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Amyloidosis (Overview)

Overview Amyloidosis is a disorder in which misfolded proteins aggregate into insoluble beta-pleated sheet fibrils and deposit extracellularly in tissues, leading to progressive organ dysfunction. It may be systemic or localized .  In current practice, the most clinically important systemic forms are AL (light-chain), AA (serum amyloid A), and ATTR (transthyretin; hereditary or wild-type) .…

Testicular Torsion

Overview Testicular torsion is a urological emergency caused by twisting of the spermatic cord, leading to acute interruption of blood flow to the testis and rapid ischemia. It most commonly occurs in adolescents (peak 12–18 years) but can occur at any age, including neonates. The incidence is approximately 1 in 4,000 males under 25 years. Early…

Achilles Tendinopathy & Rupture

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…

Mesenteric Ischaemia

Aetiology and Risk Factors Aetiology Acute mesenteric ischemia can result from occlusion of a mesenteric vessel arising from an embolus, which may emanate from an atheroma of the aorta or cardiac mural thrombus, or from primary thrombosis of a mesenteric vessel, usually at a site of atherosclerotic stenosis. Embolic occlusion is more common in the…

Anal Fissure

Overview Anal fissure is a split in the skin of the distal anal canal. It presents with severe pain on defecation, like passing “glass shards”, and rectal bleeding. It is more frequently diagnosed in younger and middle-aged individuals. Anal fissures are mostly caused by passage of hard stool but can also be a result of…

Paediatric Orthopaedics Overview

Osteochondroses Osteochondroses is a condition that affects the epiphysis of bones. Pathology consists of localised area of ischaemic bone necrosis and oedema of adjacent soft tissue. Osteochondroses result in avascular necrosis of the epiphyseal bone, similar to Perthes disease, but less common. In general osteochondroses is more troublesome than serious. Age effects usually 10-15 +/-…

Chronic Widespread Pain

Overview Chronic widespread pain (CWP) is a nociplastic pain phenotype defined by persistent (≥3 months) pain affecting multiple body regions, with high comorbidity with fatigue, sleep disturbance, mood symptoms and functional impairment. The pooled global prevalence is ~10% (women>men), with higher rates in lower-HDI settings. CWP is recognised in ICD-11 within the chronic primary pain…

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