Developmental Dysplasia of the Hip Developmental Dysplasia of the Hip Home Overview Developmental dysplasia of the hip (DDH) refers to the abnormal development of the hip joint. It involves a spectrum of conditions, ranging from mild instability to complete dislocation. DDH can affect one or both hips and is more common in women. Symptoms Unequal leg length in newborns and infants.Asymmetry of the thighs or gluteal folds and abnormal movements of the hip joint.In children of walking age, pain on the affected side, limping while walking, and reduced movements of the hip joint. Risk factors Females are more affected than males.The first-born female child is commonly affected.Genetics or family history.Breech position (feet coming out first instead of head) of the foetus during pregnancy and brain injury during or before birth (cerebral palsy). Diagnosis Physical examination of the child by performing tests, such as the Barlow test (to assess whether the hip can be dislocated and can come out from the socket) and Ortolani test (to assess whether the hip can be reduced back after dislocating it), the gait pattern at the walking age, and examination of the spine and knee joints.Ultrasonography is the preferred test in children under 6 months of age.Pelvic radiography (X-ray) is preferred in children above 6 months of age. Treatment Non-surgical treatmentThis is the initial choice of management, especially in the early stages of the disease. Treatment approaches include:Bracing (Pavlik harness) in children aged below 6 months to keep the hip joint reduced.Hip spica cast, which is a form of plaster applied around the hips, pelvis, and occasionally the knees to keep the hips in a reduced position.Surgical treatmentSurgery is considered for irreducible hip dislocation or in cases of late presentation. Procedures include:Open reduction of the hip followed by a cast.Osteotomy by creating a fracture surgically in the pelvis, hips, or both, followed by hip reduction and fixation using plates and screws.Hip replacement is occasionally recommended only for adults who have had dislocation for a prolonged duration. Read more about Developmental Dysplasia of the Hip Filter Alphabet D
Allergy Allergy Home What is an allergy? Do you often experience sneezing, itchy eyes, rashes or digestive issues like diarrhoea? These could be signs of an allergy. Allergies are one of the most widespread chronic conditions worldwide, affecting approximately 1 in 4 people. Symptoms can range from mild discomfort to severe, potentially life-threatening reactions, such as anaphylaxis. Unfortunately, many people endure these symptoms without seeking help, but it doesn’t have to be that way. Simple tests can identify if you’re allergic to specific substances, enabling effective management of your condition. What causes allergies? Our immune system plays a vital role in defending the body against harmful organisms. However, sometimes our immune system misidentifies harmless substances, such as certain foods, pollens, dust, or medications and triggers an allergic reaction. During this process, the body produces antibodies, leading to various symptoms. These symptoms can differ depending on the allergen involved, and your age. For instance, infants and toddlers are more likely to develop allergic reactions to foods like milk and eggs, while older children and adults might develop allergies to airborne substances, such as pollen or dust. Common symptoms of specific allergens BODY PARTSYMPTOMSCOMMON TRIGGERS OR ALLERGENSNOSESneezing, Itchy, Runny, Stuffy Mouth breathingPollen, house dust mites, cockroaches, pets and other animalsEYESItchiness, redness, watery or swollen eyesPollen, house dust mites, cockroaches, pets and other animalsMOUTHTingling and itching in the throat, mouth, and/or lips, swellingFruits, vegetables, nuts and legumesSKINEczema (dry, itchy), rashes, hives, swellingNuts, shellfish, eggs, milkLUNGSCoughing, wheezing, chest tightness, shortness of breath, asthmaPollen, house dust mites, cockroaches, pets and other animals, foodGASTROINTESTINALDiarrhoea, pain, nausea, vomiting, weight lossInfants and toddlers: Eggs, milk, wheat, soya beanChildren and adults: Eggs, milk, shellfish, wheat, peanuts, hazelnuts and other tree nuts, fruits and vegetablesVARIOUS ANAPHYLACTIC REACTIONSEARLY: Hives, tingling and itching around the mouth, swelling around mouth and eyesSEVERE: Itching, tingling and swelling of the mouth and throat, abnormally low blood pressure, abdominal pain, nausea and vomiting, shortness of breath, asthmaPeanuts, tree nuts, fish, soybean, seafood, milk, eggs, seeds, fruits, drugs, bee and wasp venoms How are allergies diagnosed? Diagnosing allergies involves reviewing your family and medical history, conducting a physical examination, and performing tests to confirm the presence of an allergy. Skin prick test is the most common and effective methods used for diagnosis. It is the gold standard diagnostic test worldwide for diagnosing IgE-mediated allergies.Blood test can also be done