Reference Library
Orthopaedic topic library
A searchable library of surgeon-level topic pages organised by subspecialty, built for diagnosis, investigations, operative decision-making, complications, and evidence review.
- Topics
- 1,288
- Subspecialties
- 13
- Complete
- 100%
clinical chapters
structured library sections
published coverage
By subspecialty
1288 topics
Topic cluster
Trauma
Fractures, dislocations & acute injuries
185 topics
Topic cluster
Sports Medicine
Athletic injuries & ligament surgery
98 topics
Topic cluster
Adult Reconstruction
Hip, knee & joint replacement
109 topics
Topic cluster
Paediatrics
Children's orthopaedic conditions
176 topics
Topic cluster
Basic Science
Anatomy, biomechanics & pathology
160 topics
Topic cluster
Hand & Upper Limb
General orthopaedic topics
180 topics
Topic cluster
Spine
Cervical, thoracic & lumbar spine
85 topics
Topic cluster
Foot & Ankle
Foot, ankle & lower leg conditions
86 topics
Topic cluster
Oncology
Bone & soft tissue tumours
93 topics
Topic cluster
General
General orthopaedic topics
28 topics
Topic cluster
Radiology
Imaging interpretation & modalities
70 topics
Topic cluster
Infection
Septic arthritis, osteomyelitis, prosthetic joint & soft-tissue infection
3 topics
Topic cluster
Professionalism & Ethics
General orthopaedic topics
15 topics
Orthopaedic Surgery Topic Library β 1288 Evidence-Based Articles
Comprehensive orthopaedic surgery education covering trauma, arthroplasty, spine, hand and upper limb, foot and ankle, paediatrics, sports medicine, oncology, and basic science with public editorial standards and correction routes.
Trauma β 185 topics
- Acetabular Fractures β Comprehensive guide to acetabular fractures - Judet-Letournel classification, column concept, surgical approaches for orthopaedic exam
- Acromioclavicular Joint Injuries β Comprehensive guide to AC joint injuries - Rockwood classification, Type III controversy, surgical indications, hook plate vs CC reconstruction, and management pearls for orthopaedic exam
- Acute Compartment Syndrome β Comprehensive guide to acute compartment syndrome - pathophysiology, diagnosis, fasciotomy techniques, and complications for orthopaedic surgery exam
- Acute Compartment Syndrome of the Leg β Time-critical surgical emergency: clinical diagnosis, Delta P less than 30mmHg threshold, and two-incision four-compartment fasciotomy for acute compartment syndrome of the leg.
- Ankle Dislocations β Comprehensive guide to ankle dislocations - talus tibia fibula mortise, urgent reduction, associated fractures, and treatment for orthopaedic exam
- Ankle Fractures β Comprehensive guide to ankle fractures - Weber classification, syndesmotic injury patterns, stability assessment, and surgical decision-making for orthopaedic exam
- Anterior Process Calcaneus Fractures β Comprehensive guide to anterior process calcaneus fractures - bifurcate ligament avulsion, mechanism, diagnosis, and treatment for orthopaedic exam
- Anteroposterior Compression (APC) Pelvic Injuries β Comprehensive guide to APC pelvic ring injuries including Young-Burgess classification, open book pelvis mechanics, and surgical management
- AO/OTA Fracture Classification β The universal AO/OTA alphanumeric fracture classification β bone-segment-type-group-subgroup coding, the dual meaning of types A/B/C in diaphyseal versus articular segments, its role in research and registries, and how it complements eponymous systems.
- ATLS Primary Survey and Trauma Resuscitation β Systematic ABCDE primary survey, cABCDE catastrophic haemorrhage control, damage-control resuscitation, permissive hypotension, massive transfusion protocols, and the orthopaedic role in polytrauma management.
- Atypical Femoral Fractures β Comprehensive guide to atypical femoral fractures - bisphosphonate-associated fractures, ASBMR criteria, surgical management, and drug holiday protocols for Orthopaedic orthopaedic exam
- Barton's Fractures β Comprehensive guide to Barton's fractures - volar and dorsal rim fracture-dislocations of the distal radius, classification, surgical management, and Orthopaedic exam preparation
- Basicervical Fractures β Comprehensive guide to basicervical fractures - junctional fracture between neck and intertrochanteric region, treatment ORIF vs arthroplasty, and management for orthopaedic exam
- Bennett's Fractures β Comprehensive guide to Bennett's fracture-dislocation of the thumb metacarpal base including mechanism, classification, reduction techniques, and surgical fixation for orthopaedic examination
- Blast Injuries of the Extremity β Comprehensive guide to blast-related extremity trauma including primary-quaternary mechanisms, zone of injury, serial debridement, damage control orthopaedics, traumatic amputation, wound management, and the reconstruction versus amputation decision.
- Bohler and Gissane Angles β Bohler's tuber joint angle and Gissane's crucial angle β radiographic measurements for assessing calcaneal fracture severity, guiding operative decisions, and predicting outcomes.
- Bosworth Fracture-Dislocations β Comprehensive guide to Bosworth fracture-dislocations - rare ankle injuries with fixed posterior dislocation of the fibula behind the tibia
- Both Column Acetabular Fractures β Comprehensive guide to both column acetabular fractures including Letournel classification, the pathognomonic spur sign, surgical approaches, and fixation strategies
- Both-Bone Forearm Fractures β Comprehensive guide to both-bone forearm fractures in adults - anatomic reduction imperative, plating techniques, compartment syndrome, and decision-making for orthopaedic exam
- Brodie Abscess β Comprehensive guide to Brodie abscess (subacute localised osteomyelitis), including diagnosis, imaging features, differential diagnosis, and management with curettage and antibiotics.
- Burst Fractures β Comprehensive guide to thoracolumbar burst fractures - Denis classification, load-sharing classification, McCormack score, surgical decision-making for orthopaedic exam
- Calcaneal Tuberosity Fractures β Comprehensive guide to calcaneal tuberosity fractures - Achilles tendon avulsion, ORIF techniques, tension band wiring, and outcomes for orthopaedic exam
- Canadian C-Spine Rule β The Canadian C-Spine Rule for deciding cervical-spine radiography in alert and stable adult trauma patients β high-risk factors mandating imaging, low-risk factors permitting range-of-motion testing, decision thresholds, and comparison with NEXUS.
- Capitate Fractures β Comprehensive guide to capitate fractures - rare carpal injuries, scaphocapitate syndrome, AVN risk, diagnosis, management, and Orthopaedic exam preparation
- Capitellum Fractures β Comprehensive guide to capitellar fractures - Bryan-Morrey and Dubberley classifications, coronal shear mechanism, surgical technique, and clinical decision-making for orthopaedic exam
- Cervical Facet Dislocations β Comprehensive guide to cervical facet dislocations - unilateral vs bilateral, reduction techniques, awake MRI debate, anterior vs posterior approaches for orthopaedic exam
- Cervical Spine Fracture β Cervical spine fractures: clearance rules and what their specificity costs, the classification systems and how reliable they actually are, odontoid non-union risk factors, and the evidence on decompression timing and steroids.
- Chance Fractures β Comprehensive guide to Chance fractures - seatbelt injury pattern, flexion-distraction mechanism, classification, associated abdominal injuries, surgical management for orthopaedic exam
- Chauffeur's Fractures β Comprehensive guide to Chauffeur's fractures (radial styloid fractures) - mechanism, classification, surgical fixation, carpal ligament assessment, and Orthopaedic exam preparation
- Chopart Injuries β Comprehensive guide to Chopart (Midtarsal) Joint Injuries - Talonavicular and Calcaneocuboid dislocations and fracture-dislocations.
- Clavicle Fractures β Comprehensive guide to clavicle fractures - Allman/Robinson classification, midshaft management controversy, ORIF indications, and surgical decision-making for orthopaedic exam
- Clay-Shoveler's Fractures β Comprehensive guide to clay-shoveler's fractures including spinous process avulsion, ghost sign, stability assessment, and conservative management for orthopaedic examination preparation
- Coccyx Fractures β Comprehensive guide to Coccyx Fractures (Tailbone Injuries) - Diagnosis, conservative management, and surgical options.
- Compartments of the Leg β Fellowship-level anatomy of the four leg compartments - their muscles, nerves and vessels - and the surgical relevance for acute compartment syndrome and four-compartment fasciotomy.
- Complex Regional Pain Syndrome (CRPS) β Comprehensive guide to Complex Regional Pain Syndrome - Budapest criteria, stages, prevention with vitamin C, multidisciplinary management, and treatment for orthopaedic exam
- Coronoid Fractures β Comprehensive guide to coronoid fractures - O'Driscoll classification, elbow stability implications, fixation techniques, and decision-making for orthopaedic exam
- Crescent Fracture (SI Joint Fracture-Dislocation, Day Classification) β Fellowship-level guide to the crescent fracture-dislocation of the sacroiliac joint: a lateral-compression pelvic-ring injury where the posterior ilium fractures leaving a crescent fragment attached to the sacrum, the Day classification (I-III by crescent size and proportion of SI joint dislocated), and how it guides reduction and fixation (ORIF vs percutaneous iliosacral screws).
- Crush Syndrome β Comprehensive guide to crush syndrome - rhabdomyolysis, hyperkalemia, myoglobinuria, pre-hospital IV fluids before extrication, fasciotomy indications, and renal protection strategies for orthopaedic fellowship exam
- Cuboid Fractures β Comprehensive guide to cuboid fractures - nutcracker mechanism, compression injury, Lisfranc association, and ORIF techniques for orthopaedic exam
- Cuneiform Fractures β Comprehensive guide to cuneiform fractures - medial intermediate lateral cuneiform, midfoot trauma, Lisfranc association, and ORIF techniques for orthopaedic exam
- Damage Control Orthopaedics β Comprehensive guide to damage control orthopaedics - polytrauma management, DCO vs ETC, timing of definitive fixation, physiological parameters for orthopaedic exam
- Die-Punch Fractures β Comprehensive guide to die-punch fractures of the distal radius - lunate facet depression fractures, mechanism, classification, surgical management, and Orthopaedic exam preparation
- Distal Femur Fractures β Comprehensive guide to distal femur fractures - AO classification, Hoffa fractures, retrograde nail vs plating, prosthetic considerations, and operative approaches for orthopaedic exam
- Distal Humerus Fractures β Comprehensive guide to distal humerus fractures - AO/OTA classification, bicolumnar concept, surgical approaches, TEA indications, and decision-making for orthopaedic exam
- Distal Radius Fractures β Comprehensive orthopaedic exam guide to distal radius fractures - Frykman and AO classification, volar locking plates, external fixation, and outcome optimization
- Domestic and Elder Abuse β Recognition of intimate partner violence and elder abuse in orthopaedic practice, including red flags, injury patterns, the distinction from fragility fracture and age-related bruising, validated screening, defensible documentation, capacity assessment and safeguarding referral.
- Elbow Dislocations β Comprehensive guide to elbow dislocations - simple vs complex, reduction techniques, stability assessment, and rehabilitation for orthopaedic exam
- Elbow Stiffness & Contracture (Post-traumatic Arthrofibrosis) β Fellowship-level guide to the stiff elbow: the functional arc of motion, intrinsic vs extrinsic (Morrey) causes including heterotopic ossification, why prevention (stable fixation + early motion) matters, non-operative splinting, and open or arthroscopic contracture release (arthrolysis) with its outcomes.
- Elbow Transcondylar Fractures β Comprehensive guide to Transcondylar Fractures of the Elbow - separation of the articular condyles from the humerus in adults
- Essex-Lopresti Injuries β Comprehensive guide to Essex-Lopresti injuries including forearm longitudinal instability, interosseous membrane disruption, and management for Orthopaedic examination
- Extensor Mechanism Ruptures β Comprehensive guide to extensor mechanism ruptures - quadriceps and patellar tendon ruptures, primary repair, allograft reconstruction, and treatment for orthopaedic exam
- Fat Embolism Syndrome β Comprehensive guide to fat embolism syndrome following long-bone fractures, including Gurd criteria, timing of presentation, prevention by early fixation, and supportive management.
- Femoral Head Fractures β Comprehensive guide to femoral head fractures including Pipkin classification, surgical management, and outcomes for orthopaedic examination
- Femoral Neck Fracture Nonunion β Fellowship-level guide to nonunion of the femoral neck after fixation: why the intracapsular neck fails to unite (poor blood supply, no periosteal callus, shear across a vertical fracture), and the age- and head-viability-driven decision between a valgus intertrochanteric osteotomy (converting shear to compression in the young) and arthroplasty.
- Femoral Shaft Fractures β Comprehensive orthopaedic exam guide to femoral shaft fractures - intramedullary nailing, antegrade vs retrograde, damage control orthopaedics, and ipsilateral femoral neck screening
- Fibular Shaft Fractures β Comprehensive guide to fibular shaft fractures - isolated vs associated injuries, Maisonneuve fracture, syndesmosis assessment, and treatment algorithms
- Finger Dislocations β Comprehensive guide to finger dislocations for Orthopaedic examination
- Flail Chest / Chest Wall Trauma (Orthopaedic Relevance) β Fellowship-level guide to flail chest and chest wall trauma for the orthopaedic surgeon: the definition (three or more contiguous ribs fractured in two or more places giving a paradoxically-moving segment), why the underlying pulmonary contusion and pain-related hypoventilation - not the paradox alone - drive morbidity, the role of multimodal analgesia and pulmonary toilet, and the growing evidence for surgical stabilisation of rib fractures (SSRF), especially early in flail chest.
- Floating Elbow β Fellowship-level guide to the floating elbow: ipsilateral fractures above and below the elbow (classically a supracondylar humerus fracture with a forearm fracture in children, or a humeral plus forearm fracture in adults), a marker of high-energy trauma with a high rate of open injury, neurovascular damage and compartment syndrome, requiring operative stabilisation of both fractures.
- Floating Knee Injury β Comprehensive guide to floating knee injuries: Fraser classification, damage control sequencing, associated injuries and functional outcomes
- Floating Shoulder Injuries β Comprehensive guide to floating shoulder - ipsilateral clavicle and scapula fractures disrupting superior shoulder suspensory complex, management algorithms, and surgical decision-making for orthopaedic exam
- Foot Compartment Syndrome β Comprehensive guide to foot compartment syndrome including the nine compartments, association with calcaneal and Lisfranc injuries, pressure measurement thresholds, fasciotomy indications, and late reconstruction for claw toe sequelae.
- Forearm Compartment Syndrome β Comprehensive guide to forearm compartment syndrome - pathophysiology, clinical diagnosis, pressure monitoring, fasciotomy technique, and Volkmann's contracture prevention for orthopaedic exam
- Forearm Fractures - Pediatric β Comprehensive exam-ready guide to pediatric forearm fractures - both-bone fractures, greenstick, plastic deformation, and Monteggia/Galeazzi variants
- Forearm Shaft Fracture (Adult) β Comprehensive guide to adult forearm shaft fractures including both-bone fractures, isolated radius/ulna fractures, classification, surgical fixation techniques, and complications
- Galeazzi Fractures β Comprehensive orthopaedic exam guide to Galeazzi fracture-dislocations - the fracture of necessity, DRUJ instability, ORIF with plate fixation, and rehabilitation
- Gas Gangrene (Clostridial Myonecrosis) β Comprehensive guide to gas gangrene - Clostridium perfringens, alpha toxin pathophysiology, clinical diagnosis, radical debridement, penicillin-clindamycin, hyperbaric oxygen, amputation indications for orthopaedic fellowship exam
- Glenoid Fractures β Comprehensive guide to glenoid fractures - Ideberg classification, bone loss assessment, surgical indications, arthroscopic vs open repair for orthopaedic exam
- Greater Tuberosity Fractures β Comprehensive guide to greater tuberosity fractures including classification, management algorithms, and rotator cuff considerations for Orthopaedic examination
- Hamate Fractures β Comprehensive guide to hamate fractures - anatomy of hook and body, mechanisms, classification, clinical presentation, and management for orthopaedic exam
- Heterotopic Ossification β Comprehensive exam-ready guide to heterotopic ossification (HO) in orthopaedic surgery - Brooker classification, risk factors, prevention strategies, and surgical management
- Hip Dislocations β Comprehensive guide to hip dislocations - Thompson-Epstein classification, posterior vs anterior mechanisms, associated injuries, reduction techniques, and sciatic nerve considerations for orthopaedic exam
- Hip Fracture-Dislocations β Comprehensive guide to hip fracture-dislocations - Thompson-Epstein classification, Pipkin fractures, acetabular fractures, urgent reduction, and treatment for orthopaedic exam
- Hoffa Fractures β Comprehensive guide to Hoffa fractures - coronal plane fractures of the femoral condyles, classification, surgical fixation techniques for Orthopaedic orthopaedic exam
- Humeral Head Fractures β Comprehensive guide to humeral head fractures including head-splitting, impression fractures, and management strategies for Orthopaedic examination
- Humeral Shaft Fractures β Comprehensive guide to humeral shaft fractures - AO/OTA classification, radial nerve palsy assessment, Holstein-Lewis fracture, and operative vs non-operative management for orthopaedic exam
- Humeral Shaft Nonunion β Fellowship-level guide to nonunion of the humeral shaft: the risk factors and patterns, hypertrophic versus atrophic versus infected nonunion, why exchange nailing is unreliable in the humerus, and the gold-standard treatment - compression plating with autogenous bone graft - with its high union rates and the radial-nerve caveat.
- Iliac Wing Fractures β Comprehensive guide to Iliac Wing (Duverney) Fractures - Stable pelvic injuries from direct trauma.
- Intercondylar Fractures of the Distal Humerus β Comprehensive guide to intercondylar distal humerus fractures including AO/OTA classification, surgical techniques, and outcomes for Orthopaedic examination
- Intertrochanteric Fractures β Comprehensive guide to intertrochanteric hip fractures - Evans/Jensen classification, SHS vs CMN, TAD principle, geriatric optimization for orthopaedic exam
- Isolated Radius Fractures β Comprehensive guide to Isolated Radial Shaft Fractures (Non-Galeazzi) - diagnosis, classification, and management
- Isolated Ulna Fractures (Nightstick Fractures) β Comprehensive exam-ready guide to isolated ulna shaft fractures - nightstick fracture, direct blow mechanism, nonoperative vs ORIF decision-making
- Jones Fractures β Comprehensive guide to Jones fractures of the fifth metatarsal including mechanism, classification, surgical technique, and athlete management for orthopaedic examination preparation
- Lateral Compression Pelvic Injuries β Lateral compression (LC) pelvic ring injuries - Young-Burgess classification, mechanism, associated injuries, and management from hemodynamically stable to unstable patients
- Lateral Condyle Fractures - Pediatric β Comprehensive exam-ready guide to pediatric lateral condyle fractures - Milch/Weiss classification, ORIF indications, nonunion/malunion management
- Lateral Process Talus Fractures β Comprehensive guide to lateral process talus fractures - snowboarder fracture, mechanism, classification, ORIF vs excision, and subtalar arthritis prevention for orthopaedic exam
- Lesser Tuberosity Fractures β Comprehensive guide to lesser tuberosity fractures including posterior dislocation association, subscapularis involvement, and management for Orthopaedic examination
- Low-Intensity Pulsed Ultrasound (LIPUS) for Fracture Healing β Fellowship-level guide to low-intensity pulsed ultrasound (LIPUS) - a non-invasive, low-risk mechanical-stimulation device applied daily to promote bone healing, working at the molecular level across the stages of repair - covering the proposed mechanism, the evidence base (a low-risk adjunct with the strongest rationale in delayed/non-union, though high-quality trials show inconsistent benefit in fresh fractures), the contrast with surgical revision as the definitive treatment for non-union, and the current evidence-tempered place of LIPUS in practice.
- Lunate and Perilunate Dislocations β Comprehensive guide to lunate and perilunate dislocations - Mayfield stages, diagnosis, emergency management, and surgical reconstruction for orthopaedic exam
- Lunate Fractures β Comprehensive guide to lunate fractures - diagnosis, classification, association with Kienbock's disease, surgical management, and Orthopaedic exam preparation
- Lunotriquetral Instability β Comprehensive guide to lunotriquetral instability - LTIL injury, VISI deformity, diagnosis, and management including LT arthrodesis for orthopaedic exam
- Luxatio Erecta (Inferior Glenohumeral Dislocation) β Fellowship-level guide to luxatio erecta humeri - the rare inferior glenohumeral dislocation in which the arm is locked hyperabducted above the head: its pathomechanics (axial load on an abducted arm or hyperabduction leverage over the acromion), the unmistakable clinical sign, its high rate of neurovascular injury (brachial plexus, axillary artery) and rotator-cuff/greater-tuberosity damage, traction-countertraction reduction, and outcomes.
- Maisonneuve Fractures β Comprehensive guide to Maisonneuve fractures - proximal fibula fracture with syndesmotic disruption, deltoid ligament injury, recognition and surgical management for orthopaedic exam
- Malunion, Delayed Union and Nonunion β Comprehensive guide to fracture healing complications including nonunion classification, Weber-Cech types, exchange nailing, Masquelet technique, and deformity correction for orthopaedic exam
- Mangled Extremity and Limb Salvage Decision-Making β A consultant-level orthopaedic trauma guide to mangled extremity assessment, revascularisation, limb salvage, amputation decision-making, counselling and complications.
- Masquelet Induced-Membrane Technique β Describes the Masquelet induced-membrane technique, a two-stage surgery using a cement spacer and bioactive membrane to reconstruct critical-sized bone defects from trauma, infection, or tumour resection.
- Medial Tibial Stress Syndrome (Shin Splints) β Comprehensive guide to medial tibial stress syndrome - pathophysiology, differential diagnosis, imaging, and evidence-based management for orthopaedic exam
- Metatarsal Fractures β Comprehensive guide to metatarsal fractures - fifth metatarsal zones, stress fractures and management
- Metatarsal Stress Fractures β Comprehensive guide to metatarsal stress fractures including second metatarsal marching fracture, fifth metatarsal high-risk zones, diagnosis, and management for orthopaedic examination preparation
- Monteggia and Galeazzi Fractures β Comprehensive guide to Monteggia and Galeazzi fracture-dislocations for Orthopaedic examination
- Monteggia Fractures β Complete orthopaedic exam guide to Monteggia fracture-dislocations covering Bado classification, surgical management, and complications
- Morel-Lavallee Lesion β Closed internal degloving injury after blunt shear trauma, including clinical recognition, imaging, classification, management, sclerodesis, debridement, recurrence and infection risk.
- Multi-Ligament Knee Injuries β Comprehensive guide to multi-ligament knee injuries (MLKI) and knee dislocations - classification, vascular assessment, surgical timing, reconstruction techniques for Orthopaedic orthopaedic exam
- Myositis Ossificans β Comprehensive guide to myositis ossificans - heterotopic bone formation in muscle, zoning phenomenon, maturity assessment, surgical excision timing, and treatment for orthopaedic exam
- Navicular Fractures β Comprehensive guide to tarsal navicular fractures covering anatomy, classification, clinical assessment, and management including stress fractures for orthopaedic examination preparation.
- Neck of Femur Fracture β Comprehensive guide to femoral neck fractures and Garden classification
- Nonunion Management β Comprehensive guide to fracture nonunion - classification, work-up and management
- Odontoid Fractures β Comprehensive guide to odontoid (dens) fractures - Anderson-D'Alonzo classification, stability assessment, and treatment options for orthopaedic exam
- Olecranon Fractures β Comprehensive guide to olecranon fractures - Mayo classification, tension band wiring, plate fixation, and surgical decision-making for orthopaedic exam
- Open Book Pelvic Injuries β Comprehensive guide to open book pelvic fractures including symphysis diastasis, external rotation injuries, hemorrhage control, and surgical fixation
- Open Fracture Classification and Management β A consultant-level orthopaedic guide to open fracture assessment, classification, debridement, fixation, antibiotics, orthoplastic reconstruction and complications.
