From my chamber: 12th September 2018
Total patients: 20
Pediatric patients(age < 10 years): 0
Male patients: 18
Female patients: 2
- IHD: A 39 years old man came with the history of exertional chest pain. At the time of presentation, he was also having pain. Rest pain was mild but during walking he was getting significant pain which was radiating to his jaw area. This is one of the typical symptoms of angina. I did ECG and found ischemic changes in inferior leads.
- Left ankle sprain: An expatriate lady came with swelling and pain in the left ankle joint.The swelling extended to her foot also. Most tender point was on the later(outer) aspect of her ankle joint. X ray showed no fracture.
- Post herpetic neuralgia: 2 days ago got a patient of herpes zoster and provided some information on it. Today's patient came with one of the complications of herpes zoster and it is severe pain in the affected area. The condition is known as post herpetic neuralgia.
- Acute pharyngitis: The patient came with typical features such as throat pain, cold, cough and fever. Got few more patients of sore throat too.
- Truamatic chest pain: The patient slept on his chest and a metallic object was between his body and the bed. The pain was increasing on movement or deep breath.
When to do an ankle X-ray following ankle injury?
If a patients have pain in the malleolar zone + 1 one of the following criteria present:
- Tenderness at the lateral malleolar zone
- Tenderness at the medial malleolar zone
- Not able to walk 4 weight bearing steps immediately after the injury and in the emergency department.
image source
It is called Ottawa rules
Malleolar zone: We have two small hump on either side of the ankle joint. They are called malleolus. Lateral malleolus (outer one) and medical malleolus (inner one). Mallerolar zone is the lower 6cm of the leg bones(tibia and fibula) until the tip of the malleolus.
Pain Vs tenderness: A patient will complains that he or she is having pain. It is pain. A doctor will elicit whether a patient is having pain or not. It is tenderness.
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