for allergen-specific antibodies in patients where skin prick test is not possible. Which test is right for you? The right allergy test depends on your specific symptoms, medical history, and individual needs. Blood testing is often recommended for individuals who cannot discontinue medications, have sensitive skin, or are at risk of severe allergic reactions during testing. Blood tests provide a comprehensive overview of your allergic profile, offering precise results that help identify triggers effectively. Allergy testing is a convenient and less invasive method for diagnosing allergies, offering several advantages:Accuracy for certain foods: Blood tests for certain food allergies are more reliable than skin tests.Medication-safe: Results are unaffected by medications you may be taking.No risk of anaphylaxis: Blood testing eliminates the risk of triggering a severe anaphylactic reaction.Skin condition independent: The test does not rely on the condition of your skin, making it suitable for various situations.Infant-friendly: It is safe for infants as young as six weeks old.Comprehensive and efficient: A single blood sample can be used to test for multiple allergens and allergen components. It can be easily ordered by your physician at allergy clinic What treatments are available? Treatments for allergies focus on managing symptoms and reducing exposure to allergens. Depending on the type and severity of your allergy, options include avoiding triggers, taking medications, or undergoing therapies like allergy shots to build long-term tolerance. Your doctor will help determine the most appropriate treatment for your specific condition. The common methods for the management of allergies are listed below:AvoidanceFor some allergies, particularly food-related ones, avoiding the allergen may be the only necessary treatment. This can prevent symptoms and eliminate the need for medications or additional interventions.MedicationsWhen avoiding allergens isn’t sufficient, medications can help manage allergy symptoms effectively. Fast-acting medicines such as epinephrine injections are also available to counter severe allergic reactions, such as anaphylaxis.Allergy shotsImmunotherapy, commonly referred to as allergy shots, helps increase your tolerance to allergens over time. These are often recommended for severe allergies or persistent symptoms lasting more than three months annually. While allergy shots do not cure allergies, they significantly reduce your immune system’s sensitivity to allergens. How do I get tested for an allergy? If you or your child experience symptoms of an allergy, consult a doctor about undergoing a blood test. If an allergy is confirmed through testing, you may be referred to a specialist, such as an allergist, for further evaluation and long-term management. Why regular testing matters? Allergies can evolve over time. For instance, infants may outgrow allergies to milk and eggs as they age, while other allergies might become more severe. Periodic testing is essential to accurately monitor and manage your allergy, ensuring better health and quality of life. Read more about Allergy Filter Alphabet A
Degenerative Spine Diseases Degenerative Spine Diseases Home Overview Degenerative spine disease refers to a group of conditions wherein changes in the spine occur due to ageing, wear and tear, or injury. It primarily affects the intervertebral discs, vertebrae, and associated structures, leading to pain, stiffness, and potentially neurological symptoms. Symptoms Intermittent or persistent pain in the neck and back, which may radiate to one or both lower limbs. The pain can be localised to a particular region (front or back of thigh/legs).Stiffness in the back.Occasionally, weakness of the legs or bowel and bladder involvement may occur if the compression is severe. Diagnosis Physical examination of the spine to assess if there is any structural deformity, and evaluation of the range of motion, reflexes, and muscle strength.Radiography (X-ray) to assess the vertebral bodies, disc space, bony spurs, and spinal alignment.Magnetic resonance imaging (MRI) to identify nerve and spinal cord compression and assess soft tissue. Treatment Non-surgical treatmentConservative non-surgical treatment methods include:Physical therapy with strengthening exercises, stretching, and posture correction.Medication to relieve pain and muscle spasms.Activity modification.Interventions, such as epidural steroid injection, facet joint injection, and nerve root injection.Surgical treatmentDecompression through laminectomy.Discectomy with or without spinal fusion.These are decided by the treating surgeon based on the patient’s condition. Read more about Degenerative Spine Diseases Filter Alphabet D