- Open Tibial Fractures β Comprehensive guide to open tibial fractures - Gustilo-Anderson classification, antibiotic protocols, wound management, soft tissue coverage principles for orthopaedic exam
- Orthopaedic Gunshot Wounds and Ballistics β Advanced orthopaedic guide to gunshot wounds and ballistic fractures: tissue injury, low- and high-energy patterns, antibiotics, debridement, fixation, vascular risk, compartment syndrome and retained bullets.
- Ottawa Ankle and Foot Rules β The Ottawa Ankle and Foot Rules β a validated clinical decision instrument that determines when radiography is necessary after acute ankle and midfoot injury, reducing unnecessary X-rays without missing clinically significant fractures.
- Ottawa Knee Rules β A validated clinical decision rule for acute knee injury β the five criteria that mandate knee radiography, how to apply them, and the evidence behind near-100 percent sensitivity for fracture.
- Patella Fractures β Comprehensive guide to patella fractures - AO classification, tension band wiring vs screw fixation, extensor mechanism integrity, and partial patellectomy indications for orthopaedic exam
- Pathological Fractures - Femur β Comprehensive guide to pathological fractures of the femur - metastatic disease, Mirels' score, life expectancy estimation, IMN vs arthroplasty, cement augmentation, and palliative treatment for orthopaedic exam
- Pathological Fractures (Humerus) β Comprehensive guide to pathological humerus fractures including metastatic disease, Mirels scoring, and surgical management for Orthopaedic examination
- PCL Avulsion Fractures β Comprehensive guide to PCL avulsion fractures - posterior tibial avulsion, posterior approach, screw or suture fixation, and treatment for orthopaedic exam
- Pelvic Avulsion Fractures β Comprehensive guide to Pelvic Avulsion Fractures - ASIS, AIIS, Ischial tuberosity, and Iliac crest avulsions in adolescent athletes.
- Pelvic Ring Injuries β Advanced guide to pelvic ring injuries: recognition, stability assessment, haemorrhage control, classification, fixation strategy and complications.
- Perilunate Injuries and Carpal Dislocations β Advanced orthopaedic guide to perilunate and lunate dislocations: Mayfield stages, missed diagnosis prevention, emergency reduction, fixation, ligament repair, median nerve protection and delayed-injury salvage.
- Periprosthetic Fractures of Shoulder & Elbow Arthroplasty β Fellowship-level guide to periprosthetic fractures around shoulder and elbow replacements: the location-based classifications (Wright-Cofield for the humerus after shoulder arthroplasty; Mayo/O'Driscoll-Morrey for total elbow arthroplasty), and the unifying Vancouver-style principle that fracture location, implant stability and bone quality drive treatment (ORIF/strut vs revision).
- Periprosthetic Hip Fracture β Comprehensive guide to periprosthetic hip fractures and the Vancouver classification
- Phalangeal Fractures β Comprehensive guide to proximal and middle phalanx fractures including classification, reduction techniques, fixation options, and rehabilitation for orthopaedic examination
- Phalangeal Fractures Foot β Comprehensive guide to phalangeal fractures of the foot - great toe hallux, lesser toes, proximal middle distal phalanx, and treatment for orthopaedic exam
- Pilon Fractures β Comprehensive guide to Tibial Plafond (Pilon) Fractures - diagnosis, classification, and staged management.
- Pisiform Fractures β Comprehensive guide to pisiform fractures - anatomy, mechanisms, classification, clinical presentation, and management for orthopaedic exam
- Pittsburgh Knee Rules β The Pittsburgh Knee Rules β a clinical decision rule for determining the need for radiography in acute blunt knee injuries, the three criteria, when not to apply them, and a head-to-head comparison with the Ottawa Knee Rules.
- Polytrauma Management β Comprehensive guide to polytrauma and damage control orthopaedics
- Posterior Process Talus Fractures β Comprehensive guide to posterior process talus fractures - Shepherd fracture, Cedell fracture, FHL impingement, and treatment for orthopaedic exam
- Proximal Humerus Fractures β Comprehensive guide to proximal humerus fractures - Neer classification, blood supply, surgical decision-making, and PROFHER evidence for orthopaedic exam
- Proximal Humerus Nonunion & Malunion β Fellowship-level guide to nonunion and malunion of the proximal humerus: the surgical-neck nonunion (Boileau type-3 fracture sequela), the age- and head-viability-driven choice between ORIF with bone graft and reverse total shoulder arthroplasty (preserving the tuberosities), and the management of tuberosity/surgical-neck malunion.
- Proximal Tibiofibular Joint Dislocations β Comprehensive guide to proximal tibiofibular joint dislocations including Ogden classification, peroneal nerve considerations, and management for orthopaedic examination
- Pseudo-Jones Fractures (Fifth Metatarsal Tuberosity Avulsion) β Zone 1 avulsion fractures of the fifth metatarsal tuberosity - mechanism, differentiation from true Jones fractures, conservative management, and favorable outcomes
- Pubic Rami Fractures β Comprehensive guide to Pubic Rami Fractures - Isolated vs Ring injuries, Fragility fractures, and management.
- Radial Head Dislocations β Comprehensive guide to Radial Head Dislocations - Congenital vs Traumatic, Monteggia, and Nursemaids
- Radial Head Fractures β Comprehensive guide to radial head fractures - Mason classification, surgical indications, safe zone concept, and management of complex instability patterns
- Radial Neck Fractures Pediatric β Comprehensive exam-ready guide to pediatric radial neck fractures - classification, reduction techniques, and outcomes
- Region-Specific Compartment Syndrome β Advanced orthopaedic trauma guide to region-specific acute compartment syndrome: leg, forearm, hand, foot, thigh, gluteal compartments, pressure measurement, fasciotomy principles, wound care and missed-diagnosis traps.
- Rhabdomyolysis β Comprehensive guide to rhabdomyolysis - CK elevation, myoglobinuria, acute kidney injury, crush injury, compartment syndrome complication, and management for orthopaedic exam
- Rolando's Fractures β Comprehensive guide to Rolando's fracture (comminuted intra-articular thumb metacarpal base fracture) including classification, surgical approaches, and outcomes for orthopaedic examination
- Sacral Fractures β Comprehensive guide to sacral fractures including Denis zones, neurological injury patterns, spinopelvic dissociation, and surgical fixation strategies
- Scaphoid Fractures β Scaphoid fractures for the orthopaedic exam: the retrograde blood supply and why it matters, Herbert classification, the radiograph-negative wrist, cast versus screw after SWIFFT, and nonunion reconstruction
- Scaphoid Nonunion β Comprehensive guide to scaphoid nonunion - humpback deformity, SNAC wrist progression, vascularized bone graft, Herbert classification for orthopaedic exam
- Scapholunate Dissociation β Comprehensive guide to scapholunate ligament injuries including diagnosis, staging, repair/reconstruction techniques, and SLAC wrist progression for orthopaedic examination
- Scapula Fractures β Comprehensive guide to scapula fractures - glenoid and body patterns, floating shoulder, high-energy associations, surgical indications, and decision-making for orthopaedic exam
- Scapulothoracic Dissociation β Comprehensive guide to scapulothoracic dissociation - closed forequarter amputation, neurovascular assessment, Damschen classification, limb-salvage vs amputation decision, and management priorities for orthopaedic exam
- Segond Fractures β Comprehensive guide to Segond fractures - lateral tibial plateau avulsion, anterolateral ligament injury, pathognomonic for ACL tear, and treatment for orthopaedic exam
- Shoulder Dislocations β Comprehensive guide to shoulder dislocations - anterior vs posterior mechanisms, Bankart and Hill-Sachs lesions, acute management, surgical indications, and recurrence risk for orthopaedic exam
- Shoulder Fracture-Dislocations β Comprehensive guide to anterior and posterior shoulder fracture-dislocations, including classification, reduction maneuvers, and surgical management for Orthopaedic examination
- Slipped Capital Femoral Epiphysis (SCFE) β Comprehensive exam-ready guide to SCFE - classification, in situ pinning, contralateral prophylaxis, and AVN risk
- Smith's Fractures β Comprehensive guide to Smith's fractures (reverse Colles') - volar angulated distal radius fractures, classification, mechanism, surgical fixation, and Orthopaedic exam preparation
- SNAC Wrist β Comprehensive guide to Scaphoid Nonunion Advanced Collapse - staging, surgical treatment options, 4-corner fusion, proximal row carpectomy for orthopaedic exam
- Spinal Cord Injury β Comprehensive guide to spinal cord injury - ASIA classification, neurogenic shock, methylprednisolone controversy, timing of surgery, rehabilitation for orthopaedic exam
- Spinopelvic / Lumbosacral Dissociation (U-shaped Sacral Fracture) β Fellowship-level guide to traumatic spinopelvic dissociation: a transverse sacral fracture combined with bilateral vertical sacral fractures (U-, H-, Y- or lambda-shaped) that separates the spine from the pelvis - a high-energy, frequently missed injury with a high rate of neurological injury, classified by Roy-Camille and Denis zone, and stabilised with lumbopelvic (triangular) fixation.
- Subaxial Cervical Spine Fractures β Comprehensive guide to subaxial cervical spine injuries - SLIC classification, AO Spine classification, surgical decision-making, anterior vs posterior approaches for orthopaedic exam
- Subtalar Dislocations β Pure subtalar dislocations (peritalar dislocations) - medial vs lateral types, closed reduction techniques, associated injuries, and outcomes
- Subtrochanteric Fractures β Comprehensive orthopaedic exam guide to subtrochanteric femur fractures - Russell-Taylor classification, characteristic deformity, reduction before reaming, cephalomedullary nailing, and atypical bisphosphonate fractures
- Sustentaculum Tali Fractures β Comprehensive guide to sustentaculum tali fractures - medial calcaneus, FHL tendon at risk, medial plantar nerve, and ORIF techniques for orthopaedic exam
- Talar Body Fractures β Fellowship-level guide to fractures of the talar body: the Sneppen classification, the precarious retrograde blood supply and high rate of avascular necrosis, the role of CT, principles of anatomic articular reduction and rigid fixation (often via malleolar osteotomy), and the management of AVN and post-traumatic tibiotalar/subtalar arthritis.
- Teardrop Fractures β Comprehensive guide to cervical teardrop fractures including flexion (burst) vs extension types, stability assessment, SLIC classification, and surgical management for orthopaedic examination preparation
- Terrible Triad of the Elbow β Comprehensive guide to terrible triad injuries - elbow dislocation, radial head fracture, coronoid fracture, LCL repair, and surgical decision-making for orthopaedic exam
- Tetanus Prophylaxis β Comprehensive guide to tetanus prophylaxis in orthopaedic surgery - Clostridium tetani, tetanospasmin, tetanus-prone wounds, vaccination status assessment, ADT booster vs TIG indications, and international guideline comparison (CDC, NICE/Green Book, WHO) for fellowship exam
- Thoracolumbar Spine Fractures β Comprehensive guide to thoracolumbar fractures - TLICS classification, AO Spine classification, conservative vs surgical management, posterior and anterior approaches for orthopaedic exam
- Thumb Base Fractures β Comprehensive guide to fractures of the thumb base for Orthopaedic examination
- Thumb UCL Injuries (Gamekeeper's/Skier's Thumb) β Comprehensive guide to ulnar collateral ligament injuries of the thumb MCP joint including Stener lesion, stress testing, and surgical repair for orthopaedic examination
- Tibial Fractures Pediatric β Comprehensive exam-ready guide to pediatric tibial fractures - toddler's fracture, proximal tibial metaphyseal fractures (Cozen's), tibial spine fractures
- Tibial Malunion β Comprehensive guide to tibial malunion - classification, CORA concept, indications for correction, osteotomy techniques, and outcomes for orthopaedic exam
- Tibial Nonunion β Comprehensive guide to Tibial Nonunion - evaluation, classification, and management strategies including exchange nailing, plating, and ring fixation
- Tibial Plateau Fractures β Comprehensive guide to tibial plateau fractures for orthopaedic exam - Schatzker classification, three-column concept, soft tissue management, surgical approaches, articular reduction principles, and staged management
- Tibial Shaft Fractures β Comprehensive guide to tibial shaft fractures - AO classification, open fracture management, nail vs plate fixation, compartment syndrome, and union considerations for orthopaedic exam
- Tibial Spine Fractures β Comprehensive guide to tibial spine fractures - pediatric ACL equivalent, Meyers-McKeever classification, arthroscopic reduction, suture fixation, and treatment for orthopaedic exam
- Tibial Stress Fractures β Comprehensive guide to tibial stress fractures - anterior cortex high-risk vs posteromedial low-risk, MRI grading, management principles for orthopaedic exam
- Tibial Tubercle Fractures β Comprehensive guide to tibial tubercle avulsion fractures including Ogden classification, extensor mechanism injury, and management for orthopaedic examination
- Toddler's Fracture β Comprehensive exam-ready guide to toddler's fracture - subtle spiral tibial fracture in young children, clinical diagnosis, X-ray interpretation
- Total Talar Dislocation β Comprehensive guide to total talar dislocation - talus completely dislocated from ankle subtalar talonavicular, urgent reduction, AVN risk, and treatment for orthopaedic exam
- Trapezium Fractures β Comprehensive guide to trapezium fractures - body vs ridge fractures, CMC joint implications, surgical management, and Orthopaedic exam preparation
- Trapezoid Fractures β Comprehensive guide to Trapezoid Fractures - Rare carpal injuries with anatomic, diagnostic, and management considerations.
- Triquetral Fractures β Comprehensive guide to triquetral fractures - second most common carpal fracture, dorsal chip vs body fractures, diagnosis, management, and Orthopaedic exam preparation
- Trochlea Fractures β Comprehensive guide to isolated Trochlea (Laugier) Fractures - diagnosis and management of this rare elbow injury
- Vascular Injury With Fracture or Dislocation β Advanced orthopaedic trauma guide to extremity vascular injury associated with fractures and dislocations: hard signs, ABI/API, CTA, reduction, external fixation, temporary shunts, vascular repair and fasciotomy.
- Vertebral Compression Fractures β Comprehensive guide to vertebral compression fractures - osteoporotic fractures, pathologic fractures, conservative vs surgical management, vertebroplasty/kyphoplasty for orthopaedic exam
- Vertical Shear (VS) Pelvic Injuries β Comprehensive guide to vertical shear pelvic ring injuries including Young-Burgess classification, Tile C instability, and surgical management
- Volkmann's Ischemic Contracture β Comprehensive guide to Volkmann's ischemic contracture - late sequela of compartment syndrome, Tsuge classification, claw hand deformity, reconstruction techniques, and prevention for orthopaedic exam
Sports Medicine β 98 topics
- AC Joint Injuries in Athletes β Comprehensive sports medicine guide to AC joint injuries - Rockwood classification, return to sport criteria, surgical decision-making in athletes, Type III controversy, hook plate vs CC reconstruction
- Achilles Tendinopathy β Comprehensive guide to achilles tendinopathy including insertional and non-insertional types, eccentric exercise protocols, imaging, and surgical management for Orthopaedic examination
- Adductor Strain / Groin Strain β Fellowship-level guide to adductor (groin) strain: the commonest cause of acute groin pain in athletes, usually an adductor longus musculotendinous-junction or enthesis injury from forceful eccentric contraction during cutting and kicking; the Doha groin-pain framework, examination (resisted adduction, squeeze test), grading, the high reinjury rate, and progressive eccentric-strengthening rehabilitation.
- Anterior Cruciate Ligament Injuries β Comprehensive exam-ready guide to ACL injuries - mechanism, graft selection, surgical timing, tunnel placement
- Anterior Shoulder Instability β Comprehensive exam-ready guide to anterior shoulder instability - Bankart vs Latarjet decision, bone loss assessment, surgical techniques
- Anterolateral Ligament Injury & Lateral Extra-Articular Tenodesis (LET) β Fellowship-level guide to the anterolateral complex of the knee: the anterolateral ligament (ALL) and its role in rotatory (pivot-shift) control, the Segond fracture as its radiographic signature, and the extra-articular augmentation of ACL reconstruction by lateral extra-articular tenodesis (LET) or ALL reconstruction - with the STABILITY-trial evidence, the indications in high-risk patients, and the technique.
- Articular Cartilage Injuries β Comprehensive exam-ready guide to articular cartilage injuries - chondral defects, microfracture, OATS, ACI decision-making
- Athletic Groin Pain (Sports Hernia/Athletic Pubalgia) β Comprehensive guide to athletic groin pain - Doha classification, adductor-related groin pain, pubic symphysis dysfunction, FAI differential, Copenhagen protocol, and surgical management for orthopaedic exam
- Athletic Pubalgia (Sports Hernia) β Comprehensive guide to athletic pubalgia / sports hernia, covering core muscle injury at the rectus abdominisβadductor aponeurosis, differentiation from osteitis pubis and hip FAI, imaging, conservative management, and surgical repair.
- Baker's Cyst (Popliteal Cyst) β Comprehensive guide to Baker's cyst - popliteal cyst anatomy, association with knee pathology, clinical presentation, imaging, and management for orthopaedic exam
- Bankart Lesions β Comprehensive guide to Bankart lesions - anterior-inferior labral tears with anterior shoulder instability, classification, arthroscopic repair, and surgical decision-making for orthopaedic exam
- Bipartite Patella β Comprehensive exam guide to bipartite patella - the failed-fusion accessory ossicle of the kneecap, the Saupe classification, why most are asymptomatic, how to tell it apart from a fracture, and evidence-based management of the painful superolateral fragment.
- Burners and Stingers (Cervical Nerve Root / Brachial Plexus Traction) β Fellowship-level guide to burners and stingers: a transient unilateral upper-limb burning pain, paraesthesia and weakness in collision-sport athletes, from traction, compression or nerve-root injury affecting the upper trunk (C5-C6) of the brachial plexus; the three mechanisms, the crucial rule that bilateral or lower-limb symptoms are NOT a stinger (suspect cervical cord/spine injury), return-to-play criteria and the work-up of recurrent stingers.
- Calcific Tendinitis of the Shoulder β Comprehensive guide to rotator cuff calcification
- Chronic Ankle Instability β Comprehensive Orthopaedic exam guide to chronic lateral ankle instability including pathophysiology, assessment, and evidence-based surgical reconstruction
- Chronic Exertional Compartment Syndrome β Comprehensive orthopaedic exam guide to chronic exertional compartment syndrome (CECS) - ICP measurement, fasciotomy techniques, differential diagnosis, and return to sport
- Concussion / Mild Traumatic Brain Injury in Athletes β Fellowship-level guide to sport-related concussion: a functional traumatic brain injury from biomechanical forces causing transient neurological impairment (often without loss of consciousness and with normal structural imaging); the 'if in doubt, sit them out' rule with no same-day return, sideline and office assessment (SCAT6), the graduated return-to-sport and return-to-learn strategies, red flags for structural injury, and the risks of second-impact syndrome and repeated injury.
- Distal Biceps Rupture β Comprehensive guide to distal biceps tendon rupture: the hook test, single versus double-incision repair, fixation choice and chronic tears
- Distal Clavicle Osteolysis β A sports-medicine and shoulder-focused guide to distal clavicle osteolysis (weightlifter's shoulder): the anatomy of the acromioclavicular joint, the repetitive-stress pathophysiology, how it presents and is examined, the characteristic radiographic and MRI findings, non-operative and operative management, and the key differential diagnoses that must not be missed.
- Elbow Medial Ulnar Collateral Ligament (UCL) Injury (Tommy John) β Fellowship-level guide to ulnar collateral ligament injury of the elbow in throwing athletes: the valgus-overload mechanism, the anterior-bundle anatomy, examination (moving valgus stress test), MRI diagnosis, non-operative versus reconstruction (Tommy John) decision-making, and return-to-play outcomes.
- Exertional Heat Illness / Heat Stroke β Fellowship-level guide to exertional heat illness and exertional heat stroke (EHS) - a life-threatening emergency in athletes caused by strenuous activity producing severe hyperthermia (core temperature over ~40 C) with central nervous system dysfunction - covering the spectrum (cramps, exhaustion, heat stroke), the critical recognition (collapsed/confused athlete, hot), and the management principle of immediate aggressive cooling ('cool first, transport second' - cold-water immersion) to prevent multi-organ failure and death.
- External Impingement of the Shoulder β Comprehensive guide to external shoulder impingement - subacromial impingement, Neer classification, diagnosis, and treatment for orthopaedic examination
- Female Athlete Triad / RED-S β Fellowship-level guide to the Female Athlete Triad and Relative Energy Deficiency in Sport (RED-S): low energy availability as the central driver, the triad of low energy availability, menstrual dysfunction and low bone mineral density (broadened by RED-S to many body systems and both sexes), the orthopaedic consequence of bone stress injuries, screening (LEAF-Q/LEAM-Q, DXA), and multidisciplinary management restoring energy availability.
- Femoral Neck Stress Fractures β Comprehensive guide to femoral neck stress fractures - tension vs compression side, military and athletic populations, MRI diagnosis, and surgical decision-making for Orthopaedic orthopaedic exam
- Femoroacetabular Impingement (FAI) β Comprehensive guide to femoroacetabular impingement - CAM, pincer, mixed morphology, alpha angle, FADIR test, hip arthroscopy, and surgical decision-making for orthopaedic exam
- Fifth Metatarsal Stress Fractures β Comprehensive guide to fifth metatarsal stress fractures including Jones fracture, zone classification, surgical vs conservative management, and return to sport for orthopaedic exam preparation
- Glenohumeral Internal Rotation Deficit (GIRD) β Fellowship-level guide to GIRD in the throwing athlete: loss of glenohumeral internal rotation, the physiologic (humeral retroversion) versus pathologic (posterior capsular/rotator-cuff tightness) causes, why total rotational motion matters more than absolute IR loss, the link to internal impingement, peel-back and SLAP/cuff lesions, and management led by posterior capsular stretching.
- Glenoid & Bipolar Bone Loss Assessment in Shoulder Instability (Glenoid Track) β Fellowship-level guide to bone-loss assessment in anterior shoulder instability: quantifying glenoid bone loss (en-face 3D CT, the reference standard, with 3D MRI a validated alternative), the bipolar concept of combined glenoid and Hill-Sachs loss, the glenoid-track method for on-track versus off-track Hill-Sachs lesions, and how the measurements drive the choice between arthroscopic Bankart, remplissage and bony procedures (Latarjet).
- Gluteal Tendon Tears (Hip Abductor Tears) β Surgical-focused guide to gluteus medius and minimus tendon tears - the rotator cuff of the hip. Covers anatomy, tear classification, MRI grading, fatty infiltration, endoscopic versus open repair, tendon transfer and reconstruction, abductor deficiency after total hip arthroplasty, and fellowship exam preparation.
