially over the age of 60, with a slight female predominance. Clinically, it often mimics…

Leukocyte Adhesion Deficiency

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…

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