de Quervain’s Tenosynovitis de Quervain’s Tenosynovitis Home Overview De Quervain’s tenosynovitis is an inflammatory condition that affects the tendon sheath at the base of the wrist, restricting the movement of the thumb. Symptoms Pain at the base of the thumb that sometimes radiates to the forearm or the elbow.Occasional swelling or redness of the wrist. Risk factors Wrist overuse-led injury.Women are more commonly affected than men.Middle age (40–59 years).Pregnancy and breastfeeding.Rheumatoid arthritis, diabetes, and thyroid disorders. Diagnosis Physical examination for assessing the pain and certain tests, such as asking the patient to make a fist with the thumbs inside and bending it towards the little finger.Ultrasonography to confirm the diagnosis.Magnetic resonance imaging is rarely required. Treatment Non-surgical treatmentThe primary aim of the non-surgical treatment is to alleviate pain. These treatment methods include:Anti-inflammatory medication during the initial phase of the condition.Splints to reduce inflammation by resting the affected area (keeping the thumb in an upright position).Applying ice packs to the affected area.Lifestyle modifications.Steroid injections (a maximum of 1–2 injections) to help reduce the symptoms by approximately 50%–80%.Surgical treatmentSurgery is recommended for patients in whom non-surgical treatment options have failed.The minimally invasive surgery can be performed under local or a short general anaesthesia and involves a small 1–2 inch incision at the base of the thumb to release the thickened tendon sheath and relieve the symptoms.Post-surgery care:A pressure dressing is usually applied for 2 weeks following which the sutures are removed.Physical therapy is usually initiated after suture removal and involves mobilisation and strengthening exercises. Read more about de Quervain’s Tenosynovitis Filter Alphabet D
Cervical and Lumbar Spondylosis Cervical and Lumbar Spondylosis Home Overview Cervical and lumbar spondylosis arises due to the natural ageing process of the body. The usual wear and tear of the joints and soft tissue around the neck and lower back causes degenerative changes that may result in axial neck and back pain with restricted motion. Symptoms Neck or lower back pain.Limitation of motion and pain with movements.Occasionally, referred pain in the shoulder blades, upper back, or mid-back. Risk factors Old age.Excessive strain on the neck or back in young adults.Excessive screen time, prolonged sitting without a change in position, or poor posture. Diagnosis Clinical examination to rule out other causes of neck or back pain and ensure that the pain is not referred from adjacent joints.Radiography (X-ray) of the neck and lower back to identify degenerative changes and rule out any fractures, malalignment, or abnormal findings. Treatment A short course of anti-inflammatory and analgesic medications.Local cold compress to relieve pain and improve rehabilitation.Physiotherapy for improving the range of motion and strengthening the muscles.Correction of poor posture and lifestyle modifications. Read more about Cervical and Lumbar Spondylosis Filter Alphabet C
Carpal Tunnel Syndrome Carpal Tunnel Syndrome Home Overview Carpal tunnel syndrome (CTS) is the compression of the median nerve in the carpal tunnel of the wrist joint. Symptoms Numbness and tingling sensations along the thumb, index, middle finger, and outer half of the ring finger, affecting sleep, especially at night.Pain radiating up to the forearm or shoulders.In advanced stages, weakness and atrophy (shrinkage) of hand muscles lead to loss of grip and dropping objects. Risk factors Women are more prone to develop CTS than men.Hereditary factors.Old fractures of the wrist.Frequent and repetitive wrist movements, such as typing.Associated with medical conditions, such as diabetes, obesity, hypothyroidism, pregnancy, and rheumatoid arthritis. Diagnosis Gentle tapping along the course of the nerve causes a current-like/tingling sensation (Tinel’s sign).Holding the bent wrist to elicit the pain/tingling/numbness sensation associated with nerve compression.Assessing muscle power and atrophy in the handAlthough CTS diagnosis is usually clinical, the following examinations may be required for confirmation:Radiography (X-ray) to rule out old fractures in the wrist.Ultrasonography to assess the carpal tunnel anatomy and understand the probable cause of nerve compression.Electromyography (EMG) to assess hand muscle activity.Nerve conduction velocity (NCV) to measure the electrical signals along the nerves of the hand and wrist. EMG and NCV are usually performed simultaneously.Magnetic resonance imaging (MRI) is rarely required to identify rare causes of compression. Treatment Non-surgical treatmentErgonomics and splinting for patients with occupation-related causes during the early course of the diseaseMedications, such as anti-inflammatory drugs, oral or intravenous steroids, vitamin B6, and glucocorticoids or diureticsSurgical treatmentSurgical treatment is required for patients who are at an advanced stage of the syndrome and in whom conservative management fails. The surgical treatment approaches for CTS are:Conventional open carpal tunnel release through arthroscopy procedures.Endoscopic approach. Read more about Carpal Tunnel Syndrome Filter Alphabet C