- Greater Trochanteric Pain Syndrome β Comprehensive guide to greater trochanteric pain syndrome (GTPS) - gluteal tendinopathy, trochanteric bursitis, diagnosis, injection technique, rehabilitation, and exam preparation for orthopaedic fellowship examinations
- Hamstring Injuries β Comprehensive guide to hamstring muscle injuries - proximal avulsion, mid-substance tears, grading, surgical repair indications, Nordic hamstring exercises, and return to sport criteria for orthopaedic exam
- Hill-Sachs Lesions β Comprehensive guide to Hill-Sachs lesions - pathology, glenoid track concept, and management strategies including Remplissage and Latarjet
- Hip Arthroscopy β Comprehensive guide to hip arthroscopy - femoroacetabular impingement, labral tears, portal anatomy, traction requirements, cam and pincer morphology, and rehabilitation for orthopaedic exam preparation
- Hip Flexor Strains β Comprehensive Orthopaedic exam guide to iliopsoas and rectus femoris injuries including classification, diagnosis, and evidence-based management
- Hip Pointer Injuries β Comprehensive guide to hip pointer injuries - iliac crest contusion diagnosis, imaging, treatment protocols, and return to sport criteria for orthopaedic exam preparation
- Idiopathic Chondromalacia Patellae β Fellowship-level guide to chondromalacia patellae: softening (and progressive fibrillation, fissuring and erosion) of the patellar articular cartilage causing anterior knee pain, especially in young adults; the Outerbridge arthroscopic grading, why the term is descriptive rather than a single disease, the overlap with patellofemoral pain, examination (Clarke's sign), and the predominantly conservative management.
- Iliotibial Band Syndrome β Comprehensive guide to iliotibial band syndrome - lateral knee pain in runners, compression-zone biomechanics, hip abductor weakness, activity modification and the evidence for surgery
- Internal Impingement of the Shoulder β Comprehensive guide to internal impingement - posterosuperior labrum and rotator cuff contact in ABER position, GIRD, throwing athletes, and surgical management for orthopaedic exam
- Knee Arthrofibrosis β Post-surgical knee stiffness from excessive scar - arthrofibrosis after TKA and ACL reconstruction (cyclops lesion), diagnosis, prevention and management for orthopaedic exams
- Knee Dislocation Management β Comprehensive guide to acute knee dislocation management, including vascular assessment, reduction techniques, and multiligamentous injury repair
- Knee Plica Syndrome (Synovial Plicae) β Fellowship-level guide to knee plica syndrome: symptomatic synovial plicae (embryological synovial folds), most commonly the medial (mediopatellar) plica, which when thickened and inflamed snaps over the medial femoral condyle causing anteromedial knee pain, clicking and pseudo-locking; the types of plica, the clinical and MRI diagnosis, and conservative-first management with arthroscopic resection for refractory cases.
- Lateral Ankle Sprains β Comprehensive guide to lateral ankle ligament injuries including acute management, chronic instability, and surgical reconstruction techniques
- Lateral Collateral Ligament (LCL) Injuries β Comprehensive guide to LCL injuries - anatomy, Fanelli classification, varus stress testing, isolated vs combined injuries, and evidence-based surgical vs conservative management for orthopaedic exam preparation
- Lateral Epicondylitis (Tennis Elbow) β Comprehensive guide to lateral epicondylitis - ECRB pathology, Nirschl classification, conservative management, PRP evidence, and surgical release techniques for orthopaedic exam
- Lateral Patellar Compression Syndrome (Excessive Lateral Pressure Syndrome) β Fellowship-level guide to lateral patellar compression syndrome / excessive lateral pressure syndrome (ELPS): a tight lateral retinaculum causing patellar TILT and excessive lateral patellofemoral pressure with anterior knee pain but WITHOUT instability; the patellar tilt test, the radiographic angles (patellar tilt angle, lateral patellofemoral angle) on skyline views, conservative-first management, and the role - and important limits - of lateral retinacular release.
- Little League Shoulder β Comprehensive guide to proximal humeral epiphysiolysis - pathology, clinical presentation, radiographic findings, and management of this pediatric overuse injury
- Long Head of Biceps Tendon Pathology β Comprehensive guide to long head of biceps pathology - SLAP lesions, biceps tendinitis, instability, examination tests, imaging, tenotomy vs tenodesis decision-making for orthopaedic exam
- Loose Body in the Knee β Pattern and differential for an intra-articular loose body in the knee β discriminating osteochondritis dissecans, synovial chondromatosis, fabella and osteophyte fragments on radiograph.
- Mass Behind the Knee β Pattern and differential for a popliteal mass: separating Baker's cyst from popliteal aneurysm, sarcoma and DVT, with the discriminators and the next test that changes management.
- Medial Collateral Ligament Injuries β Comprehensive exam-ready guide to MCL injuries - grading, non-operative vs surgery, combined injuries
- Medial Epicondylitis (Golfer's Elbow) β Comprehensive guide to medial epicondylitis - flexor-pronator origin pathology, golfer's elbow test, conservative and surgical management, and ulnar nerve involvement for orthopaedic exam
- Medial Patellofemoral Ligament (MPFL) Injury β Exam-focused guide to the primary soft-tissue restraint to lateral patellar translation: anatomy and isometry, injury patterns in first-time and recurrent dislocation, MRI diagnosis of femoral versus patellar avulsion, non-operative versus operative thresholds, anatomic reconstruction technique, and the key complications and failure modes.
- Meniscal Ramp Lesions β Comprehensive guide to meniscal ramp lesions - posterior meniscocapsular separation, ACL association, diagnosis, and repair techniques for orthopaedic exam
- Meniscus Tears β Comprehensive guide to meniscal tears - anatomy, ISAKOS classification, clinical tests (McMurray, Thessaly), arthroscopic repair vs meniscectomy, and evidence-based management for orthopaedic exam preparation
- Multidirectional Instability (MDI) β Comprehensive examination guide to multidirectional shoulder instability including assessment, classification, conservative management, and surgical techniques with evidence-based treatment algorithms
- Olecranon Stress Fracture β Fellowship-level guide to olecranon stress fracture: an overuse injury of throwing athletes (and gymnasts) driven by valgus extension overload, presenting with posterior elbow pain on extension; the adolescent persistent-olecranon-physis pattern versus the adult oblique stress line, the role of MRI when radiographs are normal, the link to valgus instability/UCL, and rest versus surgical fixation to return to play.
- Os Acromiale β Comprehensive guide to os acromiale - unfused acromial ossification centre causing shoulder pain and impingement - anatomy, classification, diagnosis on axillary view, and conservative vs surgical management for Orthopaedic exam preparation
- Osteitis Pubis (Pubic Symphysis Stress) β Fellowship-level guide to osteitis pubis: a chronic overuse inflammatory condition of the pubic symphysis from repetitive adductor/rectus-abdominis shear in kicking and pivoting athletes, presenting with central groin/symphyseal pain; its place in the athletic pubalgia/groin-pain spectrum, the radiographic and MRI findings (symphyseal sclerosis, erosion, bone-marrow oedema), and predominantly conservative management.
- Osteochondritis Dissecans of the Knee β Comprehensive guide to OCD of the knee - juvenile vs adult, stable vs unstable, MFC location, and treatment for orthopaedic exam
- Patellar Height Abnormalities (Patella Alta and Baja) β Exam-focused guide to patellar height: the Insall-Salvati, Caton-Deschamps, and Blackburne-Peel ratios on the lateral radiograph; how patella alta drives instability and baja restricts flexion; the causes (congenital, post-surgical, post-traumatic); when to intervene surgically; and the viva approach the examiner expects.
- Patellar Tendinitis β Comprehensive guide to Patellar Tendinitis (Jumper's Knee) - pathophysiology, Blazina classification, eccentric rehabilitation protocols, and surgical management options
- Patellar Tendon Rupture β Comprehensive guide to patellar tendon rupture - diagnosis, repair technique and rehabilitation
- Patellofemoral Instability β Comprehensive exam-ready guide to patellofemoral instability - MPFL reconstruction, trochlear dysplasia, tibial tubercle osteotomy
- Pellegrini-Stieda Lesion β Exam-focused guide to the Pellegrini-Stieda lesion: post-traumatic calcification or ossification at the femoral attachment of the medial collateral ligament, its characteristic radiographic appearance, clinical presentation with medial knee pain and stiffness, conservative and surgical management, and the key exam points including differential diagnosis and classification.
- Performance-Enhancing Drugs (Anabolic Steroids / Stimulants) in Sport β Fellowship-level guide to performance- and appearance-enhancing drugs ('doping') in sport - principally anabolic-androgenic steroids and stimulants (also growth hormone, diuretics and supplements) - covering their effects and the wide range of serious adverse effects (cardiovascular, hepatic, renal, endocrine/psychiatric, and musculoskeletal - notably tendon rupture), the orthopaedic relevance of recognising the doping athlete, and the role of anti-doping (WADA) and education/prevention.
- Pes Anserine Bursitis β Comprehensive guide to pes anserine bursitis - anatomy, clinical presentation, differential diagnosis, injection technique, rehabilitation, and exam preparation for orthopaedic fellowship examinations
- Phases of Throwing / Throwing Biomechanics β Fellowship-level guide to the biomechanics of overhead throwing (the pitching cycle) - the six phases (wind-up, stride/early cocking, late cocking, acceleration, deceleration, follow-through), the kinetic chain that transfers energy from the legs and trunk to the arm, and the enormous valgus and distraction loads generated at the shoulder and elbow during late cocking and acceleration - explaining why specific injuries (UCL, SLAP/internal impingement, GIRD) occur and how mechanics relate to injury risk and prevention.
- Popliteal Artery Entrapment Syndrome β Comprehensive guide to popliteal artery entrapment syndrome (PAES): anomalous musculo-arterial relationships in young athletes, Love-Whelan classification, provocative pulse examination, imaging, and surgical release.
- Posterior Cruciate Ligament Injuries β Comprehensive exam-ready guide to PCL injuries - grading, isolated vs combined, surgical indications
- Posterior Shoulder Instability β Comprehensive exam-ready guide to posterior shoulder instability - reverse Bankart, posterior labral tears, capsulorrhaphy
- Posterior Tibial Tendon Dysfunction (PTTD) β Adult acquired flatfoot deformity secondary to posterior tibial tendon insufficiency - staging, conservative management, surgical reconstruction techniques, and evidence-based treatment algorithms
- Posterolateral Corner Injuries β Comprehensive exam-ready guide to PLC injuries - dial test, arcuate sign, reconstruction techniques
- Prepatellar Bursitis (Housemaid's Knee) β Fellowship-level guide to prepatellar bursitis: inflammation of the superficial bursa in front of the patella from chronic kneeling microtrauma (or trauma, crystal/inflammatory disease, or infection), how to distinguish a superficial bursitis from a true knee effusion and - critically - septic from non-septic bursitis, the role of aspiration (and when NOT to aspirate), and management by type.
- Proximal Hamstring Avulsion β Comprehensive guide to ischial tuberosity hamstring avulsion injuries: anatomy, MRI grading, Wood classification, sciatic nerve proximity, and operative vs conservative management.
- Proximal Hamstring Injuries β Comprehensive guide to Proximal Hamstring Avulsions and Tendinopathy - Diagnosis, Classification, and Management
- Quadriceps Contusions β Comprehensive guide to quadriceps contusions - classification, myositis ossificans prevention, treatment protocols, and return to sport criteria for orthopaedic exam preparation
- Quadriceps Tendinitis β Comprehensive guide to Quadriceps Tendinopathy - anatomy, clinical assessment, differential diagnosis, and management strategies for suprapatellar pain
- Quadriceps Tendon Rupture β Comprehensive guide to quadriceps tendon rupture - extensor mechanism injury, repair and rehabilitation
- Quadrilateral Space Syndrome β Evidence-based guide to quadrilateral (quadrangular) space syndrome - neurogenic and vascular axillary nerve and posterior circumflex humeral artery compression in the overhead athlete, with diagnosis, imaging, and decompression.
- Rectus Femoris Strain β Fellowship-level guide to rectus femoris strain - a common quadriceps muscle injury in kicking and sprinting athletes - covering the distinction between the typical distal muscle-tendon-junction strain and the characteristic proximal INTRASUBSTANCE tear at the indirect (deep) head's intramuscular tendon (which forms an anterior-thigh mass that mimics a tumour), the role of MRI, and management (predominantly non-operative, with surgery reserved for selected cases).
- Return to Sport Criteria β Evidence-based principles and criteria for return to sport after orthopaedic injury or surgery
- REVERSE HILL-SACHS LESIONS β Comprehensive guide to Reverse Hill-Sachs lesions, including classification, detailed management algorithm, and surgical options like the Modified McLaughlin procedure.
- Rib Stress Fracture β Fellowship-level guide to the rib stress fracture - an overuse injury of the ribs from repetitive loading, classically in ROWERS (and also in throwing, golf, and back-pack/load carriage), presenting with localised activity-related chest-wall pain - covering the at-risk sites (posterolateral ribs in rowers; first rib in throwers), the contributory factors (training load, low bone density/energy availability), the diagnosis (bone scan/MRI when radiographs are negative), and a predominantly non-operative, load-managed recovery.
- Rotator Cuff Tears β Comprehensive guide to rotator cuff tears - anatomy, pathophysiology, classification, clinical assessment, imaging, surgical repair techniques, and rehabilitation for orthopaedic exam
- SCAPULAR DYSKINESIS β Comprehensive guide to Scapular Dyskinesis, including Kibler classification, SICK scapula syndrome, and kinetic chain rehabilitation.
- Scapular Winging β Comprehensive guide to medial and lateral scapular winging - long thoracic nerve, spinal accessory nerve, serratus anterior and trapezius palsy, diagnosis and surgical reconstruction.
- Semimembranosus Tendinopathy β Fellowship-level guide to semimembranosus tendinopathy - an overuse tendinopathy of the distal semimembranosus at its insertion on the posteromedial tibia, a cause of chronic posteromedial knee pain - covering its presentation (localised posteromedial pain/tenderness worse on resisted knee flexion, often in running/cutting athletes), the differential within the posteromedial corner (medial meniscus, pes anserine, popliteal cyst), the role of ultrasound/MRI, and a non-operative-first management.
- SLAP Tears β Comprehensive exam-ready guide to SLAP tears - classification, Type II critical, biceps tenotomy vs tenodesis decision
- Snapping Hip Syndrome β Comprehensive guide to Coxa Saltans - Internal, External, and Intra-articular causes, diagnosis, and management
- Snapping Scapula Syndrome β Comprehensive guide to snapping scapula syndrome and scapulothoracic bursitis - scapulothoracic anatomy, osseous and soft-tissue causes, examination, CT imaging, the role of injections, and arthroscopic bursectomy with superomedial angle resection for orthopaedic examination
- Snapping Triceps Syndrome β Exam-focused guide to snapping triceps syndrome: the dislocating medial triceps head that snaps over the medial epicondyle, often dragging the ulnar nerve with it. Covers anatomy, classification, dynamic ultrasound diagnosis, non-operative and operative management, and the key association with ulnar neuropathy.
- Stress Fractures Overview β Comprehensive guide to stress fractures in athletes and at-risk populations: fatigue versus insufficiency fractures, high-risk versus low-risk sites, RED-S, imaging, and evidence-based load management.
- Subacromial Impingement Syndrome β Comprehensive guide to subacromial impingement syndrome - anatomy, pathophysiology, clinical assessment, conservative and surgical management for Orthopaedic exam preparation
- Subscapularis Tears β Comprehensive guide to subscapularis tears - diagnosis, classification, repair techniques, and outcomes for orthopaedic examination
- Sudden Cardiac Death & Cardiac Conditions in Athletes / Pre-Participation Screening β Fellowship-level guide to sudden cardiac death (SCD) in athletes - the leading medical cause of death in sport - covering the underlying cardiac conditions (hypertrophic and arrhythmogenic cardiomyopathies, congenital coronary anomalies, channelopathies, and acquired causes), the 'athlete's heart' versus disease 'grey zone', the role and controversies of pre-participation screening (history/examination +/- ECG), and the critical importance of emergency action plans and on-site automated external defibrillators.
- Suprascapular Neuropathy β Comprehensive guide to suprascapular neuropathy including notch anatomy, paralabral cyst compression, infraspinatus atrophy, EMG diagnosis, and arthroscopic decompression.
- Triceps Tendon Rupture β Comprehensive guide to triceps tendon rupture: fleck sign, partial vs complete tears, transosseous vs suture-anchor repair, and outcomes
- Turf Toe β Comprehensive guide to first MTP joint plantar plate hyperextension injury - mechanism, Anderson grading, MRI assessment, conservative vs surgical management for orthopaedic exam
Adult Reconstruction β 109 topics
- Acetabular Bone Loss in Revision Hip Arthroplasty: Paprosky Classification and Reconstruction Ladder β Fellowship-level guide to describing acetabular defects, interpreting Paprosky patterns and selecting shells, augments, cages, distraction or custom reconstruction.
- Adductor Brevis Anatomy β Surgical anatomy of the adductor brevis β the muscle that separates the anterior and posterior divisions of the obturator nerve, the key plane in the medial (Ludloff) approach to the hip, and the landmark protecting the medial circumflex femoral artery.
- Adductor Longus Anatomy β Surgical anatomy of the adductor longus β its pubic enthesis and avulsion, adductor-related groin pain and criteria-based return to play, its role as the posteromedial wall of the adductor canal, and adductor tenotomy in athletes and in cerebral palsy.
- Adductor Magnus Anatomy β Surgical anatomy of the adductor magnus β its dual innervation from the obturator and sciatic nerves, the adductor hiatus and popliteal artery injury, the adductor tubercle as the MPFL landmark, and its role in the medial approach to the hip.
- Adult Hip Dysplasia β Comprehensive guide to adult developmental dysplasia of the hip (DDH) - diagnosis, classification, joint-preserving surgery, and arthroplasty considerations
- Ankle Arthritis β Comprehensive guide to ankle osteoarthritis including post-traumatic etiology, conservative management, ankle arthrodesis, total ankle replacement, and Orthopaedic examination preparation
- Aseptic Loosening in Total Hip Arthroplasty β Comprehensive guide to aseptic loosening after THA - particle disease, osteolysis, Gruen zones, DeLee/Charnley classification, differentiating from infection, and revision planning for orthopaedic exam
- Avascular Necrosis of the Hip β Comprehensive guide to AVN of the femoral head: pathophysiology, staging systems (Ficat, Steinberg), joint-preserving vs arthroplasty approaches, and contemporary management strategies
- Avascular Necrosis of the Humeral Head β Comprehensive guide to etiology, staging, and management of humeral head AVN including core decompression, biological treatments, and arthroplasty decision-making
- Blood Supply of the Hip β Detailed anatomy of the femoral head vascularity, including the medial femoral circumflex artery, retinacular vessels, and clinical implications for AVN.
- Cam-Type Femoroacetabular Impingement β Cam-type femoroacetabular impingement: why the alpha angle is a morphology and not a diagnosis, what the randomised trials of arthroscopy actually showed, and how to select the patients who benefit
- Cement-in-Cement Revision of the Femoral Stem β Fellowship-level technique guide to revising a loose or failed cemented femoral component while retaining a well-fixed distal cement mantle.
- Conversion Total Hip Arthroplasty After Failed Proximal Femoral Fixation β Fellowship-level guide to converting failed fixation of proximal femoral fracture to total hip arthroplasty, including nonunion, avascular necrosis, hardware removal and infection risk.
- Custom Triflange Acetabular Components in Revision Hip Arthroplasty β Fellowship-level guide to planning and implanting patient-specific custom triflange acetabular components for severe Paprosky type IIIB bone loss and pelvic discontinuity.
- Cyclops Lesion β Comprehensive guide to cyclops lesion of the knee following ACL reconstruction, including pathophysiology, clinical assessment, MRI features, and arthroscopic excision.
- Deep Peroneal Nerve Anatomy β Surgical anatomy of the deep peroneal (deep fibular) nerve: division at the fibular neck, the anterior compartment, first web space sensation, anterior tarsal tunnel syndrome and the safe zones around the proximal tibia and fibula.
- Dual Mobility Total Hip Arthroplasty β Comprehensive guide to dual mobility THA - Bousquet design, biomechanics, indications for instability prevention, intraprosthetic dislocation, outcomes, and AOANJRR data
- Elbow Arthritis β Comprehensive guide to elbow osteoarthritis including post-traumatic etiology, rheumatoid arthritis, conservative management, surgical options, and outcomes
- Extended Trochanteric Osteotomy β Planning, technique and fixation of the extended trochanteric osteotomy in revision hip arthroplasty, including stem selection, union rates and complication management.
- Femoral Bone Loss in Revision Hip Arthroplasty: Paprosky Classification and Stem Selection β Fellowship-level guide to Paprosky femoral bone loss classification, radiographic assessment, and revision stem selection from extensively coated stems to proximal femoral replacement.
- Femoral Impaction Bone Grafting β Exeter/X-change femoral impaction grafting in revision hip arthroplasty: rationale, graft biology, layered impaction technique, cemented polished taper stems, complications and long-term evidence.
- Femoral Nerve Anatomy β Fellowship-level anatomy of the femoral nerve: L2-L4 origin, course through the iliopsoas groove and under the inguinal ligament (NAVEL), quadriceps and saphenous supply, and the injury patterns in hip and pelvic surgery.
- Gastrocnemius Anatomy β Surgical anatomy of gastrocnemius: the two heads and the sural nerve between them, the medial gastrocnemius rotation flap for proximal tibial cover, gastrocnemius contracture and the Silfverskiold test, recession techniques and equinus in cerebral palsy.
- Girdlestone Procedure (Excision Arthroplasty) β Comprehensive Orthopaedic exam guide to Girdlestone procedure including indications, surgical technique, and outcomes for hip excision arthroplasty
- Gluteus Medius Anatomy β Comprehensive anatomy of the Gluteus Medius, its role as the primary hip abductor, Trendelenburg sign, and surgical significance.
- Gracilis Anatomy β Surgical anatomy of gracilis: the obturator nerve, the pes anserinus, hamstring graft harvest, and its role as a functioning free muscle transfer in brachial plexus reconstruction and facial reanimation.
- Hip Labral Tears β Comprehensive guide to hip labral tears - anatomy, diagnosis, arthroscopic repair versus debridement, and the evidence for surgery against conservative care
- Hip Osteoarthritis β Comprehensive exam-ready guide to hip OA - diagnosis, conservative treatment, THA indications
- Iliacus Anatomy β Surgical anatomy of iliacus, its femoral nerve supply arising within the abdomen, the iliac fascia compartment and iliacus haematoma, iliocapsularis in the dysplastic hip, and the iliac fossa windows of the ilioinguinal approach.
- Interprosthetic Femoral Fracture β Fellowship-level guide to the interprosthetic femoral fracture - a fracture of the femoral shaft between an ipsilateral hip implant and a knee implant: why the inter-implant bone is a stress riser (short inter-stem distance, osteoporosis), how implant stability and fracture location drive treatment (spanning locked plating, revision arthroplasty, or distal/total femoral replacement), and the high reoperation and infection rates.
- Ischiofemoral Impingement β Comprehensive guide to ischiofemoral impingement including pathoanatomy, MRI diagnosis of quadratus femoris space narrowing, and management from conservative care to endoscopic decompression.
- Knee Osteoarthritis β Comprehensive guide to knee osteoarthritis including pathophysiology, classification systems, non-operative and surgical management strategies for Orthopaedic exam preparation
- Megaprosthesis in Non-Oncologic Orthopaedic Salvage β Fellowship-level guide to selecting, planning and implanting endoprosthetic replacement for massive bone loss after failed arthroplasty, fracture, infection or nonunion.
- Meniscal Repair β Comprehensive guide to meniscal repair techniques and indications
- Meniscal Root Tears β Detailed guide to posterior meniscal root tears, biomechanics, diagnosis (Ghost Sign), and management strategies.
