Remember to consider an ASIS avulsion in young athletes who experience pain and a pop around their hip when sprinting.   Check out the Orthobullets page https://www.orthobullets.com/knee-and-sports/3091/anterior-superior-iliac-spine-asis-avulsion    www.rnzcuc.org.nz [email protected] https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to assist in ongoing medical education and peer...

A differential to consider when examining a dorsal wrist swelling.   Check out the Radiopaedia pages On Ganglion cysts On Carpal Boss   www.rnzcuc.org.nz [email protected] https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to assist in ongoing medical education and peer discussion for qualified health professionals.  Please ensure you work within your scope of practice at all times.  For...

Much like going to the gym, CPD can be a hassle or an imposition, but it can also be fun and hugely rewarding.   Check out the paper mentioned Jeong D, Presseau J, ElChamaa R, Naumann DN, Mascaro C, Luconi F, Smith KM, Kitto S. Barriers and Facilitators to Self-Directed Learning in Continuing Professional Development for Physicians in Canada: A Scoping Review. Acad Med. 2018 Aug;93(8):1245-1254....

Should we be listening for bowel sounds?  Despite evidence suggesting they are not useful, I still think it is an important part of an urgent care assessment.     Check out the papers mentioned. Elhardello O, Macfie J. Bowel Sounds: Is it Time for Surgeons to Hang-up their Stethoscopes?. World J Surg Surgical Res. 2018; 1: 1066. Link to paper.   Breum BM, Rud B, Kirkegaard T, Nordentoft T. Accuracy of abdominal auscultation for bowel obstruction. World J Gastroenterol. 2015 Sep...

What impact do your acute referral letters have on the admitting team?   You may have noticed the initial upload contained the wrong audio file of an old podcast.  Sorry, this has been corrected.   Check out the papers mentioned Chauveau P, Mazet-Guillaume B, Baron C, Roy PM, Tanguy M, Fanello S. Impact du contenu du courrier médical sur la qualité du triage initial des patients adultes admis aux urgences [Impact of the referral letter on triage decisions in adult patients admitted to the...

We must be aware of the possibility of Cozen's phenomenon in urgent care.   Check out the Radiopedia page by Tim Luijkx https://radiopaedia.org/articles/cozen-fracture-1   Check out the Orthobullets page by Macknett MD et al https://www.orthobullets.com/pediatrics/4025/proximal-tibia-metaphyseal-fractures--pediatric   Check out the obituary of Dr Lewis Cozen.    www.rnzcuc.org.nz [email protected] https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed...

Today we hear of a case of Chopart injury presenting through urgent care.  Thanks to Dr Antonio Castro.     Check out the paper mentioned Metcalfe TSN, Aamir J, Mason LW. Chopart dislocations: a review of diagnosis, treatment and outcomes. Arch Orthop Trauma Surg. 2024 Jan;144(1):131-147. doi: 10.1007/s00402-023-05040-4. Epub 2023 Sep 15. PMID: 37715068; PMCID: PMC10774188.   www.rnzcuc.org.nz [email protected] https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed...

2 years ago we spoke with Dr Tamsin Lillie, a Fellow of the RNZCUC who runs a medical charity that helps fund African students through medical training.    Last time we spoke she was calling in from Malawi, but a chance meeting in person prompted a quick catch-up about what has been going on over the last 2 years and her hopes for the charity moving forward.   www.medictomedic.org.nz    www.rnzcuc.org.nz [email protected] https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music...

Some common, non-psychotropic medications can have psychiatric side effects.     Check out the article mentioned Prescriber Update 45(1): 5-8 March 2024  https://www.medsafe.govt.nz/profs/PUArticles/March2024/Unexplained-mood-and-behavioural-changes.html     www.rnzcuc.org.nz [email protected] https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to assist in ongoing medical education and...

Hoffmann's sign is a simple test that can help in diagnosing cervical myelopathy and upper motor neurone disease as part of a thorough history and examination.    Check out the paper mentioned Nemani VM, Kim HJ, Piyaskulkaew C, Nguyen JT, Riew KD. Correlation of cord signal change with physical examination findings in patients with cervical myelopathy. Spine (Phila Pa 1976). 2015 Jan 1;40(1):6-10. doi: 10.1097/BRS.0000000000000659. PMID:...

Wellens' Syndrome is an ECG finding indicative of critical LAD stenosis.  Recognising this ECG change is vital.     Check out the Life in the Fast Lane post by Dr Mike Cadogan and Dr Robert Buttner from September 2021 https://litfl.com/wellens-syndrome-ecg-library/   This is a BMJ case report that is worth reading. Ramires TG, Sant'Anna J, Pais J, Picarra BC. Wellens' syndrome: a pattern to remember. BMJ Case Rep. 2018 Apr 10;2018:bcr2018224582. doi: 10.1136/bcr-2018-224582. PMID: 29636339;...

We must counsel about the possibility of abnormal uterine bleeding starting, or worsening when commencing oral anticoagulation.   Check out the Prescriber update - December 2023 edition - https://www.medsafe.govt.nz/profs/PUArticles/PDF/Prescriber-Update-44-No.4-December-2023.pdf   Check out the paper mentioned de Jong CMM, Blondon M, Ay C, Buchmuller A, Beyer-Westendorf J, Biechele J, Bertoletti L, Colombo G, Donadini MP, Hendriks SV, Jara-Palomares L, Nopp S, Ruiz-Artacho P, Stephan P,...