Carpal Tunnel Release Carpal Tunnel Release Home Overview Carpal tunnel release is an arthroscopy procedure to treat carpal tunnel syndrome where the surgeon releases the transverse carpal ligament in the wrist, which covers the median nerve, to decrease pressure on the nerve or decompress the nerve. Indications This nerve decompression procedure is usually recommended for patients who are in advanced stages of carpal tunnel syndrome and have not shown improvement following non-surgical interventions. Procedure Preoperative preparationThe decision for surgery is made following extensive clinical examination and a thorough discussion between the patient and surgeon. Before the surgery:Few blood tests are required before the procedure to assess the patient’s general conditionAnti-inflammatory medications and blood thinners are stopped 5–7 days before the surgerySurgeryThis arthroscopy procedure can be performed as a daycare procedure or might require 1-day admission depending on the condition. The patient is admitted a few hours before surgery and the duration of fasting required is determined by the surgeon. The procedure is done as follows:Local anaesthesia (axillary block or a wrist block) or general anaesthesia is administeredSmall incisions (around 1 inch) are made at the palmar aspect of the wrist, and the transverse carpal ligament (covering of the carpal tunnel) is cut completely to relieve the pressure (decompress) on the median nerveAll aspects of the nerve are examined to assess adequate releaseIf deemed suitable by the treating surgeon, the surgery can also be done using an endoscope (keyhole surgery).Postoperative careMedications for painWound careIce packs to reduce swellingHand elevation in the first few days to minimise swellingPhysical therapy and rehabilitationAvoiding strenuous activities involving the hand and wrist for 2-4 weeks Complications Arthroscopy procedures are generally safe but potential complications include: Tissue or nerve damageInfectionStiffness and weakness of joint Outcome Most patients experience significant relief from pain, numbness, and tingling after surgery. Improvement in hand strength and functionality is typically gradual with full recovery taking several weeks to months. Patients can usually resume light activities within 1–2 weeks, while full recovery may take 6–12 weeks, depending on the complexity of the surgery and the patient's adherence to postoperative care. Read more about Carpal Tunnel Release Filter Alphabet C
Bunion Bunion Home Overview A bunion, commonly known as hallux valgus or hallux abducto valgus, is typically described as a swelling or lump on the outer side of the big toe. Bunion formation is a progressive condition. Causes Bunions are most often caused by an inherited defect in the mechanical structure of the foot. Notably, while the bunion itself is not inherited, certain foot types render people more susceptible to developing a bunion. Bunion formation may indirectly result from wearing tight shoes that crowd the toes, which can occasionally exacerbate an inherited foot abnormality. Symptoms Soreness or painRedness and swellingA burning feelingNumbness Diagnosis A physical examination is usually adequate to confirm the diagnosis of a bunion since the deformity is apparent at the base of the big toe or on the side of the foot.Radiography (X-ray) can be performed to evaluate changes and ascertain the severity of the deformity. Treatment Non-surgical treatmentIn some cases, only observation of the bunion along with periodic evaluation and radiography is sufficient. However, in others, treatment might be essential. Early diagnosis and treatment may reduce the pain from worsening, but it cannot reverse the foot deformity. The steps that can be taken to avoid the worsening of a bunion include:Changing the type of shoesAdditional padding of the shoesChanges in daily activitiesPain-relieving medications, such as oral NSAIDs (nonsteroidal anti-inflammatory drugs), to alleviate joint painApplying ice to the affected regionInjection therapiesUse of orthopaedic supportsSurgical treatmentIf non-surgical treatments fail to provide pain relief, your doctor may recommend a bunion surgery. Bunion surgery usually involves correcting the bunion abnormality through surgical procedures like the removal of excess bone and joint fusion. Read more about Bunion Filter Alphabet B