- Meniscal Transplantation β Comprehensive guide to meniscal allograft transplantation - indications, technique and outcomes
- Metal-on-Metal Hip Complications β Comprehensive guide to adverse local tissue reactions, pseudotumors, surveillance, and revision strategies for metal-on-metal hip arthroplasty
- Obturator Nerve Anatomy β Fellowship-level anatomy of the obturator nerve: L2-L4 origin, course along the pelvic wall through the obturator canal, adductor motor supply, medial thigh sensation, and injury patterns including the Howship-Romberg sign.
- Osteochondral Defects of the Knee β Comprehensive guide to osteochondral defects and cartilage restoration of the knee
- Pectineus Anatomy β Surgical anatomy of the pectineus β the dually innervated adductor, the floor of the femoral triangle, its release in the medial (Ludloff) approach to the hip, and the medial circumflex femoral artery it guards.
- Pelvic Discontinuity β Diagnosis and reconstruction of pelvic discontinuity in revision hip arthroplasty: imaging criteria, Paprosky IIIB defects, cup-cage, distraction and custom triflange techniques.
- Periprosthetic Joint Infection β Comprehensive guide to periprosthetic joint infection following hip and knee arthroplasty, covering MSIS and EBJIS diagnostic criteria, serum and synovial fluid markers, differentiation of acute versus chronic presentations, and management options including DAIR, one-stage and two-stage revision.
- Periprosthetic Joint Infection After THA β Comprehensive guide to periprosthetic joint infection (PJI) diagnosis, MSIS/ICM criteria, DAIR, one-stage and two-stage revision for orthopaedic exam
- Pincer-Type Femoroacetabular Impingement β Comprehensive guide to pincer-type FAI diagnosis and management
- Piriformis Anatomy β Detailed anatomy of the Piriformis muscle, its critical relationship with the Sciatic Nerve, and clinical significance in Piriformis Syndrome.
- Plantaris Anatomy β Surgical anatomy of plantaris: its absence in a significant proportion of limbs, the tennis leg differential, its role in midportion Achilles tendinopathy, and its use as a tendon graft donor.
- Popliteus Anatomy β Surgical anatomy of popliteus: the intra-articular femoral origin, the popliteus tendon and popliteofibular ligament as posterolateral corner restraints, unlocking the screw-home mechanism, and popliteus dysfunction after total knee arthroplasty.
- Posteromedial Corner Knee Injury β Comprehensive guide to posteromedial corner injuries of the knee, including sMCL, dMCL, POL and semimembranosus anatomy, anteromedial rotatory instability, association with ACL, examination, MRI, and repair versus reconstruction.
- Preoperative Optimization & Risk Stratification for Arthroplasty β Fellowship-level guide to optimising modifiable risk factors before hip and knee arthroplasty - obesity, malnutrition, diabetes, anaemia, smoking, opioids, Staph decolonisation and dental health - and the shift from 'clearance' to optimization.
- Protrusio Acetabuli β Exam-focused guide to protrusio acetabuli: what it is, the difference between primary (idiopathic) and secondary protrusio, the underlying conditions to look for, how it is diagnosed and measured on an AP pelvis radiograph (the ilioischial or Kohler line and the centre-edge angle), and how it is managed - from observation and osteotomy in the young hip to total hip arthroplasty with restoration of the hip centre and bone grafting of the medial defect.
- Psoas Major β Surgical anatomy of psoas major, the lumbar plexus within the muscle and the femoral nerve at its lateral border, transpsoas lateral interbody safe working zones, psoas abscess, iliopsoas impingement after hip arthroplasty and snapping iliopsoas.
- Quadratus Femoris Anatomy β Surgical anatomy of quadratus femoris: the short external rotators, the medial circumflex femoral artery deep branch, ischiofemoral impingement and the quadratus femoris space, and external rotator repair in the posterior approach.
- Radial Head Arthroplasty β Comprehensive guide to radial head arthroplasty - indications for unreconstructable fractures, terrible triad management, surgical technique with PIN protection, sizing principles, and outcomes
- Rectus Femoris Anatomy β Surgical anatomy of the rectus femoris β its two heads, biarticular action, AIIS avulsion and subspine impingement, Ely test, and its role in the anterior hip intervals and stiff-knee gait transfer.
- Reverse Total Shoulder Arthroplasty β Comprehensive guide to reverse total shoulder arthroplasty - indications, Grammont principles, surgical technique, complications, and outcomes for rotator cuff arthropathy and complex shoulder pathology
- Revision Shoulder Arthroplasty β Comprehensive guide to revision shoulder arthroplasty including indications, bone loss classification, surgical techniques, and outcomes for failed shoulder replacements
- Revision TKA Bone Loss, Cones and Sleeves β Advanced orthopaedic guide to revision total knee arthroplasty bone loss, including AORI classification, defect mapping, cement, screws, augments, stems, metaphyseal cones, sleeves, rotating hinge indications, operative sequence and complications.
- Revision Total Hip Arthroplasty β Comprehensive exam-ready guide to revision THA: indications, bone defect classification, reconstruction techniques, and outcomes
- Revision Total Knee Arthroplasty β Comprehensive guide to revision TKA including indications, AORI bone loss classification, constraint selection, and surgical techniques for failed knee arthroplasty.
- Robotic-Assisted and Computer-Navigated Arthroplasty β Fellowship-level guide to robotic and computer-navigated hip and knee arthroplasty: system taxonomy, the evidence on alignment accuracy versus clinical outcomes, limitations, cost, and the exam debate.
- Rotator Cuff Arthropathy β Comprehensive guide to Cuff Tear Arthropathy, covering pathophysiology (Acetabularization), Seebauer classification, and Reverse TSA management.
- Sartorius Anatomy β Comprehensive anatomy of the Sartorius muscle, 'The Tailor's Muscle', including its relations, clinical significance in Pes Anserine Bursitis, and surgical relevance.
- Sciatic Nerve Anatomy β Comprehensive guide to the anatomy, clinical assessment, and management of the Sciatic Nerve, including Piriformis relations and injection safety
- Semimembranosus Anatomy β Surgical anatomy of semimembranosus: its five distal expansions, the posteromedial corner, anteromedial rotatory instability, semimembranosus bursitis, Baker cyst and proximal hamstring avulsion.
- Semitendinosus Anatomy β Surgical anatomy of semitendinosus: the pes anserinus, hamstring autograft harvest and its pitfalls, the fascial bands to medial gastrocnemius, infrapatellar saphenous nerve injury and tendon regeneration.
- Shoulder Arthroplasty Anatomy β Comprehensive surgical anatomy for shoulder arthroplasty including neurovascular structures at risk, deltopectoral approach, rotator cuff anatomy, and critical anatomical relationships
- Shoulder Arthroplasty Complications β Comprehensive guide to shoulder arthroplasty complications including instability, infection, glenoid loosening, nerve injury, and management strategies
- Shoulder Hemiarthroplasty β Comprehensive guide to shoulder hemiarthroplasty for proximal humerus fractures, avascular necrosis, and glenohumeral arthritis - indications, surgical technique, and outcomes
- Shoulder Osteoarthritis β Comprehensive guide to Glenohumeral Osteoarthritis, including pathophysiology, classification, and management strategies.
- Spontaneous Osteonecrosis of the Knee (SPONK/SONK) β Comprehensive guide to spontaneous osteonecrosis of the knee including subchondral insufficiency fracture hypothesis, MRI staging, differential diagnosis, and decision-making between conservative care, unloading osteotomy and unicompartmental arthroplasty.
- Superior Gemellus Anatomy β Surgical anatomy of superior gemellus: the triceps coxae and the conjoint tendon, the nerve to obturator internus at the ischial spine, its relation to the medial circumflex femoral artery, and external rotator repair in the posterior approach.
- Superior Gluteal Nerve Anatomy β Surgical anatomy of the superior gluteal nerve: L4 to S1 usually above piriformis, supply to gluteus medius, minimus and tensor fasciae latae with a sensory branch to the superior hip capsule, the safe zone above the greater trochanter, and abductor deficiency after total hip arthroplasty.
- Surgical Hip Dislocation (Ganz Trochanteric Flip) β Comprehensive guide to Ganz safe surgical dislocation of the hip via trochanteric flip osteotomy preserving the medial femoral circumflex artery - indications including FAI, intra-articular pathology, AVN and acetabular fractures, retinacular vessel anatomy and protection, step-by-step surgical technique, complications including AVN and trochanteric nonunion, and evidence-based outcomes
- THA Heterotopic Ossification β Comprehensive guide to heterotopic ossification after total hip arthroplasty including classification, prevention strategies, and management
- THA Leg Length Discrepancy β Assessment, prevention, and management of leg length discrepancy in total hip arthroplasty - a critical complication affecting patient satisfaction and outcomes
- THA Neurovascular Injury β Prevention, recognition, and management of neurovascular complications in total hip arthroplasty
- THA Templating and Preoperative Planning β Advanced orthopaedic guide to total hip arthroplasty templating and preoperative planning, including radiograph requirements, digital templating, acetabular and femoral planning, leg length and offset restoration, complex cases, pitfalls and evidence.
- THA Wear and Osteolysis β Comprehensive guide to polyethylene wear, particle disease, osteolysis mechanisms, HXLPE benefits, surveillance strategies, and management of established osteolysis in total hip arthroplasty
- The Hip-Spine Relationship in Total Hip Arthroplasty β Fellowship-level guide to spinopelvic mobility and the hip-spine relationship in THA: spinopelvic parameters, why the stiff/fused spine raises dislocation risk, the Hip-Spine Classification, functional cup targets, and dual mobility.
- The Painful Total Knee Replacement β Pattern and differential approach to the painful total knee replacement: discriminators separating infection, loosening, instability, malrotation and extrinsic causes, with the investigation sequence.
- TKA Alignment Options β Mechanical, kinematic, and restricted kinematic alignment philosophies in total knee arthroplasty - evolution from traditional to patient-specific approaches
- TKA Aseptic Loosening β Comprehensive Orthopaedic exam guide to aseptic loosening of total knee arthroplasty including pathophysiology, diagnosis, and revision strategies
- TKA Balancing, Gaps and Instability β Advanced orthopaedic guide to total knee arthroplasty balancing and instability: gap mechanics, clinical examination, imaging, varus and valgus releases, flexion instability, mid-flexion instability and revision constraint selection.
- TKA Complications: Instability β Comprehensive guide to knee instability after total knee arthroplasty
- TKA Cruciate Retention vs Substitution β Comprehensive guide to cruciate retaining (CR) and posterior stabilized (PS) total knee arthroplasty design principles, biomechanics, indications, and outcomes
- TKA Extensor Mechanism Failure β Comprehensive Orthopaedic exam guide to extensor mechanism disruption after total knee arthroplasty including patellar tendon rupture, quadriceps rupture, and management strategies
- TKA Implant Design β Comprehensive overview of total knee arthroplasty implant design principles, component options, polyethylene types, constraint levels, and evolution of modern knee replacement systems
- TKA Neurovascular Injury β Recognition and management of neurovascular complications following total knee arthroplasty including common peroneal nerve injury and vascular injuries
- TKA PATELLAR COMPLICATIONS β Comprehensive guide to patellar complications after Total Knee Arthroplasty including fracture, instability, clunk syndrome, and loosening.
- TKA Periprosthetic Fractures β Comprehensive guide to periprosthetic fractures around total knee arthroplasty - classification, management algorithms, and surgical techniques
- TKA Periprosthetic Joint Infection β Comprehensive guide to diagnosis using MSIS criteria, management algorithm including DAIR vs 2-stage revision, and prevention strategies for periprosthetic joint infection following total knee arthroplasty
- TKA Stiffness and Arthrofibrosis β Comprehensive guide to prevention, diagnosis, and management of post-TKA stiffness including classification, manipulation timing, and surgical revision strategies
- TKA Wound Complications β Prevention and management of wound complications after total knee arthroplasty including superficial infections, dehiscence, and wound healing problems
- Total Ankle Arthroplasty β Comprehensive guide to total ankle arthroplasty including indications, patient selection, surgical technique, and outcomes compared to ankle arthrodesis
- Total Elbow Arthroplasty β Comprehensive guide to total elbow arthroplasty - indications, implant design, surgical technique, rehabilitation, and complications for orthopaedic exam
- Total Femur Replacement for Salvage Reconstruction β Fellowship-level guide to total femur endoprosthetic replacement for extensive non-oncologic or oncologic femoral loss, including hip, knee and soft-tissue reconstruction.
- Total Hip Arthroplasty Bearing Surfaces β Comprehensive guide to THA bearing surfaces - metal-on-polyethylene, ceramic-on-polyethylene, ceramic-on-ceramic, metal-on-metal, dual mobility, wear rates, particle disease, and AOANJRR data for orthopaedic exam
- Total Hip Arthroplasty Fixation Options β Comprehensive guide to THA fixation methods - cemented, cementless, and hybrid techniques, patient selection criteria, AOANJRR outcomes data, and implant survival for orthopaedic exam
- Total Hip Arthroplasty Indications β Comprehensive guide to THA patient selection, indications, contraindications, preoperative assessment, templating, and decision-making for Orthopaedic exam
- Total Hip Arthroplasty: Dislocation β Comprehensive guide to THA dislocation including risk factors, Lewinnek safe zones, combined anteversion, dual mobility, and revision strategies for recurrent instability
- Total Knee Arthroplasty Indications β Comprehensive guide to indications and contraindications for total knee arthroplasty including patient selection, timing of surgery, and preoperative optimization
- Total Shoulder Arthroplasty β Comprehensive guide to total shoulder arthroplasty including indications, surgical technique, glenoid component options, reverse vs anatomic designs, and outcomes for Orthopaedic exam preparation
- Total Shoulder Arthroplasty (Anatomic) β Comprehensive guide to Anatomic Total Shoulder Arthroplasty (TSA) including indications, surgical technique, and outcomes.
- Trunnionosis and Taper Corrosion β Comprehensive exam-ready guide to trunnionosis and taper corrosion in total hip arthroplasty - head-neck junction mechanics, corrosion mechanisms, diagnosis with metal ions and MARS MRI, and revision surgery principles
- Unicompartmental Knee Arthroplasty (UKA) β Comprehensive guide to partial knee replacement - Indications (Oxford Criteria), Surgical Technique, and Outcomes vs TKA.
- Vascular Injury in Hip & Knee Arthroplasty β Fellowship-level guide to vascular injury complicating hip and knee arthroplasty: a rare but potentially limb- and life-threatening complication; the at-risk vessels (popliteal artery in TKA; external iliac/femoral and the acetabular screw 'quadrants' in THA), the mechanisms (direct laceration, traction, tourniquet-related thrombosis in peripheral arterial disease, retractor/screw injury), the anatomic variants and risk factors, acute and delayed (pseudoaneurysm/AV fistula) presentations, and urgent management with vascular surgery.
- Vastus Intermedius Anatomy β Surgical anatomy of the vastus intermedius β the layered architecture of the quadriceps tendon relevant to autograft harvest and V-Y turndown, articularis genu and suprapatellar pouch adhesions, and extension contracture after femoral fracture treated by Thompson or Judet quadricepsplasty.
- Vastus Lateralis Anatomy β Surgical anatomy of the vastus lateralis β the lateral approach to the femur, elevation off the intermuscular septum, control of the profunda femoris perforators, its use as a flap, and its contribution to the lateral retinaculum.
- Vastus Medialis Anatomy β Surgical anatomy of the vastus medialis β VMO fibre angle and patellar stabilisation, the subvastus and midvastus approaches to the knee and their trade-offs against medial parapatellar arthrotomy, the infrapatellar branch of the saphenous nerve, and VMO wasting in patellofemoral pain.
Paediatrics β 176 topics
- Cerebral Palsy Gait and SEMLS β Comprehensive orthopaedic guide to cerebral palsy gait assessment, gait pattern classification, lever-arm dysfunction, instrumented gait analysis, and single-event multilevel surgery.
- Cerebral Palsy Hip Surveillance β Comprehensive orthopaedic guide to cerebral palsy hip surveillance, GMFCS risk, Reimers migration percentage, hip abduction, AP pelvis monitoring, adductor-psoas release, VDRO, pelvic osteotomy, salvage surgery and family counselling.
- Guided Growth and Angular Deformity Correction β Comprehensive orthopaedic guide to paediatric guided growth, angular deformity analysis, mechanical axis deviation, LDFA, MPTA, hemiepiphysiodesis, genu valgum, genu varum, rebound and osteotomy indications.
- Limb Length Discrepancy and Epiphysiodesis β Detailed clinical guide to paediatric limb length discrepancy: assessment, calibrated imaging, growth prediction, treatment thresholds, epiphysiodesis, physeal bar management, shortening, lengthening, congenital deficiency planning and complications.
- Limping Child β Structured orthopaedic approach to the limping child, including age-based differential diagnosis, painful versus painless limp, septic arthritis exclusion, imaging, laboratory workup, and red flags.
- Paediatric Bone and Joint Infection β Comprehensive orthopaedic reference on paediatric osteomyelitis and septic arthritis beyond the hip, including septic knee, shoulder, ankle, neonatal disease, Brodie abscess, CRMO, pyomyositis, and treatment principles.
- Paediatric Distal Radius, Buckle and Physeal Wrist Fractures β Structured orthopaedic guide to paediatric distal radius fractures, torus/buckle fractures, greenstick injuries, distal radial physeal injuries, acceptable alignment, remodelling, and follow-up.
- Paediatric Elbow Radiology and Assessment β Orthopaedic reference guide to paediatric elbow radiology, including CRITOE ossification centres, Baumann angle, anterior humeral line, radiocapitellar line, fat pad signs, and common injury traps.
- Paediatric Femur Fractures by Age β Structured orthopaedic guide to paediatric femoral shaft fractures by age, including Pavlik harness, spica cast, traction, flexible nails, submuscular plating, rigid nails, open fractures, and complications.
- Congenital Hand Anomalies Overview β Comprehensive orthopaedic guide to congenital hand differences, including assessment, Oberg-Manske-Tonkin classification, syndactyly, polydactyly, thumb hypoplasia, symbrachydactyly, cleft hand, timing of surgery, complications and counselling.
- Congenital Lower Limb Deficiency Overview β Comprehensive orthopaedic guide to congenital lower limb deficiency, including congenital femoral deficiency, fibular hemimelia, tibial hemimelia, limb length prediction, joint stability, foot reconstructability, lengthening, prosthetic pathways, amputation options and family counselling.
- Paediatric ACL Injury β Advanced orthopaedic guide to ACL injury in skeletally immature patients, including tibial spine avulsion, meniscal risk, skeletal maturity, physeal-respecting reconstruction, graft choice, rehabilitation and return to sport.
- Paediatric Femoral Neck Fractures β Comprehensive orthopaedic guide to paediatric femoral neck fractures, Delbet classification, femoral-head perfusion risk, urgent reduction, fixation, decompression, AVN, coxa vara and long-term surveillance.
- Paediatric Rotational Profile and In-toeing/Out-toeing β Comprehensive orthopaedic guide to paediatric rotational profile, in-toeing, out-toeing, femoral anteversion, tibial torsion, metatarsus adductus, natural history, red flags and derotation osteotomy indications.
- Radial Longitudinal Deficiency β Orthopaedic teaching chapter on radial longitudinal deficiency, including systemic screening, radius and thumb classification, clinical assessment, centralisation, radialisation, pollicisation, recurrence and follow-up.
- Seymour Fracture and Paediatric Nail-bed Injuries β Orthopaedic reference guide to Seymour fractures, paediatric open distal phalanx physeal injuries, nail-bed trauma, fingertip injuries, infection risk, and operative management.
- Accessory Navicular β A comprehensive guide to the Accessory Navicular (Os Tibiale Externum), including classification, clinical presentation, and management strategies (Kidner Procedure).
- Achondroplasia β Comprehensive guide to Achondroplasia covering orthopaedic manifestations including spinal stenosis, limb deformity, and management principles.
- Adolescent Idiopathic Scoliosis β Comprehensive guide to adolescent idiopathic scoliosis - Lenke classification, bracing protocols, surgical indications, posterior spinal fusion for Orthopaedic exam
- Apert Syndrome β Comprehensive guide to Apert syndrome covering FGFR2 genetics, the complex hand and foot syndactyly, Upton classification, and staged surgical reconstruction.
- Arthrogryposis β Comprehensive guide to Arthrogryposis Multiplex Congenita (AMC) - Classification, orthopaedic manifestations, and management.
- Atlantoaxial Instability β Comprehensive guide to atlantoaxial instability - C1-C2 pathology, Down syndrome association, ADI measurement, surgical stabilization and fusion techniques for orthopaedic exam
- Beckwith-Wiedemann Syndrome β Fellowship-level guide to Beckwith-Wiedemann syndrome (BWS) - an imprinting/overgrowth disorder (11p15 region) featuring macrosomia, macroglossia, abdominal wall defects, hyperinsulinism and a predisposition to embryonal tumours (especially Wilms tumour) - focusing on the orthopaedic relevance of lateralised overgrowth/hemihypertrophy, the resulting limb-length discrepancy, the mandatory tumour surveillance, and management of the discrepancy by epiphysiodesis or lengthening.
- Bladder Exstrophy (Pelvic Manifestations) β Orthopaedic guide to the pelvic ring abnormality in bladder exstrophy - pubic diastasis, iliac external rotation, the role of osteotomy in closure, immobilisation, and long-term gait and hip outcomes.
- Blount Disease (Tibia Vara) β Comprehensive Orthopaedic exam guide to Blount disease including LangenskiΓΆld classification, infantile vs adolescent forms, metaphyseal-diaphyseal angle measurement, bracing protocols, and surgical management strategies including proximal tibial osteotomy and guided growth techniques.
- Brachial Plexus Birth Palsy β Comprehensive guide to Brachial Plexus Birth Palsy (BPBP) - Erb's, Klumpke's, Narakas Classification, and Surgical Management.
- Caffey Disease β Comprehensive exam-ready guide to Caffey Disease (Infantile Cortical Hyperostosis) - diagnosis, pathophysiology, differential diagnosis, management, and outcomes for orthopaedic fellowship examination preparation
- Calcaneovalgus Foot β Comprehensive guide to Calcaneovalgus Foot (talipes calcaneovalgus) for the orthopaedic exam. Covers the dorsiflexed-everted postural newborn foot, differentiation from congenital vertical talus and posteromedial bowing of the tibia, the DDH association, and management.
- Camptomelic Dysplasia β Fellowship-level guide to camptomelic (campomelic) dysplasia - a rare, often lethal skeletal dysplasia caused by SOX9 mutation, defined by congenital BOWING (camptomelia) of the long bones (especially the tibia/femur), a small thorax with respiratory compromise, and sex reversal (XY females) - covering the characteristic anterior tibial bowing with a skin dimple, the laryngotracheomalacia/respiratory threat, the associated anomalies, and the largely supportive/palliative management.
- Camurati-Engelmann Disease β Comprehensive guide to Camurati-Engelmann disease (progressive diaphyseal dysplasia): TGFB1 pathophysiology, symmetric diaphyseal hyperostosis, limb pain and waddling gait, radiographic features, corticosteroid and losartan management, and exam differentials.
- Caudal Regression Syndrome (Sacral Agenesis) β Comprehensive orthopaedic guide to caudal regression syndrome / sacral agenesis covering the Renshaw classification, spinopelvic instability, lower-limb deformities, and management.
- Causes of Limb Length Discrepancy β Pattern and differential page for limb length discrepancy in children: measuring true versus apparent shortening, discriminating congenital, growth arrest, overgrowth and neuromuscular causes.
- Cavus Foot (Pediatric) β Comprehensive guide to pediatric cavus foot deformity including etiology, Coleman block test, conservative and surgical management, and differentiation from adult cavovarus
- Cerebral Palsy β Comprehensive guide to Cerebral Palsy management - GMFCS classification, Hip Surveillance, Gait Analysis, and Multilevel Surgery.
