Monthly Archives: June 2019


Had to see someone yesterday about a lowish phosphate level, and, since I know nothing about hypophosphatemia, it was learning time. I found a couple of useful articles for quick reference – this one in the BMJ and this one … Continue reading

Posted in Credits 2019, DENs, Lab results | Leave a comment

Red flags in low back pain

I noticed I have someone booked into an upcoming session to see me about back pain, so I decided it was time I checked the list of red flags for back pain to be sure I don’t miss anything. This … Continue reading

Posted in Back pain, Credits 2019, Don't miss, Musculoskeletal | 1 Comment

Axial spondyloarthritis

The spondyloarthritides are a group of inflammatory conditions which can affect axial or peripheral joints. Axial spondyloarthritis Radiographic axial spondyloarthritis* Non-radiographic axial spondyloarthritis** *This is the entity that used to be known as ankylosing spondyloarthritis. However, the criteria for diagnosing … Continue reading

Posted in Back pain, Musculoskeletal, Rheumatology | 1 Comment

Flexor sheath infections

AKA infected tenosynovitis. These are bad news; the flexor sheaths in the hand are a closed continuous system; if they get infected, the swelling can lead to necrosis, necrotising faciitis, and osteomyelitis. Common causes include animal bites, puncture wounds, IV … Continue reading

Posted in Credits 2019, Don't miss, Orthopaedics, Tendons | Leave a comment

Subclinical hypothyroidism

A decent-sized meta-analysis of RCTs on the treatment of subclinical hypothyroidism (raised TSH with normal T4) has been done, and the conclusion is that treatment makes no difference to symptoms, compared to placebo. There are some caveats: Pregnant women weren’t … Continue reading

Posted in Credits 2019, Endocrinology, Thyroid | Leave a comment


I was recently presented with an audiogram to interpret, and realised that the printout we get from our practice equipment has no labels on the axes and no accompanying notes, which is not very helpful. I remembered roughly how to … Continue reading

Posted in Credits 2019, ENT, Hearing loss | Leave a comment