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Case report 01/09/2008

A zebra amongst the horses

A zebra amongst the horses

Time to read article: 3 mins
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Mr A, an office administrator in his 40s, was referred by an out-of-hours GP to the orthopaedic on-call team at the local district general hospital (DGH). Mr A had previously worked as a mechanic, but had been forced to change career because of a long-standing back problem, for which he had an L4/L5 microdiscectomy performed five years earlier.

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Case report 01/01/2008

Too long to run

Too long to run

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Mr C, a 45-year-old PE teacher, attended the outpatient clinic to see Mr V, consultant orthopaedic surgeon. Mr C was also a keen marathon runner, but due to an increasingly painful right hip he had found running more difficult. X-rays confirmed advanced degenerative changes on his right hip joint.

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Case report 05/01/2007

An orthopaedic emergency

An orthopaedic emergency

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Mrs A, a 31-year-old dental nurse, sustained a complex fracture of her dominant right distal humerus after falling from her bike. She attended the local A&E Department, where other injuries were excluded, and she was admitted to the orthopaedic unit. She was reviewed by the orthopaedic team on call.

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Case report 01/08/2005

Operate or wait?

Operate or wait?

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Mr E had developed a bad back and a friend had recommended that he see Mr G, an orthopaedic specialist. Mr E made an appointment to see Mr G at a private hospital in the UK without asking his GP to refer him. Mr G thought that Mr E had a prolapsed lumbar disc, which he treated with epidural and facet-joint injections. An MRI scan confirmed a small left-sided paracentral disc prolapse, pressing on the L3/4 nerve root.

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Case report 01/05/2005

Scarred for life?

Scarred for life?

Time to read article: 2 mins
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Rachel broke her left clavicle when she was an infant. Unfortunately, it healed poorly and became a malunited pseudarthrosis. In 1997, aged 16, she was tired of the pain, swelling and unsightliness this caused her and she saw Mr C, specialist orthopaedic surgeon.

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Case report 01/05/2005

Moot myelopathy

Moot myelopathy

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Mr U, a 50-year-old dentist, had suffered from symptoms of cervical myelopathy – due to spinal canal stenosis and intervertebral disc protrusion – for five years. The diagnosis had been confirmed by magnetic resonance imaging (MRI).

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Case report 01/08/2004

Could it make me worse?

Could it make me worse?

Time to read article: 2 mins
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Mr W had suffered with left-sided ulnar nerve pain for some years. He saw Dr H, an orthopaedic surgeon. Fifteen years previously he’d had surgery on his left ulnar nerve to treat his pain, but had recently suffered increasingly severe pain.

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Case report 01/05/2004

Complications happen

Complications happen

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Mr K, a manager in his sixties, saw an orthopaedic consultant, Mr C, about his painful right hip and thigh. Mr C suspected avascular necrosis of the femoral head as the cause of Mr K’s symptoms. An MRI scan confirmed this diagnosis.

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Case report 01/05/2004

A crucial x-ray overlooked

A crucial x-ray overlooked

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Mr V injured his right wrist whilst playing with his son. The next morning he went to A&E, where his wrist was x-rayed. A fracture of the wrist was suspected and a plaster applied to the right wrist and forearm, with follow-up at the fracture clinic arranged for the following week.

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Case report 01/02/2004

No notes, no leg to stand on

No notes, no leg to stand on

Time to read article: 2 mins
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Ms Q was a young shop worker living in the south of England. She had been experiencing low back pain for several months and it had not responded to conservative treatment. The results of an x-ray had been inconclusive and, rather than wait to have further investigations as an NHS patient, Ms Q asked her GP to refer her to an orthopaedic surgeon as a private patient.

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Case report 01/08/2003

Shouldering responsibility

Shouldering responsibility

Time to read article: 2 mins
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Mr W was a young dad with a wife and two small children. He developed pain in his neck and right shoulder and consulted his GP, Dr J. Finding some slight tenderness over the right shoulder with a full range of movement, Dr J prescribed ibuprofen.

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Case report 01/08/2003

A tight situation

A tight situation

Time to read article: 2 mins
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Mrs W, a retired lady in her seventies, had suffered from a painful and stiff left knee for some years. She saw an orthopaedic surgeon, Mr D, who recommended a left total-knee replacement. Mr D had some trouble operating on Mrs W’s knee. He had to use a substantial medial release procedure, stripping the entire postero-medial aspect of the tibia.

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