Arthritis Arthritis Home Overview Arthritis is a broad term for joint inflammation, covering various conditions that affect the joints. It can cause pain, swelling, and stiffness, with severity ranging from mild to debilitating. Arthritis can significantly impact the quality of life. Types Arthritis is categorised into the following types:Osteoarthritis (OA): This is a degenerative joint condition associated with cartilage degeneration, which causes joint stiffness and pain; OA is the most common type of arthritis.Inflammatory arthritis: This represents an autoimmune condition; the immune system mistakenly recognises the joint's synovial lining as ‘foreign’ and attacks it, leading to inflammation and pain. Common examples include rheumatoid arthritis (RA), ankylosing spondylitis (often affecting the spine), and psoriatic arthritis (linked with skin lesions).Gout: This condition arises from the build-up of uric acid crystals in the joints, causing sudden, intense pain, typically in the big toe.Juvenile arthritis: This type of arthritis typically occurs in children under the age of 16. Causes Ageing is the most common cause of arthritis, with the exception of juvenile arthritis.According to gender differences, Some types of arthritis like RA and lupus are more common in women than men.A family history of arthritis can increase the risk of developing specific types of arthritis, such as OA and RA.Obesity has also been reported to serve as a risk factor for arthritis, given that excess weight puts pressure on the joints, particularly those associated with carrying weight, such as the knee joints.Previous joint injuries or repetitive strain can lead to a higher likelihood of developing secondary osteoarthritis (OA).People with autoimmune disorders may have an increased susceptibility to arthritis. Symptoms Persistent or occasional joint pain, particularly in weight-bearing joints, such as the knee and ankle jointsSwelling caused by inflammation in the affected jointsStiffness, especially noticeable in the morning or after prolonged inactivityLimited range of motion, causing difficulties in joint movementWarmth and redness, commonly seen in inflammatory types of arthritis like rheumatoid arthritis (RA) Diagnosis Physical Examination: The physician evaluates joint swelling, tenderness, range of motion, and overall joint function.Medical History: This involves the discussion of the severity and duration of symptoms and any family history of arthritis.Blood Tests: These help assess the levels of inflammation-specific markers, such as the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), autoimmune antibodies (e.g., rheumatoid factor for RA), and uric acid levels (for gout).Imaging Studies: X-ray or magnetic resonance imaging (MRI) helps to assess structural changes in the joint and ascertain the severity of joint damage and inflammation. Treatment Non-surgical treatmentNon-surgical treatment methods vary depending on the type and severity of arthritis; one or more of the following methods may be used:Medications:Analgesics: Mainly non-steroidal anti-inflammatory drugs (NSAIDs).Disease-modifying antirheumatic Drugs (DMARDs): Used for rheumatoid arthritis (RA) and other inflammatory types of arthritis.Urate-lowering medications: For managing gout.Physical Therapy: Exercises for enhancing muscle strength and flexibility.Lifestyle Modifications: Weight management, joint protection strategies, and regular exercise.Surgical treatmentFor patients with severe arthritis, surgical procedures, such as joint replacement or arthroscopy, may be necessary. Overall, a multidisciplinary approach is often required to effectively treat specific types of arthritis based on the severity of the condition. Read more about Arthritis Filter Alphabet A
Anterior Knee Pain Anterior Knee Pain Home Overview Anterior knee pain refers to discomfort behind or around the kneecap (patella). It arises from various joint abnormalities and varies widely in severity. Causes Structural or anatomical abnormalities.Patellar malalignment or instability.Muscle weakness, tightness, or imbalance.Overuse or repetitive use of knee muscles, especially in sports.Patellar fractures.Certain medical conditions like obesity.Conditions causing anterior knee pain include:Patellofemoral pain syndrome (Runner’s knee)Patellar tendonitis (Jumper’s knee)Chondromalacia patellaPatellar arthritisOsgood Schlatter diseaseIliotibial band syndrome Symptoms The primary symptom is pain behind or around the kneecap, which may worsen during activities such as:Descending the stairsWearing high heelsSitting for prolonged durationsSquattingUsing a car clutchKnee instabilityCrepitus (grating feeling or noise)Quadriceps muscle weakness if pain persists Risk factors Common in women, teenagers, adolescents (affects 30% of adolescents), and young adults.Repetitive physical activity.Engagement in running, cycling, and athletics.History of knee injury. Diagnosis Medical historyPhysical examinationImaging techniques, such as ultrasonography, radiography, or magnetic resonance imaging MRI for joint painAssessment of core stability, muscle imbalances, and functional limitations Treatment Non-surgical treatmentRest and pain managementStrengthening and stretching the thigh and buttock musclesMaintaining a healthy weightUsing shoe inserts for flat feetTaping to realign the kneecapProper footwearHeat and ice applicationPhysical therapy helps address malalignment and provides strengthening programmesSurgical treatmentSurgery is considered only for patients who do not benefit from non-surgical interventions and need fast recovery. Read more about Anterior Knee Pain Filter Alphabet A