- Charcot-Marie-Tooth Disease β Comprehensive guide to Charcot-Marie-Tooth Disease (CMT), covering classification, cavus foot deformity, and surgical management principles.
- Chondrodysplasia Punctata β Fellowship-level guide to chondrodysplasia punctata (CDP) - a heterogeneous group of skeletal dysplasias whose radiographic hallmark in infancy is stippled (punctate) epiphyseal/peri-articular calcification - covering the main forms (rhizomelic CDP, X-linked Conradi-Hunermann, the X-linked recessive/brachytelephalangic type, and secondary/teratogenic causes such as warfarin embryopathy and maternal autoimmune disease), the orthopaedic sequelae (rhizomelic limb shortening, asymmetric limb-length discrepancy, scoliosis, cataracts), and management.
- Chondrolysis of the Hip (Idiopathic and Post-SCFE) β Fellowship-level guide to chondrolysis of the hip - rapid loss of articular cartilage with concentric joint-space narrowing, stiffness and pain in adolescents: the idiopathic form (a diagnosis of exclusion with normal inflammatory markers, diagnosed early on MRI) and chondrolysis complicating slipped capital femoral epiphysis (especially with pin/implant penetration), plus its management spectrum from anti-inflammatory/physiotherapy to salvage.
- Chronic Nonbacterial Osteomyelitis and CRMO β Advanced orthopaedic guide to chronic nonbacterial osteomyelitis and chronic recurrent multifocal osteomyelitis, including clinical presentation, imaging, differential diagnosis, biopsy indications, treatment escalation, orthopaedic role and complications.
- Cleidocranial Dysostosis β Comprehensive coverage of cleidocranial dysostosis (cleidocranial dysplasia) including RUNX2 (CBFA1) deficiency, absent or hypoplastic clavicles, delayed cranial ossification with Wormian bones, dental and skeletal anomalies, and orthopaedic management for fellowship examination preparation
- Clubfoot (Congenital Talipes Equinovarus) β Comprehensive guide to clubfoot - Ponseti method, pathoanatomy, classification, treatment, casting technique, tenotomy, bracing, and recurrence management for orthopaedic exam
- Congenital Constriction Bands (Amniotic Band Syndrome) β Comprehensive guide to congenital constriction bands - amniotic band syndrome, classification, clinical features, treatment, and differentiation from other congenital limb deformities
- Congenital Dislocation of the Knee β Comprehensive guide to congenital dislocation of the knee (CDK), including Tarek grading, associated conditions (DDH, clubfoot, arthrogryposis, Larsen syndrome), serial casting, and quadricepsplasty for resistant cases.
- Congenital Dislocation of the Patella β Comprehensive guide to congenital fixed lateral patellar dislocation from birth, including differentiation from habitual dislocation, associated deformities, and extensive lateral release with realignment strategies.
- Congenital Kyphosis β A comprehensive guide to Congenital Kyphosis, covering Winter classification, neurological risks, and surgical management with emphasis on early intervention.
- Congenital Pseudarthrosis of the Clavicle β Fellowship-level guide to congenital pseudarthrosis of the clavicle: a rare painless failure of fusion of the clavicular ossification centres presenting as a mobile mid-clavicular lump, almost always RIGHT-sided and (unlike congenital pseudarthrosis of the tibia) NOT associated with neurofibromatosis - covering the distinction from a birth fracture and cleidocranial dysplasia, and the observation-versus-surgery management.
- Congenital Pseudarthrosis of the Tibia β Comprehensive guide to congenital pseudarthrosis of the tibia, including NF1 association, Crawford classification, anterolateral bowing progression, and surgical strategies for this recalcitrant nonunion.
- Congenital Scoliosis β Comprehensive guide to congenital scoliosis - failure of formation vs segmentation, VACTERL screening, natural history, and surgical management strategies
- Congenital Vertical Talus β Comprehensive guide to Congenital Vertical Talus (CVT) - The 'Rocker Bottom Foot' causes, diagnosis, and management.
- Coxa Vara β Comprehensive guide to Congenital and Acquired Coxa Vara - Diagnosis, HE Angle, and Valgus Osteotomy
- Cozen Fracture β Comprehensive guide to Cozen fracture (proximal tibial metaphyseal fracture in children), including post-traumatic valgus deformity, natural history, and the critical principle of avoiding premature corrective osteotomy.
- Curly Toes β Comprehensive guide to curly toes - pediatric toe deformity, flexor tenotomy, age-appropriate treatment, and differentiation from other lesser toe deformities
- DDH Treatment Options β Comprehensive guide to developmental dysplasia of the hip (DDH) treatment - age-based management from Pavlik harness to open reduction and osteotomies, AVN prevention, and outcomes
- Developmental Dysplasia of the Hip (DDH) β Comprehensive guide to DDH - screening, diagnosis, and treatment
- Diastrophic Dysplasia β Comprehensive guide to diastrophic dysplasia - an autosomal recessive short-limbed skeletal dysplasia due to SLC26A2 sulfate transporter mutations, featuring hitchhiker thumb, cauliflower ear, rigid clubfoot, cervical kyphosis, and progressive scoliosis.
- Discoid Lateral Meniscus β Comprehensive guide to discoid lateral meniscus in children and adolescents: Watanabe and Ahn classifications, snapping knee presentation, MRI criteria, and arthroscopic saucerisation with or without stabilisation.
- Distal Femoral Physeal Injuries β A comprehensive guide to Distal Femoral Physeal Injuries, covering the unique risks of this growth plate, management principles, and long-term surveillance.
- Distal Tibial Physeal Injuries β A comprehensive guide to Distal Tibial Physeal Injuries, including standard Salter-Harris patterns and transitional fractures (Tillaux and Triplane).
- Down Syndrome Orthopaedic β Comprehensive guide to orthopaedic manifestations in Down Syndrome including atlantoaxial instability, hip dysplasia, and foot deformities.
- Duchenne Muscular Dystrophy β Comprehensive guide to Duchenne Muscular Dystrophy - Orthopaedic manifestations, scoliosis management, and fracture considerations.
- Early Onset Scoliosis (EOS) β A comprehensive guide to Early Onset Scoliosis, covering the C-EOS classification, Mehta (Rib-Vertebral Angle Difference), and growth-friendly management strategies.
- Ehlers-Danlos Syndrome β Comprehensive guide to orthopaedic manifestations of Ehlers-Danlos Syndrome including joint instability, dislocations, and management principles.
- Facioscapulohumeral Muscular Dystrophy (FSHD) β Fellowship-level guide to facioscapulohumeral muscular dystrophy (FSHD): the third most common muscular dystrophy with a descending facioscapulohumeral pattern of weakness, the 4q35 D4Z4 / DUX4 genetic basis, the orthopaedic problem of scapular winging, and the role, technique, outcomes and complications of scapulothoracic arthrodesis (with preserved deltoid) within multidisciplinary care.
- Familial Dysautonomia (Riley-Day) - Orthopaedic Features β Fellowship-level guide to the orthopaedic features of familial dysautonomia (Riley-Day syndrome, hereditary sensory and autonomic neuropathy type III) - an autosomal-recessive disorder (Ashkenazi Jewish, ELP1/IKBKAP) of autonomic dysfunction and reduced pain/temperature sensation - covering the resulting neuropathic (insensate) orthopaedic problems shared with other insensate states: Charcot (neuropathic) joints, painless/unrecognised fractures, scoliosis, osteomyelitis/septic arthritis and self-injury - and the management principle of early diagnosis, protection and patient/family education.
- Fibrodysplasia (Myositis) Ossificans Progressiva (FOP) β Fellowship-level guide to fibrodysplasia ossificans progressiva: an ultra-rare autosomal dominant ACVR1 (ALK2) disorder causing progressive heterotopic ossification that turns soft tissue into bone, recognised at birth by malformed great toes, with flares triggered by trauma - so biopsy, intramuscular injections and surgery are contraindicated; covering the genetics/pathophysiology (Activin A), clinical course, diagnosis and supportive management (palovarotene).
- Fibular Hemimelia β Comprehensive guide to fibular hemimelia - Achterman-Kalamchi and Birch classifications, treatment decision (Syme amputation vs reconstruction), limb length discrepancy management, and outcomes
- Flexible Flatfoot (Pediatric) β Fellowship-level guide to paediatric flexible flatfoot (pes planovalgus): natural history, examination, imaging, deformity-specific reconstruction and evidence-based counselling.
- Frayed Metaphysis β Pattern and differential for the frayed, cupped or splayed metaphysis on paediatric radiographs β rickets, metaphyseal dysplasias, infection, leukaemia and non-accidental injury discriminated.
- Friedreich Ataxia β Comprehensive guide to Friedreich Ataxia covering scoliosis, foot deformity, and cardiomyopathy management in this hereditary ataxia.
- Gaucher Disease β Comprehensive guide to orthopaedic manifestations of Gaucher Disease including bone crises, AVN, pathological fractures, and management for Orthopaedic examination.
- Generalised Ligamentous Laxity β Pattern and differential for the hypermobile child: Beighton scoring, discriminating features of Marfan, Ehlers-Danlos, Loeys-Dietz, Down and osteogenesis imperfecta, and next tests.
- Genu Valgum and Genu Varum in Children β Comprehensive guide to pediatric angular knee deformities - physiological vs pathological, Blount disease, rickets, hemiepiphysiodesis, and guided growth
- Goldenhar Syndrome β Oculo-auriculo-vertebral spectrum with hemifacial microsomia, epibulbar dermoids and ear anomalies, and its orthopaedic burden of cervical spine anomalies, scoliosis, radial deficiency and anaesthetic airway risk.
- Gymnast's Wrist (Distal Radial Physeal Stress Injury) β Exam-focused guide to gymnast's wrist: repetitive compressive loading of the distal radial physis in young athletes, presenting with dorsal wrist pain. Covers the pathomechanics (compressive microtrauma to the open physis), radiographic findings (widening, irregularity, cystic changes, positive ulnar variance), MRI staging of physeal stress injury, and management from activity modification to surgical epiphysiodesis in refractory cases.
- Hemihypertrophy (Hemihyperplasia) β Congenital lateralized overgrowth causing progressive limb-length discrepancy and limb/digit enlargement, with a critical embryonal tumour (Wilms, hepatoblastoma) surveillance imperative - orthopaedic assessment, monitoring and growth-modulating management for fellowship exam preparation
- Hemophilia β Comprehensive guide to the orthopaedic manifestations of haemophilia: haemophilic arthropathy, target joints and hemarthrosis, radiosynovectomy, perioperative factor cover and inhibitors, and arthroplasty in the modern prophylaxis era.
- Hereditary Motor Sensory Neuropathies β Comprehensive guide to Hereditary Motor Sensory Neuropathies (Charcot-Marie-Tooth Disease) - Orthopaedic manifestations and management.
- Hereditary Spastic Paraplegia / Metachromatic Leukodystrophy (Orthopaedic Sequelae) β Fellowship-level guide to the orthopaedic sequelae of two progressive neurological disorders - hereditary spastic paraplegia (HSP, a group of inherited disorders of the corticospinal tracts causing progressive lower-limb spasticity and a spastic gait) and metachromatic leukodystrophy (MLD, a lysosomal storage leukodystrophy causing neuroregression) - focusing on the spasticity-driven lower-limb problems (equinus/pes planovalgus, flexed-knee 'crouch', hip displacement, contractures) and neuromuscular scoliosis, managed on cerebral-palsy-like principles with tone management, orthoses and selective surgery.
- Herring Lateral Pillar Classification of Perthes β The Herring lateral pillar classification for Legg-CalvΓ©-Perthes disease β groups A, B, B-C border, and C by lateral pillar height preservation, prognosis, and containment guidance.
- Hypochondroplasia β Fellowship-level guide to hypochondroplasia - a common autosomal-dominant skeletal dysplasia caused by FGFR3 gain-of-function mutation (a milder allelic relative of achondroplasia) producing disproportionate short stature with mild rhizomelia and lumbar features - covering its often subtle, postnatally-diagnosed phenotype, the radiographic clues (failure of interpedicular widening down the lumbar spine, squared short pelvis), the differential from achondroplasia, and management (limb-length/spinal monitoring, with emerging FGFR3-pathway therapy).
- Idiopathic Toe Walking β A comprehensive guide to Idiopathic Toe Walking, including differential diagnosis (CP, muscular dystrophy), clinical assessment, and management algorithm.
- Infantile Idiopathic Scoliosis β A comprehensive guide to Infantile Idiopathic Scoliosis (Age 0-3), distinguishing resolving from progressive curves using the Mehta Angle and Rib Head Phases.
- Iselin Disease (Fifth Metatarsal Apophysitis) β Comprehensive guide to Iselin disease - traction apophysitis of the base of the fifth metatarsal and a frequently missed cause of lateral foot pain in active children. Covers the peroneus brevis traction mechanism, the apophysis-versus-fracture trap, evidence-based conservative management, and exam viva preparation.
- Juvenile Hallux Valgus β A comprehensive guide to Juvenile Hallux Valgus, focusing on the high recurrence rates, Distal Metatarsal Articular Angle (DMAA), and physeal-sparing surgical options.
- Juvenile Idiopathic Arthritis β Comprehensive guide to orthopaedic manifestations of Juvenile Idiopathic Arthritis including joint contractures, growth disturbance, and surgical management.
- Juvenile Idiopathic Scoliosis β A comprehensive guide to Juvenile Idiopathic Scoliosis (Age 4-10), emphasizing the high risk of progression, neural axis abnormalities, and management challenges.
- Kingella kingae Osteoarticular Infection β Comprehensive guide to Kingella kingae musculoskeletal infections in young children, covering the commonest cause of septic arthritis and osteomyelitis under 4 years, indolent presentation, blood-culture-bottle inoculation, PCR diagnosis, and beta-lactam treatment.
- Klippel-Feil Syndrome β Comprehensive guide to Klippel-Feil Syndrome - congenital cervical fusion, Samartzis classification, associated anomalies (Sprengel's, Renal, Cardiac), and management of instability.
- Klippel-TrΓ©naunay-Weber Syndrome β Fellowship-level guide to Klippel-TrΓ©naunay(-Weber) syndrome - a sporadic, PIK3CA-mosaic, low-flow combined capillary-lymphatic-venous malformation with limb overgrowth - covering the clinical triad (capillary malformation, atypical lateral varicosities, limb overgrowth), the embryonic lateral marginal vein of Servelle, localised intravascular coagulopathy, the distinction from the high-flow Parkes-Weber syndrome, imaging, and orthopaedic and vascular management including compression, sclerotherapy, endovenous ablation, epiphysiodesis and sirolimus.
- Kniest Dysplasia β Fellowship-level guide to Kniest dysplasia: an autosomal dominant COL2A1 type II collagenopathy causing disproportionate short-trunk dwarfism with stiff enlarged joints and dumbbell-shaped long bones, plus the extra-skeletal features of type II collagen disease (myopia/retinal detachment, hearing loss), its place in the COL2A1 spectrum, and supportive multidisciplinary management.
- Kohler Disease (Navicular Osteochondrosis) β Comprehensive guide to Kohler disease - avascular necrosis of the tarsal navicular in children, including diagnosis, imaging, conservative management, and excellent prognosis
- Larsen Syndrome β Comprehensive coverage of Larsen syndrome (FLNB-related osteochondrodysplasia) including multiple large-joint dislocations, congenital knee and hip dislocation, clubfeet, cervical kyphosis with myelopathy risk, dysmorphic facies, and a staged orthopaedic management approach for fellowship examination preparation
- Legg-CalvΓ©-Perthes Disease β Comprehensive guide to Legg-CalvΓ©-Perthes disease - idiopathic avascular necrosis of the femoral head in children, classification systems, containment principles, and surgical decision-making for orthopaedic exam
- Little League Elbow β Exam-focused guide to Little League elbow: medial epicondyle apophyseal stress in young throwers, how valgus overload injures the open apophysis, imaging choices, rest-and-rehab management, return-to-throwing, red flags for avulsion fracture, and viva-ready prevention advice.
- Marfan Syndrome β Comprehensive guide to orthopaedic manifestations of Marfan Syndrome including scoliosis, protrusio acetabuli, and pes planus.
- McCune-Albright Syndrome β Comprehensive guide to McCune-Albright Syndrome covering the classic triad, GNAS1 mutation, skeletal manifestations, endocrine features, and orthopaedic management including shepherd's crook deformity.
- Medial Epicondyle Fractures in Children β Comprehensive guide to pediatric medial epicondyle fractures - elbow dislocation association, fragment entrapment, classification, ORIF indications, and ulnar nerve considerations
- Metaphyseal Chondrodysplasia β Comprehensive guide to metaphyseal chondrodysplasias (Schmid, Jansen, McKusick types), including genetics, clinical features, differentials, and management.
- Metatarsus Adductus β Comprehensive guide to metatarsus adductus covering packaging aetiology, Bleck classification, non-operative management, and the rare indications for surgery.
- Metatropic Dysplasia, Jeune (Asphyxiating Thoracic) & Ellis-van Creveld β Fellowship-level guide to a group of rare skeletal dysplasias with a small/narrow thorax and limb shortening - Jeune asphyxiating thoracic dysplasia (short-rib thoracic dysplasia, with life-threatening thoracic insufficiency and renal disease), Ellis-van Creveld (chondroectodermal dysplasia - postaxial polydactyly, nail/dental defects, congenital heart disease) and metatropic dysplasia (a 'changing pattern' dysplasia with a coccygeal tail, severe progressive kyphoscoliosis and platyspondyly) - covering recognition, the thoracic/spinal threats, and management.
- Monteggia Fractures in Children β Comprehensive guide to pediatric Monteggia fracture-dislocations - Bado classification, missed diagnosis pitfalls, reduction maneuvers, and management of chronic radial head dislocation
- Mucopolysaccharidoses β Comprehensive guide to mucopolysaccharidoses (MPS) - lysosomal storage disorders affecting orthopaedic practice including Hurler, Hunter, Morquio, and Maroteaux-Lamy syndromes with clinical features, radiographic findings, and surgical management
- Multiple Epiphyseal Dysplasia β Comprehensive guide to Multiple Epiphyseal Dysplasia (MED), including COMP and COL9 mutations, clinical presentation with small irregular epiphyses, early-onset osteoarthritis, and differentiation from bilateral Perthes disease.
- Multiple Fractures in a Child β Pattern and differential for a child with multiple fractures: separating non-accidental injury from osteogenesis imperfecta, rickets, and metabolic bone disease with real discriminators.
- Multiple Hereditary Exostoses β Comprehensive guide to Multiple Hereditary Exostoses (HME/MHE) covering diagnosis, deformity, malignant transformation, and surgical management.
- Myelomeningocele β Comprehensive guide to Myelomeningocele (Spina Bifida) management - Neurological levels, Orthopedic interventions, Chiari II, Tethered Cord, and Latex Allergy.
- Nail-Patella Syndrome β Orthopaedic-focused guide to nail-patella syndrome (LMX1B): the classic tetrad of dysplastic nails, absent/hypoplastic patellae, iliac horns and elbow dysplasia, with patellar instability management and nephropathy surveillance.
- Neurofibromatosis β Comprehensive guide to orthopaedic manifestations of Neurofibromatosis Type 1 including scoliosis, tibial dysplasia, and congenital pseudarthrosis.
- Neuromuscular Scoliosis β Comprehensive guide to neuromuscular scoliosis management - Cerebral Palsy, SMA, Duchenne, pelvic obliquity, and surgical fixation strategies
- Non-Accidental Injury β A comprehensive guide to Non-Accidental Injury (NAI) in children, covering recognition, fracture patterns, investigation protocols, and medico-legal considerations.
- Nursemaid's Elbow (Pulled Elbow / Radial Head Subluxation) β Fellowship-level guide to nursemaid's elbow: radial head subluxation under the annular ligament in young children, the classic pull mechanism, a clinical diagnosis, and reduction by the hyperpronation manoeuvre (better than supination-flexion on Cochrane evidence).
- Oblique Talus β Comprehensive guide to Oblique Talus for the Orthopaedic Exam. Covering differentiation from congenital vertical talus, radiographic findings, and management spectrum.
- Osgood-Schlatter Disease β Comprehensive guide to Osgood-Schlatter disease - tibial tubercle apophysitis, diagnosis, treatment, return to sport, and differentiation from other causes of anterior knee pain in adolescents
- Osteogenesis Imperfecta β Comprehensive guide to Osteogenesis Imperfecta covering classification, fracture management, bisphosphonates, and rodding surgery.
- Osteopetrosis β Comprehensive guide to Osteopetrosis covering pathophysiology, clinical types (malignant infantile vs benign adult), radiographic features, surgical challenges, and management including bone marrow transplant.
- Paediatric Amputee & Congenital Limb Deficiency Management β Fellowship-level guide to the management of the paediatric amputee and congenital limb deficiency - covering the key differences from adults (the growing skeleton, terminal bony overgrowth, the preference for disarticulation over transosseous amputation, and remarkable adaptation/prosthetic tolerance), the evaluation of congenital limb differences (often part of a syndrome) versus acquired amputation (most commonly traumatic), and a multidisciplinary, family-centred plan integrating prosthetic milestones, growth and function.
- Paediatric Ankle Fractures and Transitional Injuries β Advanced orthopaedic guide to paediatric ankle fractures and transitional injuries: mechanism, distal tibial physeal closure, Salter-Harris patterns, Tillaux and triplane fractures, CT-based thresholds, operative technique and growth-arrest follow-up.
- Paediatric Back Pain β Pattern and differential page for back pain in children: separating spondylolysis, discitis, osteoid osteoma, tumour and inflammatory causes by age, site and discriminating features.
- Paediatric Pelvic Osteomyelitis & Sacroiliac Joint Infection β Fellowship-level guide to pelvic osteomyelitis and septic sacroiliitis in children: the vague, often-delayed presentation (limp, hip/buttock/back pain, refusal to weight-bear, fever) that mimics hip and spine pathology, the 'metaphyseal equivalent' concept that makes the sacroiliac joint and pubis common sites, the central role of MRI, the predominance of Staphylococcus aureus, and antibiotic-led management with drainage reserved for abscess.
- Paediatric Pelvis and Hip Trauma β Advanced orthopaedic guide to paediatric pelvis and hip trauma, including assessment, injury families, imaging, pelvic ring injury, acetabular injury, traumatic hip dislocation, paediatric femoral neck fracture, apophyseal avulsion fractures, operative decision-making and complications.
- Paediatric Radial Neck, Olecranon and Elbow Dislocation Injuries β Advanced orthopaedic guide to paediatric radial neck fractures, olecranon fractures and elbow dislocations: clinical assessment, radiographic interpretation, treatment thresholds, operative choices and complications.
- Panner Disease (Capitellar Osteochondrosis) β Comprehensive guide to Panner disease - osteochondrosis (avascular necrosis) of the humeral capitellum in young children, including how to distinguish it from osteochondritis dissecans, imaging, conservative management and excellent prognosis
- Patellar Instability (Pediatric) β Comprehensive guide to Pediatric Patellar Instability - Risk Factors, TT-TG, MPFL Reconstruction, and Management
- Pediatric Acute Osteomyelitis β Comprehensive guide to Pediatric Acute Osteomyelitis - Hematogenous spread, diagnosis, antibiotics, and surgical indications.
- Pediatric Patella Sleeve Fractures β Comprehensive guide to Pediatric Patella Sleeve Fractures - Diagnosis, treatment, and the importance of early recognition.
