Musculoskeletal Features

Cervical spine injury is a potentially life threatening trauma. Given the increase in the number of patients presenting to the emergency department who are elderly and who have fallen and sustained trauma, it has become challenging to manage this cohort.

Bone cement implantation syndrome is a rare but severe peri-operative pathology that presents on cementation of orthopaedic implants. Effects range from transient hypotension to cardio-respiratory arrest. 

This article discusses a case of recurrent rhabdomyolysis caused by underlying hypothyroidism. Rhabdomyolysis is a serious condition and one that all physicians encounter. Hypothyroidism is an important diagnosis not to miss.

The management of patients who have suffered a neck of femur fracture requires the input not only by surgeons but also the medical doctors. This has given rise to a nationally agreed standard that all hospitals must adhere to by rewarding trusts via a ‘Best Practice Tariff’ System.

Serving an ageing population is one of the biggest challenges faced by the NHS. Falls are a common presentation in this cohort where the cause is often multi-factorial and reversible. We as clinicians need to dig deeper in our histories, observe more closely in our examinations and broaden our differentials to ensure we don’t slip up.

Oral bisphosphonates, such as alendronate, risedronate and etidronate, are the initial therapy advised by NICE for osteoporosis because of their efficacy and cost. They must, however, be taken under a certain set of conditions, which some patients may find difficult to adhere to.

Sarcopenia is emerging as an important phenomenon in the older population and in future regular screening may allow us to deliver interventions that could improve important functional outcomes associated with the condition.