An interesting eponymous syndrome with a Kiwi connection.     Check out the Stat Pearls Page Tafti D, Cecava ND. Poland Syndrome. [Updated 2023 May 22]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532259/ https://www.ncbi.nlm.nih.gov/books/NBK532259/   Read more about Patrick Clarkson, MBE, FRCS - https://en.wikipedia.org/wiki/Patrick_Clarkson Read more about Jeremy Beadle, MBE -...

In cases of ongoing post-prandial epigastric pain and sitophobia despite endoscopy work up and treatment perhaps we should remember to recall Dunbar Syndrome to our differential list.   Check out the paper mentioned Li J, Tan XY, Megahed A, Evangelista A. Dunbar syndrome: An unusual cause of chronic postprandial abdominal pain. Radiol Case Rep. 2020 Aug 2;15(10):1747-1749. doi: 10.1016/j.radcr.2020.07.016. PMID: 32774573; PMCID: PMC7397697....

Grover disease might present through your urgent care.  While not a critical or life-threatening condition, recognising it so we can advise and support your patient is important.  To help us consider differentials for various presenting complaints there is a useful website you can use.   Check out the Cunneliffe (TP) General Dermatology Diagnostic Tool - https://www.pcds.org.uk/general-dermatology-table   Check out the Dermnet page on Grover disease - authored by Prof Amanda Oakley and Dr Ian...

When considering calcaneal fractures we must remember the Böhler angle and the angle of Gissane.   Check out the Orthobullets page written by Crag Forsthoefel MD. https://www.orthobullets.com/trauma/1051/calcaneus-fractures   Check out the Radiopaedia articles  Benoudina S, Worsley C, Knipe H, et al. Gissane angle. Reference article, Radiopaedia.org (Accessed on 08 Feb 2024) https://doi.org/10.53347/rID-40094 Amini B, Worsley C, Weerakkody Y, et al. Böhler angle. Reference article,...

Do you know about the Corona Mortis?  Today with chat to Dr Tim Brabants who has seen a case and feels we should be aware of its potential in urgent care.   Tim is a UK-trained doctor who has worked in the UK and South Africa, predominantly in emergency medicine.  Now based in New Zealand, he is a senior Registrar with the RNZCUC   Check out these resources on the Corona Mortis.   Radiopaedia - Hsu C, Ismail M, Furaiji H, et al. Corona mortis. Reference article, Radiopaedia.org (Accessed on...

Could caffeine withdrawal result in an urgent care visit?   Check out the paper mentioned Sajadi-Ernazarova KR, Anderson J, Dhakal A, et al. Caffeine Withdrawal. [Updated 2023 Aug 8]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from:...

An eponymous sign that helps in the diagnosis of glandular fever.     Check out the paper mentioned.   Otsuki T, Ishizuka K, Hirose M, Ie K. Hoagland sign in infectious mononucleosis. BMJ Case Rep. 2022 Nov 16;15(11):e252839. https://pubmed.ncbi.nlm.nih.gov/36384885/    Check out the obituary of Colonel Robert. J. Hoagland MD - https://courierpostonline.newspapers.com/article/the-charlotte-observer-robert-j-hoagland/82137229/   Check out the Patient.info page on glandular fever, written by Dr...

This week, the world's best snooker players are competing for the Paul Hunter Trophy at the Masters in London.  Paul sadly died of neuroendocrine tumours in 2006 whilst in his snooker prime.     Check out the paper mentioned Ahmed M. Gastrointestinal neuroendocrine tumors in 2020. World J Gastrointest Oncol. 2020 Aug 15;12(8):791-807. doi: 10.4251/wjgo.v12.i8.791. PMID: 32879660; PMCID: PMC7443843. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7443843/   Check out this blog page detailing Paul...

What is your acute referral rate from UC to secondary care?   Check out the paper mentioned. Blinkenberg J, Hetlevik Ø, Sandvik H, Baste V, Hunskaar S. The impact of variation in out-of-hours doctors' referral practices: a Norwegian registry-based observational study. Fam Pract. 2023 Dec 22;40(5-6):728-736. https://pubmed.ncbi.nlm.nih.gov/36801994/      www.rnzcuc.org.nz [email protected] https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed...

Jean Batten was a New Zealand pioneering aviatrix who died of empyema.   Check out Jean Batten's history. From the NZ History website - https://nzhistory.govt.nz/people/jean-batten From Te Ara, the Encyclopedia of New Zealand - https://teara.govt.nz/en/biographies/4b13/batten-jean-gardner From Wikipedia - https://en.wikipedia.org/wiki/Jean_Batten#   Check out the paper mentioned - Dyrhovden R, Nygaard RM, Patel R, Ulvestad E, Kommedal Ø. The bacterial aetiology of pleural empyema. A...

You might encounter an Ice Cream Headache over Christmas.      Check out the International Classification of Headaches - Third Edition) Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013 Jul;33(9):629-808. doi: 10.1177/0333102413485658. PMID: 23771276. https://pubmed.ncbi.nlm.nih.gov/23771276/   Check out the paper mentioned Özyürek H, Koray Bayrak I, Yayici Köken...

The 2024 Urgent Care Bootcamp conference will be held at the Rydges Hotel in Wellington on September 14th and 15th.     If you would like to express an interest in presenting a talk, abstract or poster, go to this link - https://rnzcuc.org.nz/urgent-care-bootcamp-2024/     www.rnzcuc.org.nz [email protected] https://www.facebook.com/rnzcuc https://twitter.com/rnzcuc   Music licensed from www.premiumbeat.com Full Grip by Score Squad   This podcast is intended to assist in ongoing medical...