- Pediatric Psoas Abscess β Fellowship-level guide to the paediatric psoas (iliopsoas) abscess - a collection of pus within the psoas/iliacus muscle that classically mimics hip septic arthritis or appendicitis in a child - covering the primary (haematogenous, often Staphylococcus aureus/MRSA) versus secondary forms, the characteristic presentation (fever, flexed irritable hip, painful extension/'psoas sign', limp), the central role of MRI/ultrasound, and management by antibiotics plus drainage (image-guided or open retroperitoneal).
- Pediatric Spondylolysis β Comprehensive guide to pediatric spondylolysis (pars defect) - diagnosis (Scottie Dog), imaging algorithm (SPECT/MRI), and management from bracing to repair
- Physeal Injuries (Salter-Harris Classification) β A comprehensive guide to Physeal Injuries using the Salter-Harris Classification, covering anatomy, prognosis, and management principles.
- Poland Syndrome β Advanced orthopaedic guide to Poland syndrome (congenital unilateral chest wall and ipsilateral hand hypoplasia), covering the subclavian artery disruption theory, symbrachydactyly, classification, imaging, hand and chest wall management, complications and global practice.
- Poliomyelitis (Orthopaedic Sequelae) β Exam-focused guide to the orthopaedic sequelae of poliomyelitis - flaccid paralysis, limb-length discrepancy, flail joints, foot deformity, post-polio syndrome, and the principles of tendon transfer, osteotomy and arthrodesis.
- Polydactyly of the Foot β A comprehensive guide to Polydactyly of the foot, covering classification (Pre-axial, Post-axial, Central), surgical management, and syndrome associations.
- Posteromedial Bow of Tibia β Comprehensive guide to congenital posteromedial bowing of the tibia - benign angular deformity that remodels spontaneously, but with progressive limb-length discrepancy that frequently requires treatment, plus calcaneovalgus and ankle-dorsiflexion sequelae
- Prader-Willi Syndrome (Orthopaedic Manifestations) β Fellowship-level guide to the orthopaedic manifestations of Prader-Willi syndrome - a genetic imprinting disorder (loss of paternal 15q11-q13) characterised by hypotonia, hyperphagia/obesity and developmental issues - focusing on the high prevalence of scoliosis and developmental hip dysplasia, the effects of hypotonia and growth-hormone therapy, and the perioperative considerations (obesity, OSA, anaesthetic risk) for the orthopaedic surgeon.
- Proteus Syndrome β Fellowship-level guide to Proteus syndrome - a rare mosaic AKT1 (c.49G>A, p.Glu17Lys) overgrowth disorder defined by progressive, disproportionate, distorting overgrowth with cerebriform connective-tissue naevi, vascular malformations and orthopaedic deformity - covering the dyadic diagnostic criteria, the tumour and thromboembolic risks, cystic lung disease, and the principles of staged orthopaedic management including the evidence for guided growth in leg-length discrepancy and AKT-pathway targeted therapy.
- Proximal Femoral Focal Deficiency β Comprehensive guide to proximal femoral focal deficiency (PFFD) - classification (Aitken), clinical features, treatment options from reconstruction to rotationplasty, and outcomes
- Proximal Tibial Physeal Injuries β A comprehensive guide to Proximal Tibial Physeal Injuries, covering vascular risks, classification, and management principles.
- Pseudoachondroplasia β Fellowship-level guide to pseudoachondroplasia: an autosomal dominant COMP skeletal dysplasia presenting as normal-at-birth short-limb dwarfism with a normal face and normal intelligence, its epiphyseal-and-metaphyseal radiographic features, the orthopaedic problems (lower-limb malalignment, early osteoarthritis, cervical instability), and how it differs from achondroplasia, MED and SED.
- Pterygium Syndromes / Congenital Popliteal Webbing β Fellowship-level guide to the pterygium syndromes - congenital skin/soft-tissue webs ('pterygia') bridging the flexor aspect of joints, producing fixed flexion deformity - focusing on popliteal pterygium syndrome (a popliteal web with knee flexion contracture, often with orofacial clefting, genital and foot anomalies) and the multiple pterygium syndrome (Escobar) - covering the soft-tissue/neurovascular challenges, the role of the shortened sciatic nerve in the popliteal web, and a staged surgical and rehabilitative approach.
- Pyknodysostosis β Comprehensive coverage of pyknodysostosis (Toulouse-Lautrec disease) including cathepsin K deficiency, clinical features, radiographic findings including diffuse osteosclerosis and acroosteolysis, orthopaedic management of fractures and complications for fellowship examination preparation
- Radioulnar Synostosis β Comprehensive guide to Congenital and Post-Traumatic Radioulnar Synostosis - Classification (Cleary & Omer), Management, and Complications
- Rett Syndrome β Comprehensive guide to Rett Syndrome focusing on orthopaedic manifestations including scoliosis and orthopaedic management principles.
- Rigid Flatfoot β A comprehensive guide to the assessment and management of Rigid Pes Planus (Rigid Flatfoot), focusing on Tarsal Coalition, Vertical Talus, and other etiologies.
- Russell-Silver Syndrome β Fellowship-level guide to Russell-Silver (Silver-Russell) syndrome - an imprinting disorder of prenatal and postnatal growth restriction defined clinically by the Netchine-Harbison Clinical Scoring System and molecularly by loss of methylation at the 11p15.5 H19/IGF2 ICR1 or maternal uniparental disomy of chromosome 7 - covering relative macrocephaly, feeding failure and ketotic hypoglycaemia, the hemihypoplastic (SMALLER-side) body asymmetry that distinguishes it from Beckwith-Wiedemann overgrowth, limb-length discrepancy and spinal deformity, growth hormone evidence, perioperative hypoglycaemia and airway risk, and why routine tumour surveillance is not part of Russell-Silver care.
- Scheuermann Kyphosis β Comprehensive guide to Scheuermann disease - juvenile kyphosis, diagnostic criteria, bracing, surgical indications, and differentiation from postural kyphosis
- SCIWORA β Comprehensive guide to SCIWORA (Spinal Cord Injury Without Radiographic Abnormality) - pathophysiology, pediatric susceptibility, Pang classification, and management protocols.
- Scurvy β Vitamin C deficiency causing defective collagen synthesis with characteristic musculoskeletal manifestations including subperiosteal hemorrhage, pathognomonic radiographic signs, and implications for differential diagnosis from non-accidental injury
- Secondary Causes of SUFE β Pattern and differential for atypical slipped upper femoral epiphysis: when age, weight, bilaterality or side signs point to endocrine, renal or syndromic disease.
- Septic Arthritis of the Pediatric Hip β Comprehensive guide to diagnosis and management of septic arthritis of the hip in children - a true orthopaedic emergency requiring urgent surgical washout.
- Sever's Disease (Calcaneal Apophysitis) β Comprehensive guide to Sever's disease - the most common cause of heel pain in active children. Covers the calcaneal apophysis, traction overuse mechanism, the squeeze test, differential diagnosis, evidence-based conservative management, and exam viva preparation.
- Sickle Cell Disease β Comprehensive guide to orthopaedic manifestations of sickle cell disease including AVN, osteomyelitis, bone infarcts, and perioperative management.
- Sinding-Larsen-Johansson Syndrome β Comprehensive guide to Sinding-Larsen-Johansson syndrome - inferior pole patellar apophysitis, diagnosis, treatment, return to sport, and differentiation from other causes of anterior knee pain in adolescents
- Skeletal Dysplasias β Comprehensive guide to skeletal dysplasias - achondroplasia, osteogenesis imperfecta, mucopolysaccharidoses, classification, radiographic diagnosis, and orthopaedic management for fellowship examinations
- Skewfoot β Comprehensive guide to skewfoot: component anatomy, differentiation from metatarsus adductus and planovalgus, imaging measurements, and selective reconstruction.
- Spastic Equinovarus Foot (Cerebral Palsy) β Comprehensive guide to spastic equinovarus foot deformity in cerebral palsy, covering dynamic vs fixed deformity, gait analysis, orthopaedic management including SPLATT, tendon transfers, and bracing strategies.
- Spastic Hemiplegia of Cerebral Palsy β Fellowship-level guide to spastic hemiplegia of cerebral palsy (unilateral spastic CP) - covering perinatal arterial ischaemic stroke and periventricular venous infarction as the dominant aetiologies, the Winters, Gage and Hicks gait groups as originally defined, hemiatrophy and limb-length discrepancy, the examination that separates tibialis anterior from tibialis posterior as the driver of varus, botulinum toxin A and serial casting evidence and their limits, unilateral single-event multilevel surgery, SPLATT and tibialis posterior procedures, and the sensation-led selection of children for upper-limb surgery.
- Spina Bifida β Comprehensive guide to Spina Bifida focusing on orthopaedic manifestations including hip dysplasia, scoliosis, clubfoot, and fractures.
- Spinal Muscular Atrophy β Comprehensive guide to Spinal Muscular Atrophy (SMA), covering classification, orthopaedic manifestations, and management including scoliosis and hip dysplasia.
- Sprengel Deformity β Advanced orthopaedic guide to congenital elevation of the scapula, including clinical assessment, associated anomaly screening, imaging, classification, non-operative care, Woodward and Green procedures, complications and follow-up.
- Stickler Syndrome β Fellowship-level guide to Stickler syndrome - an inherited collagenopathy (most often COL2A1, type I; COL11A1, type II) producing ocular, orofacial, auditory and skeletal abnormalities - covering the high-myopia/retinal-detachment risk, the Pierre Robin/cleft-palate orofacial features, the sensorineural hearing loss, and the orthopaedic relevance of early-onset osteoarthritis, joint hypermobility and spinal/epiphyseal changes, with the central message of mandatory ophthalmology surveillance.
- Stippled Epiphyses β Pattern and differential for stippled epiphyses on paediatric radiographs: discriminating features separating peroxisomal, teratogenic, endocrine and storage causes, with a viva-ready algorithm.
- Supracondylar Humerus Fracture β Comprehensive guide to supracondylar humerus fractures in children
- Thrombocytopenia-Absent Radius (TAR) Syndrome β Orthopaedic teaching chapter on Thrombocytopenia-Absent Radius (TAR) syndrome: the absent-radii-with-thumbs-present pattern, RBM8A genetics, neonatal thrombocytopenia, lower-limb and knee deformity, and how the bleeding disorder shapes the timing of hand and limb reconstruction.
- Tarsal Coalition β Comprehensive guide to Tarsal Coalition - Diagnosis, classification, and management of Calcaneonavicular and Talocalcaneal coalitions.
- Thalassemia β Comprehensive guide to orthopaedic manifestations of thalassemia including bone changes, osteoporosis, pathological fractures, and management strategies.
- The Widened or Abnormal Physis β Pattern-based approach to the widened, irregular or abnormal growth plate on paediatric radiographs β rickets, SCFE, trauma, infection and dysplasia, with the discriminators that separate them.
- Thiemann Disease β Exam-focused guide to Thiemann disease: its pathophysiology as an avascular necrosis of the phalangeal epiphyses, clinical presentation, radiological findings of epiphyseal fragmentation, and conservative management.
- Tibial Hemimelia β Comprehensive guide to tibial hemimelia - Jones classification, knee functionality assessment, treatment from synostosis to amputation, and outcomes
- Torticollis in Children β Comprehensive guide to pediatric torticollis - congenital muscular torticollis, differential diagnosis, stretching programs, surgical release indications, and outcome assessment
- Transient Synovitis β Comprehensive exam-ready guide to transient synovitis of the hip in children - diagnosis, differentiation from septic arthritis using Kocher criteria, management, and outcomes
- Transitional Fractures: Tillaux and Triplane β A comprehensive guide to transitional ankle fractures in adolescents, including Tillaux and Triplane patterns, CT-based treatment decisions, and surgical techniques.
- Transphyseal Distal Humerus Fracture (Distal Humeral Physeal Separation) β Fellowship-level guide to transphyseal fracture of the distal humerus: a separation through the largely cartilaginous distal humeral physis in infants and young children, its strong link to birth and non-accidental trauma, how to diagnose it (forearm-humerus malalignment, arthrogram/ultrasound), the DeLee classification, and treatment by closed reduction and percutaneous pinning.
- Trevor Disease (Dysplasia Epiphysealis Hemimelica) β Comprehensive Orthopaedic exam guide to Trevor disease (dysplasia epiphysealis hemimelica) covering its hemimelic epiphyseal osteochondromas, the Azouz and Arealis classifications, distinction from osteochondroma, MRI-led diagnosis, marginal excision, deformity correction, and the risks of recurrence and early osteoarthritis.
- Turner Syndrome (Orthopaedic Manifestations) β Fellowship-level guide to the orthopaedic manifestations of Turner syndrome (45,X and variants) - whose skeletal features are largely attributable to haploinsufficiency of the SHOX gene - covering the characteristic short stature, cubitus valgus, genu valgum, short fourth metacarpals, Madelung deformity and high-arched palate, the increased risk of scoliosis/kyphosis and reduced bone density, and the management interface with growth-hormone and oestrogen therapy.
- VEPTR and Growing Rods for Early-Onset Scoliosis β Growth-friendly surgery for early-onset scoliosis: casting, traditional and magnetic growing rods, VEPTR and Shilla β rationale, decision thresholds, complications and graduation strategy.
- Wheelchair Seating and Positioning β Comprehensive exam-focused review of wheelchair seating and positioning principles including pelvic positioning, pressure management, postural supports, and interface with orthopaedic surgery for patients with neurological conditions
- Windswept Deformity (CP / Rickets) β Fellowship-level guide to the windswept deformity - the combination of genu valgum in one leg and genu varum in the other (or, at the hips, abduction of one and adduction of the other) - covering its varied aetiologies (rickets and other metabolic bone disease being the largest group, plus skeletal dysplasias/genetic disorders, trauma/physeal injury, and neuromuscular causes such as cerebral palsy, with an idiopathic group), the diagnostic work-up to find the underlying cause, and aetiology-directed management.
- Wormian Bones β Pattern and differential for wormian bones on skull radiographs: how to confirm they are pathological, the PORKCHOPS causes, and the discriminators that separate each.
Basic Science β 160 topics
- Abductor Digiti Minimi - Anatomy and Clinical Relevance β Comprehensive guide to the abductor digiti minimi muscle anatomy, innervation, blood supply, function, and clinical relevance for orthopaedic examinations
- Adult-Onset Still's Disease β Fellowship-level guide to adult-onset Still's disease (AOSD) - a systemic autoinflammatory disorder of the IL-1/IL-18 axis presenting with the classic tetrad of daily (quotidian) spiking fever, an evanescent salmon-pink rash, arthralgia/arthritis and a strikingly high ferritin - covering the Yamaguchi diagnostic criteria, AOSD as a diagnosis of exclusion (mimicking sepsis, malignancy and other rheumatic disease), its feared complication of macrophage activation syndrome, the orthopaedic relevance (chronic arthritis, notably carpal/wrist ankylosis), and management from NSAIDs/steroids to IL-1/IL-6 biologics.
- Apoptosis and Cell Death in Orthopaedics β Fellowship-level guide to apoptosis (programmed cell death) for orthopaedic exams: the contrast with necrosis, the intrinsic (mitochondrial, Bcl-2/cytochrome c/caspase-9) and extrinsic (death-receptor/caspase-8) pathways converging on executioner caspases, and its orthopaedic relevance - growth-plate chondrocyte apoptosis in endochondral ossification, interdigital apoptosis, and chondrocyte/osteocyte apoptosis in osteoarthritis and osteonecrosis.
- Articular Cartilage Structure and Function β Comprehensive guide to articular cartilage structure, composition, zonal organization, and biomechanical properties for basic science viva preparation
- Bending Moment Distribution in Fracture Fixation β Bending mechanics, stress distribution, neutral axis, working length, and clinical applications in fracture fixation
- Biceps Femoris Short Head Anatomy β Detailed anatomy of the Short Head of Biceps Femoris, the only hamstring muscle that does NOT cross the hip joint, including its unique innervation and clinical significance.
- Bioabsorbable & Magnesium (Biodegradable Metal) Implants β Fellowship-level guide to biodegradable metal implants - chiefly magnesium-based devices (and zinc/iron alloys) that resorb after fulfilling their fixation role - covering why they are attractive (an elastic modulus close to bone reducing stress shielding, biocompatibility and osteoconductivity/pro-osteogenic effects, no removal surgery, less imaging artefact than titanium/steel), the main limitation of controlling corrosion/degradation and hydrogen-gas evolution, the radiological evolution that can mimic complications, and current clinical use (e.g. the MAGNEZIX magnesium compression screw in foot/ankle) - distinct from the bioabsorbable polymers covered elsewhere.
- Bioabsorbable Materials β Bioabsorbable implants in orthopaedics: polymer chemistry, degradation timescales, sterile foreign-body reaction, and how they compare with metal.
- Biofilm Formation in Orthopaedic Infections β Comprehensive guide to bacterial biofilm formation, structure, antimicrobial resistance mechanisms, and clinical implications for prosthetic joint infections and implant-related infections
- Bisphosphonates β Exam-focused guide to bisphosphonates in orthopaedics: mechanism of action, classes and potency, indications, dosing, evidence for fracture prevention, and the key complications (atypical femoral fracture, osteonecrosis of the jaw) plus the drug holiday concept.
- Blood Management Strategies β Comprehensive exam-ready guide to perioperative blood management - preoperative optimization, tranexamic acid, cell salvage, transfusion thresholds, and massive transfusion protocols
- Bone Composition and Structure β Comprehensive guide to bone composition, hierarchical organization, mineral and organic matrix components for basic science viva preparation
- Bone Healing and Fracture Biology β Comprehensive guide to primary and secondary bone healing, cellular mechanisms, growth factors, and factors affecting fracture union
- Bone Morphogenetic Proteins (BMPs) β Comprehensive guide to bone morphogenetic proteins, signaling pathways, clinical applications, and osteoinductive properties for basic science viva preparation
- Bone Remodeling β Comprehensive guide to bone remodeling physiology, BMU function, coupling mechanisms, and regulation for basic science viva preparation
- Bone Signaling Pathways (Wnt, RANK-RANKL-OPG, BMP/TGF-Ξ², Hedgehog, Notch) β Fellowship-level basic-science guide to the molecular pathways that control bone: the RANK-RANKL-OPG axis of osteoclastogenesis, Wnt/Ξ²-catenin and its sclerostin brake, BMP/TGF-Ξ² in osteoblast differentiation, and the Hedgehog and Notch pathways - with the drugs (denosumab, romosozumab, BMP-2) that target them.
- Calcific Periarthritis & Hydroxyapatite Deposition Disease (HADD) β Fellowship-level guide to hydroxyapatite crystal deposition disease (HADD) and calcific periarthritis - deposition of basic calcium phosphate (hydroxyapatite) crystals in periarticular soft tissues (tendons, bursae, capsule, ligaments) producing calcific tendinopathy (classically of the rotator cuff), acute crystal-induced 'periarthritis' attacks, and occasionally destructive arthropathy (Milwaukee shoulder) - covering the radiographic amorphous calcification, the resorptive-phase acute attack, the differential from gout/CPPD, and management from conservative care to ultrasound-guided barbotage.
- Calcium Homeostasis β Exam-focused guide to calcium homeostasis and metabolic bone disease: the PTH, vitamin D and calcitonin axis, the roles of bone, gut and kidney, and the diagnosis and management of osteoporosis, osteomalacia and rickets, hyperparathyroidism, renal bone disease and Paget disease.
- Calcium Phosphate Cements β Calcium phosphate cements: setting chemistry, apatite versus brushite, why they are strong in compression and weak in tension, resorption, and where the randomised evidence supports their use
- Cartilage Healing and Repair β Articular cartilage healing biology and repair: why the tissue cannot heal itself, what microfracture, osteochondral transfer and cell therapy actually achieve, and how to read a literature in which repair histology does not predict how patients do.
- Cellular & Molecular Biology Basics for Orthopaedics β Fellowship-level basic-science primer for orthopaedics: the eukaryotic cell and its organelles, the cell cycle and its controls, the central dogma (DNA to RNA to protein), collagen synthesis as the orthopaedic exemplar, cell death (apoptosis vs necrosis), and cell signalling - with the musculoskeletal relevance of each.
- Ceramic Bearing Surfaces in Arthroplasty β Alumina and zirconia ceramics in total joint replacement: structure, properties, wear characteristics, fracture risk, and clinical outcomes
- Chondrocyte Metabolism and Cartilage Homeostasis β Metabolic pathways, nutrition, and regulatory mechanisms in articular cartilage cells
- Chondromyxoid Fibroma β Rare benign cartilaginous tumor with characteristic lobular myxoid matrix and eccentric metaphyseal location
- Clinical Practice Guidelines β Comprehensive guide to clinical practice guidelines including development methodology, GRADE system, implementation, and critical appraisal in orthopaedic surgery.
- Cobalt Chrome Alloys β Cobalt chrome alloys in orthopaedics: composition and processing, why the modulus mismatch matters, how the metal-on-metal failure was detected, and what the ion thresholds do and do not tell you.
- Common Pathogens in Orthopaedic Infections β Comprehensive guide to bacterial pathogens in orthopaedic infections including osteomyelitis, septic arthritis, and surgical site infections with antimicrobial susceptibility patterns
- Common Statistical Tests β Comprehensive guide to common statistical tests in orthopaedic research including t-tests, ANOVA, chi-square, and regression, with guidance on test selection.
- Composite Materials and PEEK in Orthopaedics β Fellowship-level guide to composite biomaterials and PEEK: what a composite is (matrix plus reinforcement, e.g. carbon-fibre-reinforced PEEK; bone itself as a natural composite), the properties of polyetheretherketone (PEEK) - an elastic modulus close to bone, radiolucency and biocompatibility - its bioinert limitation requiring surface modification, and its orthopaedic uses (interbody cages, trauma plates).
- Corrosion Mechanisms in Orthopaedic Implants β Types of corrosion, electrochemistry, metal ion release, ALVAL, and clinical implications for orthopaedic implants
- Corticosteroids β Exam-focused guide to corticosteroids in orthopaedics: how they work, the difference between systemic and intra-articular use, the major musculoskeletal side effects (glucocorticoid-induced osteoporosis, osteonecrosis of the femoral head, tendon and soft-tissue effects), the evidence on intra-articular steroid injections, and the practical rules for safe use around surgery.
- Deep Vein Thrombosis β Comprehensive exam-ready guide to DVT diagnosis and treatment in orthopaedic patients - Wells score, D-dimer interpretation, ultrasound, anticoagulation protocols, and a side-by-side global guideline comparison
- Delirium Prevention β Comprehensive guide to delirium prevention, risk assessment, HELP protocol, and perioperative management for orthopaedic fellowship examinations
- Denosumab β Exam-focused guide to denosumab in orthopaedics: the RANKL mechanism, how it differs from bisphosphonates, indications in osteoporosis and giant cell tumour of bone, dosing, the evidence for fracture prevention, and the critical rebound vertebral fracture risk after stopping plus the complications of hypocalcaemia, osteonecrosis of the jaw, and atypical femoral fracture.
- Dermatomyositis & Polymyositis (Idiopathic Inflammatory Myopathies) β Fellowship-level guide to the idiopathic inflammatory myopathies - dermatomyositis and polymyositis (and juvenile dermatomyositis) - autoimmune diseases of symmetric proximal muscle weakness with a raised creatine kinase, characteristic skin signs in dermatomyositis (heliotrope rash, Gottron's papules), and important systemic associations (interstitial lung disease and, in adults, occult MALIGNANCY) - covering diagnosis (myositis-specific antibodies, EMG, MRI, biopsy), the calcinosis of juvenile disease, and management with corticosteroids/immunosuppression and IVIG, framed around the orthopaedic relevance of weakness, contracture and calcinosis.
- Diagnostic Test Statistics: Sensitivity, Specificity, PPV/NPV, Likelihood Ratios & ROC β Fellowship-level biostatistics guide to interpreting diagnostic tests: the 2x2 table, sensitivity and specificity (with SnNout/SpPin), the prevalence-dependence of PPV and NPV, likelihood ratios and post-test probability, and the ROC curve and AUC - worked with real orthopaedic examination data.
- Dialysis-Related Amyloid Arthropathy (Beta-2 Microglobulin) β Fellowship-level guide to dialysis-related amyloidosis - deposition of beta-2 microglobulin amyloid in the osteoarticular tissues of long-term (especially long-vintage) haemodialysis patients - presenting with carpal tunnel syndrome, a chronic shoulder/large-joint arthropathy, flexor tenosynovitis/trigger fingers, destructive (erosive) spondyloarthropathy and subchondral bone cysts that predispose to pathological fracture - covering the pathophysiology (impaired beta-2 microglobulin clearance), the radiographic cysts, the reduced incidence with modern high-flux/ultrapure dialysis, and management (surgery for compression/instability; transplantation removes the source and relieves symptoms but does not clear established deposits).
- Distraction Osteogenesis β Principles and biology of bone lengthening through gradual distraction and the tension-stress effect
- Dysbaric Osteonecrosis (Caisson Disease) β Evidence-based guide to dysbaric osteonecrosis: how decompression exposure can injure bone in divers and compressed-air workers, its juxta-articular and shaft patterns, MRI and radiographic diagnosis, classification, and stage-directed management
- Electrical Stimulation and Bone Healing (Direct/Capacitive/Inductive Coupling) β Fellowship-level guide to electrical and electromagnetic bone-growth stimulation: the piezoelectric/stress-generated-potential rationale, the three modalities (invasive direct current, non-invasive capacitive coupling, and inductive coupling/pulsed electromagnetic field), their mechanisms and indications (non-union, delayed union, spinal fusion, osteonecrosis), and the device-specific, compliance-dependent evidence.
- Electrosurgery, Diathermy & Surgical Energy Devices β Fellowship-level guide to electrosurgery (diathermy) and surgical energy devices for the orthopaedic surgeon - how high-frequency alternating current cuts and coagulates tissue, the difference between monopolar (current passes through the patient to a return/dispersive electrode) and bipolar (current confined between forceps tips) diathermy, cut versus coagulation/blend waveforms, and the safety essentials (correct return-electrode placement, pacemaker/ICD precautions, alternative-site burns, surgical-fire risk and surgical-smoke hazards) - plus the principles of harmonic (ultrasonic) and advanced bipolar/RF/microwave devices.
- Enhanced Recovery After Surgery (ERAS) Protocols β Comprehensive guide to ERAS protocols in orthopaedic surgery - evidence-based perioperative optimization, multimodal analgesia, early mobilization for exam preparation
- Epigenetics in Musculoskeletal Disease β Fellowship-level guide to epigenetics in musculoskeletal disease - heritable, potentially reversible changes in gene expression without alteration of the DNA sequence (DNA methylation, histone modification and non-coding RNAs such as microRNAs) - covering how epigenetic dysregulation contributes to osteoarthritis, osteoporosis and bone tumours, the concept of epigenetic clocks/ageing as biomarkers of degenerative musculoskeletal disease, and the emerging diagnostic and therapeutic (and regenerative) implications, framed for the orthopaedic exam.
- Evidence-Based Orthopaedics and Critical Appraisal β Advanced orthopaedic guide to evidence-based practice and critical appraisal: PICO, study design, bias, effect size, confidence intervals, applicability, reporting guidelines and journal-club decision-making.
- Ewing Sarcoma β Highly malignant small round cell bone tumor affecting children and adolescents, requiring multimodal treatment with chemotherapy, surgery, and radiation
- Extensor Digitorum Longus Anatomy β Comprehensive anatomy of extensor digitorum longus muscle including origin, insertion, neurovascular supply, clinical relations, and surgical considerations for lower limb procedures
- Fatigue Failure in Biomaterials β Mechanisms of cyclic loading failure, S-N curves, and endurance limits in orthopaedic implants
- Foot Anatomy and Biomechanics (Arch, Windlass Mechanism, Gait Cycle) β Fellowship-level basic-science guide to the functional anatomy and biomechanics of the foot: the hindfoot/midfoot/forefoot, the longitudinal and transverse arches and their bony, ligamentous (plantar fascia, spring ligament) and muscular supports, the WINDLASS mechanism, the subtalar/transverse-tarsal coupling that converts the foot from a flexible shock absorber to a rigid lever, and the phases of the gait cycle.
- Fracture Healing β Comprehensive guide to fracture healing including primary and secondary healing, phases, biology, and factors affecting union.
- Gait Cycle Analysis β Comprehensive exam-focused review of Gait Cycle Analysis including clinical presentation, investigation, management, and key exam points
- Gene Therapy and Tissue Engineering in Orthopaedics β Fellowship-level guide to regenerative orthopaedics: the tissue-engineering triad (cells, scaffold, signals), clinical examples such as autologous chondrocyte implantation and BMP-loaded constructs, the principles of gene therapy (viral vs non-viral vectors, in vivo vs ex vivo), and the challenges of vector safety, vascularisation and translation.
- General Anaesthesia for Orthopaedic Surgery β Exam-focused guide to general anaesthesia in orthopaedics: the stages of a general anaesthetic, airway management and the difficult airway, induction and maintenance agents, the general versus regional anaesthesia debate for hip fracture, postoperative delirium, and the major complications every orthopaedic trainee must recognise.
- Genetics & Modes of Inheritance in Orthopaedics β Fellowship-level basic-science guide to inheritance patterns and the genetics of musculoskeletal disease: autosomal dominant (achondroplasia, OI, Marfan, MHE, NF1), autosomal recessive, X-linked and mitochondrial inheritance, plus key concepts (penetrance, anticipation, mosaicism) - with the genes examiners expect.
- Glucocorticoid-Induced & Secondary Osteoporosis β Fellowship-level guide to secondary osteoporosis: when to suspect it, the causes to screen for, and the management of glucocorticoid-induced osteoporosis (GIOP) - mechanism, fracture-risk assessment and the 2022 ACR treatment algorithm (bisphosphonates, denosumab, anabolics).
- Growth Factors in Bone Healing β Comprehensive guide to growth factors regulating bone healing, BMP family, VEGF, TGF-Ξ², PDGF, FGF, IGF roles, clinical applications, and therapeutic controversies for basic science viva preparation
- Haemochromatosis Arthropathy β Comprehensive guide to the arthropathy of hereditary haemochromatosis - iron-overload joint disease, the pathognomonic MCP hook osteophyte, links with CPPD, metabolic screening and orthopaedic management for fellowship exam preparation
- Highly Crosslinked & Vitamin-E Polyethylene (Advanced Bearings) β Fellowship-level guide to the polyethylene bearing in arthroplasty: why conventional UHMWPE wear and particle-induced osteolysis drive long-term failure, how highly crosslinked polyethylene (HXLPE) dramatically reduces wear (with strong hip registry evidence), the free-radical/oxidation trade-off of crosslinking, and the two stabilisation strategies - thermal treatment (remelting vs annealing) and vitamin-E (antioxidant) incorporation.
- Hip Joint Biomechanics β Comprehensive analysis of hip joint biomechanics including joint reaction forces, muscle moment arms, gait mechanics, stability mechanisms, and clinical applications in total hip arthroplasty and hip pathology.
- HIV and the Musculoskeletal System β Comprehensive guide to musculoskeletal manifestations of HIV infection including HIV-associated arthropathy, septic arthritis, osteomyelitis risk, avascular necrosis, perioperative considerations, occupational exposure and PEP, and fracture healing.
- Hyperparathyroidism β Comprehensive guide to primary, secondary, and tertiary hyperparathyroidism - pathophysiology, bone effects, brown tumors, biochemistry, surgical indications for orthopaedic fellowship exams
- Hypertrophic Osteoarthropathy (incl. Pachydermoperiostosis) β Fellowship-level guide to hypertrophic osteoarthropathy (HOA) - the triad of digital clubbing, periostosis (periosteal new bone of the long bones) and arthralgia/joint effusions - in its primary form (pachydermoperiostosis, a genetic prostaglandin-pathway disorder, also with pachyderma/cutis verticis gyrata) and its far commoner secondary form (a paraneoplastic/systemic marker, classically of intrathoracic malignancy and suppurative lung disease) - covering recognition, the Schamroth sign, the bone scan/radiographic periostosis, and management directed at the underlying cause.
- Hypoparathyroidism β Comprehensive guide to hypoparathyroidism - etiology, pathophysiology, clinical presentation with tetany, biochemistry, orthopaedic manifestations, and perioperative management for fellowship exams
- Hypophosphatasia β Fellowship-level guide to hypophosphatasia (HPP): an inherited ALPL/TNSALP deficiency causing impaired mineralization with the paradoxical LOW serum alkaline phosphatase, the age-related clinical spectrum (perinatal to adult/odonto), premature loss of primary teeth and poorly-healing fractures, the critical pitfall that BISPHOSPHONATES are contraindicated, and enzyme replacement with asfotase alfa.
- Iatrogenic Nerve Injury & Positioning Injuries in Orthopaedic Surgery β Fellowship-level guide to iatrogenic peripheral nerve injuries and intra-operative positioning injuries in orthopaedic surgery - the mechanisms (direct laceration, retraction/traction, compression, thermal, ischaemic and patient-positioning), the nerves most at risk by procedure (e.g. sciatic/femoral/superior gluteal/LFCN in hip surgery; ulnar at the elbow, common peroneal at the fibular neck, brachial plexus from positioning), strategies for prevention (positioning, padding, retractor discipline, limb-length awareness), and the recognition, work-up and management (and medico-legal framing) when a deficit occurs.
- Immunology in Orthopaedics (Innate, Adaptive, HLA & Transplant Immunology) β Fellowship-level guide to the immune system for orthopaedic exams: innate immunity (complement, phagocytes, NK cells) and adaptive immunity (T cells, B cells/antibodies, MHC/HLA antigen presentation and memory), the mechanisms and types of allograft rejection, and the orthopaedic application - why processed bone allografts are weakly immunogenic and not HLA-matched while fresh osteochondral allografts are more immunogenic.
- Implant and Fracture Biomechanics β Biomechanical principles governing fracture fixation, implant design, and load sharing in orthopaedic surgery
- Inferior Gluteal Nerve Anatomy β Fellowship-level guide to the inferior gluteal nerve: the sole motor nerve to gluteus maximus (L5-S2), its exit below piriformis through the greater sciatic foramen, its entry into the deep surface of gluteus maximus about 5 cm from the greater trochanter, the resulting hip-extension deficit and gluteus maximus lurch if injured, and its vulnerability in the posterior hip approach (the safe split rule).
- Inflammation & Cytokines in Orthopaedics (TNF-Ξ±, IL-1, IL-6) β Fellowship-level basic-science guide to inflammation and cytokines in musculoskeletal disease: the acute inflammatory response, the key pro-inflammatory cytokines (TNF-Ξ±, IL-1, IL-6, IL-17), osteoimmunology and how cytokines drive RANKL-mediated bone erosion, and the biologic drugs (anti-TNF, anti-IL-6, IL-1Ra) that target them.
- Intervertebral Disc Biology β Comprehensive overview of intervertebral disc anatomy, biomechanics, nutrition, and degeneration for Orthopaedic examination
- Joint Reaction Forces β Biomechanical principles of joint reaction forces - calculation, magnitude across hip/knee/shoulder, and clinical implications for arthroplasty design
- Knee Biomechanics β Fundamental biomechanical principles of the knee joint including tibiofemoral mechanics, patellofemoral tracking, ligament function, and clinical implications
- Landmark Trials β Advanced orthopaedic guide to landmark trials across trauma, sports, arthroplasty, spine and paediatrics, including DRAFFT, PROFHER, FLOW, FAITH, HEALTH, FORCE, KANON, METEOR, FIDELITY, MOON, CRISTAL, EPCAT II and SPORT.
- Lateral Antebrachial Cutaneous Nerve Anatomy β Fellowship-level guide to the lateral antebrachial cutaneous nerve (LABCN/LACN): the terminal sensory continuation of the musculocutaneous nerve that emerges lateral to the biceps tendon at the elbow (deep to the cephalic vein) to supply the lateral forearm; its course, the clinical vulnerability during distal biceps repair and antecubital venepuncture, and how its injury presents and is distinguished from other neuropathies.
- Levels of Evidence β Comprehensive guide to levels of evidence framework including GRADE, Oxford CEBM, and application to orthopaedic decision-making.
- Ligament Biology β Comprehensive review of ligament structure, composition, biomechanics, healing, and graft biology for orthopaedic surgery exams
- Ligament Healing β Comprehensive guide to ligament healing phases, biology, and factors affecting repair
- Local Anaesthetics β Exam-focused guide to local anaesthetics in orthopaedics: how they block sodium channels, the amide versus ester classes, onset and duration, maximum safe doses with and without adrenaline, why infected tissue is hard to anaesthetise, the role of liposomal bupivacaine, and how to recognise and treat local anaesthetic systemic toxicity (LAST) with lipid emulsion.
- Local Antibiotic Delivery Systems β Comprehensive review of local antibiotic delivery methods including PMMA beads, calcium sulfate, and bioabsorbable carriers for orthopaedic infection management
- Malignant Hyperthermia β Comprehensive guide to malignant hyperthermia: RYR1-mediated hypermetabolic crisis triggered by volatile anaesthetic agents and suxamethonium, covering pathophysiology, clinical recognition, dantrolene management, and relevance to orthopaedic anaesthesia.
- Measures of Effect: Odds Ratio, Relative Risk, NNT & Effect Size β Fellowship-level biostatistics guide to measures of effect: relative risk, odds ratio, absolute and relative risk reduction, number needed to treat, hazard ratio, effect size and confidence intervals - how to calculate, interpret and tell them apart, worked with real orthopaedic trial data.
- Medication-Related Osteonecrosis of the Jaw (MRONJ) β Exam-focused guide to medication-related osteonecrosis of the jaw (MRONJ): definition, staging (AAOMS), risk with bisphosphonates and denosumab, why dental extractions trigger it, radiographic features, prevention, conservative versus surgical management, and the key viva distinctions between exposed bone, infection, and pathologic fracture.
- Meniscus Structure and Function β Comprehensive overview of meniscal anatomy, biomechanics, and clinical significance for Orthopaedic examination
- Moment Arms and Levers in Musculoskeletal Biomechanics β Fundamental principles of moment arms, lever systems, and mechanical advantage in the musculoskeletal system. Essential biomechanics for understanding force transmission, joint mechanics, and clinical applications in orthopaedic surgery.
- Multimodal Analgesia β Comprehensive guide to multimodal analgesia principles, drug classes, protocols, and perioperative pain management for orthopaedic surgery
- Muscle Injury and Healing β Comprehensive guide to skeletal muscle injury classification, healing phases, regeneration biology, and rehabilitation principles for Orthopaedic examination preparation
- Muscle Physiology β Comprehensive review of skeletal muscle structure, contraction mechanisms, fiber types, motor unit physiology, and biomechanical properties essential for orthopaedic practice
- Needlestick and Sharps Injury β Exam-focused guide to occupational needlestick and sharps injury in surgery: why orthopaedics is high risk, the per-injury transmission risk of hepatitis B, hepatitis C and HIV, what to do the moment you are stuck (first aid, risk assessment, source testing, post-exposure prophylaxis), and how double gloving, blunt needles and a no-touch technique prevent it.
- Nerve Anatomy and Physiology β Comprehensive guide to nerve structure, fiber classification, action potential physiology, nerve injury patterns, and regeneration for basic science viva preparation
- Nerve Injury and Regeneration β Comprehensive guide to peripheral nerve injury classification, Wallerian degeneration, chromatolysis, Schwann cell biology, axonal regeneration and factors affecting nerve repair for basic science viva preparation
- NSAIDs in Orthopaedics β Student-first guide to non-steroidal anti-inflammatory drugs (NSAIDs) in orthopaedics: how COX-1 and COX-2 inhibition works, COX-2 selective versus non-selective agents, the gastrointestinal, renal, cardiovascular and bleeding side effects, the controversy over fracture healing, and the evidence for NSAIDs in heterotopic ossification prophylaxis and multimodal analgesia.
- Ochronosis (Alkaptonuria Arthropathy) β Homogentisic acid accumulation, ochronotic pigment deposition, and the spine-first arthropathy of alkaptonuria
- Orthopaedic Antibiotic Therapy β Exam-focused guide to antibiotic therapy for bone and joint infection: how antibiotics work, the agents and their bone penetration, biofilm and the role of rifampicin, route and duration of treatment, and the high-yield evidence from OVIVA, the Zimmerli rifampicin trial, and open-fracture data.
- Orthopaedic Surgical Instruments β Exam-focused guide to the orthopaedic instrument set: how to group the basic instruments (cutting, holding, retracting, bone-handling, power), how each is designed to do its job, the principles behind safe drilling and sawing (thermal necrosis), why sharps and power tools matter for infection and sharps injury, and how instruments are decontaminated and laid out - the practical knowledge basic-science and operative vivas test.
- Osseointegration β Comprehensive guide to osseointegration mechanisms, surface modifications, implant stability, and clinical applications in orthopaedic surgery
- Ossification: Intramembranous and Endochondral β Understanding the two pathways of bone formation during development and fracture healing
- Osteoarthritis Pathophysiology β Molecular and cellular mechanisms of cartilage degeneration, subchondral bone changes, and synovial inflammation in OA
- Osteoblasts and Bone Formation β Comprehensive guide to osteoblast biology, differentiation, bone matrix synthesis, and regulation for basic science viva preparation
- Osteochondroma β Benign cartilage-capped bone lesion, most common benign bone tumor
- Osteoclasts and Bone Resorption β Understanding osteoclast function, regulation, and clinical implications in bone metabolism and pathology
- Osteocytes and Mechanotransduction β Cellular mechanisms of bone mechanosensing and the role of osteocytes in bone homeostasis and adaptation
- Osteomyelitis β Comprehensive review of osteomyelitis pathophysiology, microbiology, classification, and evidence-based management for orthopaedic fellowship examinations
- Outcome Measures and PROMs β Comprehensive guide to outcome measures and Patient-Reported Outcome Measures (PROMs) in orthopaedic surgery including WOMAC, DASH, SF-36, and joint-specific scores.
- Outpatient / Same-Day / Rapid-Recovery Arthroplasty β Fellowship-level guide to outpatient and rapid-recovery joint arthroplasty: the enhanced-recovery (ERAS) bundle that makes same-day discharge possible, the patient-selection criteria that keep it safe, the evidence on success and complication rates, and the causes and risk factors for same-day-discharge failure.
- P-Values and Confidence Intervals β Comprehensive guide to understanding p-values, confidence intervals, statistical significance, and clinical interpretation in orthopaedic research.
- Paget's Disease of Bone β Comprehensive guide to Paget's disease - pathophysiology, biochemical markers, radiology, orthopaedic complications, medical and surgical management for fellowship exams
- Perioperative Antibiotic Prophylaxis β Comprehensive guide to surgical antibiotic prophylaxis in orthopaedic surgery including timing, agent selection, dosing, duration, and evidence-based protocols
- Perioperative Anticoagulation Management β Comprehensive exam-ready guide to perioperative anticoagulation management in orthopaedic surgery - warfarin, DOACs, heparin bridging, and bleeding risk stratification
- Phantom Limb Pain and Amputation Pain β Comprehensive guide to phantom limb pain, residual limb pain and stump neuroma pain after amputation, including cortical reorganisation, prevention strategies and multimodal management.
- Physis (Growth Plate): Anatomy & Physiology β Fellowship-level basic-science guide to the physis: the four histological zones (resting, proliferative, hypertrophic, provisional calcification), the dual blood supply, the perichondral ring of LaCroix and groove of Ranvier, the PTHrP-Ihh feedback loop, and why the hypertrophic zone is the plane of Salter-Harris failure.
- Platelet-Rich Plasma (PRP) & Orthobiologics β Fellowship-level guide to PRP and orthobiologics: what PRP is and the growth factors it delivers, how it is prepared and classified (leukocyte-rich vs leukocyte-poor, PAW/Mishra), the level-1 evidence in knee osteoarthritis and tendinopathy, and the wider orthobiologics landscape (BMAC, MSCs, ACS) with its big caveat - lack of standardisation.
- PMMA Bone Cement β Comprehensive guide to polymethylmethacrylate bone cement - properties, handling and clinical implications
- Polyethylene in Arthroplasty: UHMWPE and XLPE β Ultra-high molecular weight polyethylene (UHMWPE) and highly crosslinked polyethylene (XLPE) bearing surfaces: structure, manufacturing, wear properties, and clinical outcomes
- Preoperative Medical Optimization β Comprehensive exam-focused review of Preoperative Medical Optimization including clinical presentation, investigation, management, and key exam points
- Proteoglycans and Collagen in Connective Tissue β Comprehensive guide to proteoglycan and collagen structure, function, biosynthesis, and clinical significance in orthopaedic tissues
- Pseudohypoparathyroidism (Albright Hereditary Osteodystrophy) β Fellowship-level guide to pseudohypoparathyroidism (PTH resistance) and Albright hereditary osteodystrophy: the GNAS/Gs-alpha defect and parent-of-origin imprinting (PHP1a vs pseudo-pseudohypoparathyroidism), the biochemical triad of hypocalcaemia + hyperphosphataemia + HIGH PTH, the AHO phenotype with short 4th/5th metacarpals (the metacarpal sign), and management with calcium and active vitamin D.
- Pulmonary Embolism β Comprehensive exam-ready guide to pulmonary embolism in orthopaedic patients - PERC rule, Wells criteria, CTPA diagnosis, risk stratification (massive/submassive/low-risk), thrombolysis, and prevention
- Pulmonary Risk Assessment β Comprehensive perioperative pulmonary risk assessment including OSA screening, COPD optimization, postoperative pulmonary complication prediction, and management strategies
- Radiculopathy vs Peripheral Nerve Lesion β Comprehensive guide to differentiating nerve root (radiculopathy) from peripheral nerve and plexus lesions using dermatomal vs peripheral nerve territory mapping, myotome patterns, reflex changes, and electrodiagnostic findings.
- Regional Anaesthesia Techniques β Comprehensive guide to regional anesthesia blocks including neuraxial, upper and lower extremity peripheral nerve blocks, ultrasound guidance, LAST management, and perioperative considerations for orthopaedic exam
- Relapsing Polychondritis β Fellowship-level guide to relapsing polychondritis - a rare, immune-mediated disease of recurrent inflammation and progressive destruction of cartilage (auricular, nasal, laryngotracheal and articular) with systemic involvement - covering the hallmark bilateral auricular chondritis with sparing of the non-cartilaginous earlobe, the life-threatening laryngotracheal disease, the seronegative non-erosive arthritis, the diagnostic criteria (McAdam/Michet), associations (including ANCA-associated vasculitis and myelodysplasia/VEXAS), and management with corticosteroids and immunosuppression.
- Reliability and Validity (Kappa, ICC, Bland-Altman) β Fellowship-level guide to reliability and validity in orthopaedic research: the distinction (precision vs accuracy), intra- and inter-observer reliability, Cohen's/Fleiss' kappa for categorical agreement (with the Landis-Koch interpretation), the intraclass correlation coefficient for continuous data, the Bland-Altman plot for method comparison, why correlation is not agreement, and the validity types - applied to fracture classifications and outcome measures.
- Sarcoidosis - Musculoskeletal Manifestations β Fellowship-level guide to the musculoskeletal manifestations of sarcoidosis - a multisystem non-caseating granulomatous disease - covering acute sarcoid arthropathy (Lofgren syndrome: ankle periarthritis + erythema nodosum + bilateral hilar lymphadenopathy, usually self-limiting) versus chronic arthritis, granulomatous myopathy (often clinically silent), osseous sarcoidosis (classically lace-like lytic lesions of the hands/feet phalanges), and the indirect skeletal effects of hypercalcaemia/osteoporosis - with the role of MRI, the differential, and management directed at the systemic disease.
- Sclerosing Bone Dysplasias (Osteopetrosis, Pycnodysostosis, Osteopathia Striata, Sclerosteosis/Van Buchem) β Fellowship-level guide to the sclerosing bone dysplasias - a group of genetic disorders of increased bone density classified by the bone-formation pathway affected: dysplasias of endochondral bone (osteopetrosis, pycnodysostosis, osteopoikilosis, osteopathia striata, enostosis), of intramembranous bone (Camurati-Engelmann diaphyseal dysplasia; Van Buchem disease and sclerosteosis), and mixed (melorheostosis) - covering the radiographic patterns, the key clinical pitfalls (brittle dense bone, marrow failure, cranial-nerve compression), and orthopaedic management including the challenges of fracture fixation in dense bone.
- Screw Biomechanics β Comprehensive guide to screw biomechanics including screw anatomy, pullout strength, lag screw technique, and locking versus non-locking screws for basic science viva preparation
- Septic Arthritis β Comprehensive review of septic arthritis pathophysiology, diagnosis, and urgent management for orthopaedic fellowship examinations
- Seronegative Spondyloarthropathy (Overview) β Fellowship-level overview of the seronegative spondyloarthritides: the HLA-B27-associated family (ankylosing spondylitis/axial SpA, psoriatic, reactive, enteropathic, juvenile), their shared features (enthesitis, dactylitis, inflammatory back pain, extra-articular manifestations), diagnosis, the IL-17/23 gut-joint biology, treatment ladder, and the orthopaedic hazard of the ankylosed spine.
- Shoulder Biomechanics β Fundamental biomechanical principles of the glenohumeral joint including stability mechanisms, rotator cuff function, scapulothoracic motion, and force couples
- Sjogren Syndrome - Musculoskeletal Manifestations β Fellowship-level guide to the musculoskeletal manifestations of Sjogren syndrome - a chronic autoimmune exocrinopathy (dry eyes and mouth from lymphocytic infiltration of lacrimal and salivary glands) - covering its very common arthralgia and a usually non-erosive inflammatory arthritis, the overlap with rheumatoid arthritis and other connective-tissue disease (primary vs secondary Sjogren), the myalgia/inflammatory myopathy, and the orthopaedic relevance of a seropositive (anti-Ro/anti-La) systemic disease behind joint symptoms, with management directed at symptoms and the systemic disease.
- Skeletal Fluorosis & Other Toxic Osteopathies (Hypervitaminosis A/D, Aluminium Bone Disease) β Fellowship-level guide to the toxic osteopathies - principally skeletal fluorosis (chronic excess fluoride causing dense osteosclerosis, ligament/interosseous-membrane ossification and paradoxically fragile, low-quality bone), together with hypervitaminosis A (cortical hyperostosis/periostosis and bone pain), hypervitaminosis D (hypercalcaemia and metastatic calcification) and aluminium-related (renal osteodystrophy) bone disease (a low-turnover osteomalacia) - covering recognition on imaging, the diagnostic pitfall of 'dense but weak' bone, the surgical implications, and management by removing the toxin.
- Smoking Cessation β Comprehensive guide to perioperative smoking cessation - impact on orthopaedic outcomes, timing, pharmacotherapy, and counseling strategies for exam preparation
- Spinal Biomechanics β Fundamental biomechanical principles of the spine including motion segments, load distribution, and clinical implications for surgical practice
- Spinal Cord & Vertebral Column Vascular Anatomy (Artery of Adamkiewicz) β Fellowship-level guide to the blood supply of the spinal cord: the single anterior spinal artery (anterior two-thirds) and paired posterior spinal arteries (posterior third), the segmental radiculomedullary feeders and the dominant artery of Adamkiewicz, the thoracic watershed, and anterior spinal artery (anterior cord) syndrome relevant to spine deformity and aortic surgery.
- Statistical Power and Sample Size β Comprehensive guide to statistical power, sample size calculation, and ensuring adequate study design for detecting clinically meaningful differences.
- Stem Cells & Mesenchymal Stromal Cells (MSCs) in Orthopaedics β Fellowship-level basic-science guide to stem cells in orthopaedics: stem-cell hierarchy, the ISCT definition of mesenchymal stromal cells, their sources (bone marrow, adipose, umbilical cord), trilineage differentiation, the paracrine/immunomodulatory mechanism of action, clinical applications (BMAC, cartilage, nonunion) and the regulatory and evidence caveats.
- Stress Concentration β Geometric discontinuities creating localized stress elevation and their role in implant failure
- Stress, Strain, and Elastic Modulus β Fundamental material properties, stress-strain relationships, elastic modulus, and mechanical testing principles
- Study Design Types β Comprehensive guide to research study designs including RCTs, cohort studies, case-control studies, and observational designs used in orthopaedic research.
- Surgical Site Infection Prevention (Perioperative) β Evidence-based strategies for preventing surgical site infections in orthopaedic surgery including antibiotic prophylaxis, skin preparation, sterile technique, and perioperative optimization protocols
- Survival Analysis (Kaplan-Meier, Cox Regression, Implant Survivorship) β Fellowship-level guide to survival (time-to-event) analysis in orthopaedics: censoring, the Kaplan-Meier estimator and survivorship curves, the log-rank test, Cox proportional-hazards regression and the hazard ratio, the importance of endpoint definition, and the competing risk of death that can make Kaplan-Meier overestimate implant revision risk.
- Synovial Fluid and Synovium β Comprehensive guide to synovium structure, synoviocyte types, synovial fluid composition, joint lubrication mechanisms, and clinical pathology for basic science viva preparation
- Systemic Lupus Erythematosus - Musculoskeletal β Comprehensive orthopaedic guide to the musculoskeletal manifestations of SLE: Jaccoud arthropathy, multifocal avascular necrosis from corticosteroids, perioperative risk stratification, and antiphospholipid syndrome considerations for the surgeon.
- Systemic Sclerosis / Scleroderma - Musculoskeletal β Fellowship-level guide to the musculoskeletal and hand manifestations of systemic sclerosis (scleroderma): sclerodactyly and flexion contractures, Raynaud's and digital ulcers, calcinosis, acro-osteolysis, tendon friction rubs, arthritis and erosive change - the autoantibody/subtype associations, and the cautious, mostly medical management with the pitfalls of operating on scleroderma skin.
- Tendon Healing β Biology of tendon healing including phases, intrinsic vs extrinsic mechanisms, collagen synthesis, growth factors, and factors affecting healing outcomes
- Tendon Structure and Composition β Comprehensive overview of tendon ultrastructure, molecular composition, hierarchical organization, and biomechanical properties essential for understanding tendon pathology and healing.
- Tendon-Bone Interface (Enthesis) β Anatomy, biomechanics, and healing of the specialized fibrocartilaginous insertion between tendon and bone
- Teriparatide β Exam-focused guide to teriparatide in orthopaedics: what it is (recombinant PTH 1-34), the anabolic mechanism that builds bone, why intermittent dosing differs from continuous PTH excess, indications in severe osteoporosis, the evidence for fracture reduction, the role in fracture healing and atypical femoral fractures, the duration limit and osteosarcoma concern, and the must-do sequencing with anti-resorptives.
- The Surgical Sieve (Clinical Reasoning Framework) β Exam-focused guide to the surgical sieve and clinical reasoning: how to build a complete differential diagnosis with the VITAMIN CDEF / VINDICATE framework, dual-process thinking (fast pattern recognition versus slow analysis), the cognitive biases that cause diagnostic error, and how to use a structured sieve to score well in orthopaedic vivas and avoid missing diagnoses.
- Thromboprophylaxis β Comprehensive guide to venous thromboembolism prevention in orthopaedic surgery including risk stratification, prophylaxis protocols, and evidence-based guidelines.
- Titanium Alloys β Comprehensive guide to titanium alloys - Ti-6Al-4V composition, osseointegration and orthopaedic applications
- Tourniquet Use in Orthopaedic Surgery β Exam-focused guide to the surgical pneumatic tourniquet: how it works, how to set safe cuff pressure (limb occlusion pressure), correct application and exsanguination, safe inflation time, the evidence in knee replacement, and the key complications (nerve injury, post-tourniquet syndrome, ischaemia-reperfusion) plus the contraindications you must know.
- Tranexamic Acid Use β Comprehensive guide to tranexamic acid - mechanism, evidence, dosing protocols, safety, and clinical applications in arthroplasty, trauma, and spine surgery for orthopaedic exam
- Transient Osteoporosis of the Hip / Regional Migratory Osteoporosis β Fellowship-level guide to transient osteoporosis of the hip (bone marrow oedema syndrome): a self-limiting, reversible cause of acute hip pain in middle-aged men and pregnant women, the diffuse femoral-head marrow oedema on MRI that distinguishes it from avascular necrosis, conservative management with protected weight-bearing, and the regional migratory variant.
- Tribology and Wear in Orthopaedic Implants β Fundamental principles of friction, lubrication, and wear mechanisms in total joint arthroplasty including osteolysis and strategies for wear reduction
- Type I and Type II Errors β Comprehensive guide to Type I (false positive) and Type II (false negative) errors, alpha and beta thresholds, and their clinical implications in research.
- Vasculitides (Polyarteritis Nodosa / GPA) - Orthopaedic Relevance β Fellowship-level guide to the systemic vasculitides relevant to orthopaedics - inflammatory disorders of blood vessels classified by vessel size (large: giant-cell/Takayasu; medium: polyarteritis nodosa; small/ANCA-associated: granulomatosis with polyangiitis [GPA], microscopic polyangiitis, EGPA) - covering their musculoskeletal manifestations (arthralgia/arthritis, myalgia), the limb-threatening consequences of ischaemia (digital/peripheral gangrene, mononeuritis multiplex), the danger of misdiagnosing a vasculitic limb as primary orthopaedic disease, and the principle that recognition leads to urgent immunosuppression rather than surgery alone.
- Viscoelasticity β Comprehensive guide to viscoelastic behaviour in orthopaedic biomaterials and tissues
- Wear Mechanisms in Orthopaedic Implants β Comprehensive guide to wear types affecting orthopaedic bearing surfaces including adhesive, abrasive, fatigue, and third-body wear
- Wound Closure Techniques β Exam-focused guide to surgical wound closure: the layered approach, suture materials (absorbable vs non-absorbable, monofilament vs braided), the common suture techniques (simple interrupted, continuous, mattress, subcuticular), staples, tissue adhesives and adhesive strips, how to choose between them, and the principles of a tension-free, well-apposed, low-infection closure relevant to orthopaedic surgery.
- Wound Healing β Exam-focused guide to soft-tissue and skin wound healing: the four overlapping phases (haemostasis, inflammation, proliferation, remodelling), the key cells and growth factors, healing by primary versus secondary intention, the factors that impair healing, and the practical and surgical relevance for orthopaedic wounds.
- X-Linked Hypophosphataemic / Oncogenic (Tumour-Induced) Osteomalacia β Fellowship-level guide to FGF23-mediated hypophosphataemic bone disease: X-linked hypophosphataemia (XLH, PHEX mutation) and tumour-induced (oncogenic) osteomalacia (TIO), the renal phosphate wasting with inappropriately low 1,25-vitamin D and NORMAL/high alkaline phosphatase, the biochemical and imaging workup (including localising FGF23-secreting tumours), and treatment with phosphate/active vitamin D, the anti-FGF23 antibody burosumab, and tumour resection for TIO.
Hand & Upper Limb β 180 topics
- Adductor Pollicis Anatomy β Surgical anatomy of adductor pollicis β transverse and oblique heads, the terminal deep ulnar motor branch, the adductor aponeurosis and Stener lesion, Froment and Jeanne signs, and first web space contracture release.
- Adhesive Capsulitis (Frozen Shoulder) β Exam-focused guide to adhesive capsulitis (frozen shoulder): what it is, the inflammation-then-fibrosis pathology of the capsule, the three clinical stages, how it is a clinical diagnosis with global loss of passive external rotation, the link with diabetes, the evidence behind injection, physiotherapy, hydrodilatation, manipulation under anaesthesia and arthroscopic capsular release, and the practical rules for the exam.
- Adult Brachial Plexus Injury β Exam-focused guide to adult traumatic brachial plexus injury: applied anatomy of the five-section plexus, preganglionic versus postganglionic injury, the supraclavicular versus infraclavicular patterns, how to examine and image (clinical signs, CT myelography, MRI), why timing of surgery matters, and the reconstructive ladder of neurolysis, nerve graft, nerve transfer and free functioning muscle transfer.
- ALPSA Lesions β Comprehensive guide to Anterior Labroligamentous Periosteal Sleeve Avulsion (ALPSA), a variant of Bankart lesion characterised by medialized healing.
- Anconeus Anatomy β Surgical anatomy of anconeus: the Kocher and anconeus-based lateral elbow approaches, the anconeus rotation flap for posterior elbow cover and triceps reconstruction, and its role as a dynamic lateral stabiliser in posterolateral rotatory instability.
- Animal Bites β Comprehensive guide to the management of animal bites, focusing on microbiology, antibiotic prophylaxis, and surgical indications.
- Anterior Interosseous Nerve Anatomy β Comprehensive guide to the Anatomy of the Anterior Interosseous Nerve (AIN), including its course, innervation, variants (Martin-Gruber), and clinical syndrome (Kiloh-Nevin).
- Anterior Interosseous Nerve Syndrome β Comprehensive guide to anterior interosseous nerve syndrome including anatomy, clinical presentation, differential diagnosis with Parsonage-Turner syndrome, and management from observation to surgical decompression.
- Axillary Nerve Anatomy β Comprehensive guide to the anatomy, clinical assessment, and management of Axillary Nerve injuries
- Blood Supply of the Forearm β Comprehensive anatomy of the Radial and Ulnar arteries, their branches, anastomoses, and clinical relevance.
- Boutonniere Deformity β Comprehensive guide to Boutonniere Deformity (Central Slip rupture), covering anatomy, Elson's test, and management protocols.
- Brachial Plexus Anatomy β Fellowship-level anatomy of the brachial plexus: roots, trunks, divisions, cords and terminal branches; the branch at each level; Erb's vs Klumpke's palsy; and the supraclavicular/infraclavicular surgical map.
- Brachialis Anatomy β Surgical anatomy of brachialis: its two heads, dual musculocutaneous and radial innervation, its relation to the anterior elbow capsule, and its role in anterior approaches, contracture release and post-traumatic heterotopic ossification.
- Brachioradialis Anatomy β Surgical anatomy of brachioradialis: the paradoxical radial-innervated flexor, its place in the mobile wad and the Henry approach interval, and its use as a tendon transfer to flexor pollicis longus in tetraplegia and high median nerve palsy.
- Bristow-Latarjet Procedure β Comprehensive guide to the Bristow and Latarjet coracoid transfer procedures for anterior shoulder instability with bone loss, including indications, surgical technique, complications, and outcomes.
- Camptodactyly β Camptodactyly: the three types and how unequally they are evidenced, why splinting outperforms surgery in the largest series, and how to read two surgical series that reach opposite conclusions about the same operation.
- Carpal Boss (Carpometacarpal Boss) β Fellowship-level guide to the carpal boss (carpe bossu) - a symptomatic bony prominence on the dorsum of the wrist at the second/third carpometacarpal joints (a localised osteoarthritic osteophyte/exostosis at the base of the index/middle metacarpal and adjacent trapezoid/capitate) - covering its presentation as a fixed, hard dorsal lump distinct from a ganglion, the diagnosis (the 'carpal boss view'/CT), and a non-operative-first management with simple excision of the exostosis for refractory pain (fusion reserved for secondary CMC instability).
- Carpal Instability - DISI/VISI β Comprehensive guide to dorsal and volar intercalated segment instability patterns - classification, diagnosis, and management for orthopaedic exam preparation
- Carpal Tunnel Syndrome β Comprehensive guide to carpal tunnel syndrome, including anatomy, diagnosis, electrodiagnostic criteria, and surgical release techniques
- Central Slip Injuries β Comprehensive guide to central slip extensor tendon injuries of the finger, including diagnosis, treatment, and boutonniere deformity prevention.
- Charcot (Neuropathic) Arthropathy of the Shoulder β Fellowship-level guide to neuropathic (Charcot) arthropathy of the shoulder: the painless, grossly destructive glenohumeral joint of syringomyelia, its pathophysiology (loss of proprioception/protective sensation), the classic radiographic 'bag of bones' destruction, the crucial differential from tumour and infection, and the largely supportive management with surgery reserved for selected cases.
- Charcot (Neuropathic) Joint of the Elbow β Fellowship-level guide to the Charcot (neuropathic) joint of the elbow - a progressive, destructive arthropathy of an insensate joint - whose classic cause is SYRINGOMYELIA (and other causes of upper-limb sensory loss), presenting with a strikingly swollen, often relatively painless, unstable elbow with marked radiographic destruction/debris - covering the work-up (notably MRI of the cervical spine for a syrinx), the differential from infection and tumour, and the largely supportive management.
- Cleft Hand β Comprehensive guide to cleft hand (typical and atypical ectrodactyly) including Manske-Halikis classification, associated syndromes, functional assessment, and surgical reconstruction.
- Clinodactyly β Comprehensive guide to clinodactyly including delta phalanx, bracket epiphysis, associated syndromes, indications for surgery, and corrective osteotomy techniques for Orthopaedic examination.
- Complex Metacarpophalangeal Joint Dislocation β Comprehensive guide to irreducible dorsal metacarpophalangeal joint dislocations, including Kaplan lesion, volar plate interposition, pathognomonic signs, and surgical approaches for reduction.
- Congenital Clasped Thumb β Fellowship-level guide to congenital clasped thumb - a progressive flexion and adduction deformity of the thumb (held flexed/adducted into the palm) caused by a deficient or absent extensor mechanism (extensor pollicis brevis/longus), often with first-web narrowing and metacarpophalangeal-joint laxity - covering the supple vs complex (rigid) classification, the syndromic associations, and a management algorithm of early splinting first (effective for flexible types) and surgical reconstruction (tendon transfer, web release, capsular stabilisation) for complex or splint-resistant thumbs.
- Coracobrachialis Anatomy β Surgical anatomy of coracobrachialis: the conjoined tendon, the musculocutaneous nerve piercing the muscle below the coracoid, the safe zone for the anterior shoulder approach, and its relevance to the Latarjet coracoid transfer.
- CRPS - Hand (Complex Regional Pain Syndrome) β Diagnosis, Budapest Criteria, and multidisciplinary management of CRPS Type I and Type II in the hand.
- Crystalline Arthropathy of the Hand β Comprehensive guide to crystalline arthropathies affecting the hand including gout and CPPD, clinical presentation, crystal identification, medical management, and surgical indications for tophaceous gout and chronic arthropathy.
- Cubital Tunnel Syndrome β Comprehensive guide to cubital tunnel syndrome including McGowan grading, Froment's and Wartenberg's signs, and surgical treatment options.
- Cutibacterium acnes Shoulder Periprosthetic Infection β Comprehensive guide to Cutibacterium acnes periprosthetic joint infection of the shoulder, including diagnosis, microbiology, surgical management, and antibiotic strategies.
- De Quervain Tenosynovitis β Comprehensive guide to first dorsal compartment stenosing tenosynovitis
- Deep Space Infections - Hand β Comprehensive examination guide to deep space infections of the hand including anatomical spaces, clinical presentations, surgical drainage techniques, and antibiotic management
- Deltoid Anatomy β Surgical anatomy of the deltoid: three heads with distinct actions, the axillary nerve safe zone that scales with arm length rather than sitting at a fixed distance from the acromion, deltoid handling in the deltopectoral and anterosuperior approaches, deltoid tensioning in reverse arthroplasty, and axillary palsy after dislocation.
- Deltoid Rupture / Avulsion β Fellowship-level guide to deltoid muscle rupture/avulsion - an uncommon injury, most often IATROGENIC (notably anterior-deltoid detachment after open or arthroscopic acromioplasty/cuff surgery), occasionally traumatic or secondary to massive rotator cuff failure - covering the resulting deltoid insufficiency (weakness, pain, anterosuperior escape), the diagnosis, and the difficult surgical repair/reconstruction with the key principle that deltoid origin must be protected and meticulously repaired at the time of shoulder surgery.
- Digit and Hand Replantation β Comprehensive guide to digit and hand replantation - indications and absolute/relative contraindications, warm and cold ischaemia times for digits and the proximal upper limb, the classical sequence of repair (bone, extensor, flexor, artery, nerve, vein), microvascular anastomosis technique, anticoagulation, post-operative monitoring and salvage of the failing replant, Chen and Tamai functional outcome criteria, and the decision-making between replantation and revision amputation
- Digital Nerve Compression β Comprehensive guide to Digital Nerve Compression syndromes, including Bowler's Thumb, Harpist's Finger, and their management.
- DIP Joint Arthritis β Comprehensive guide to distal interphalangeal joint arthritis - classification, clinical assessment, non-operative and surgical management including arthrodesis and arthroplasty.
- Dorsal Interossei of the Hand β Surgical anatomy of the four dorsal interossei β DAB, bipennate architecture, the deep ulnar motor branch, first dorsal interosseous wasting as the earliest sign of ulnar neuropathy, and the intrinsic contribution to MCP flexion and IP extension.
- DRUJ Arthritis (Distal Radioulnar Joint Arthritis) β Degenerative or post-traumatic arthritis of the distal radioulnar joint causing ulnar-sided wrist pain and forearm rotation limitation, managed with conservative measures or surgical procedures including DRUJ arthroplasty and salvage procedures
- Dupuytren's Disease β Comprehensive guide to Dupuytren's contracture: pathophysiology, classification, surgical indications, treatment options, and recurrence management
- Elbow Interposition / Distraction Arthroplasty β Fellowship-level guide to interposition (and distraction interposition) arthroplasty of the elbow: a joint-preserving, bone-preserving alternative to total elbow arthroplasty for the young, high-demand patient with end-stage (usually post-traumatic) elbow arthritis; the technique (resurfacing the debrided distal humerus with an interposed soft-tissue graft, with or without a hinged distraction external fixator), the central importance of elbow stability, the modest but useful outcomes, and conversion to total elbow arthroplasty.
- Epidermal (Epidermoid) Inclusion Cyst of the Hand β Fellowship-level guide to the epidermal inclusion cyst of the hand: a benign keratin-filled cyst that follows traumatic implantation of epidermis, presenting as a firm subcutaneous nodule (or an intraosseous lytic lesion of the distal phalanx) - covering pathogenesis, the differential (ganglion, GCTTS, enchondroma, osteomyelitis), histology, and treatment by complete excision/curettage.
- Extensor Pollicis Longus Rupture β Comprehensive guide to attritional rupture of the extensor pollicis longus tendon at the wrist, including pathogenesis after distal radius fracture and rheumatoid arthritis, diagnosis with the retropulsion (drumming) sign, and EIP-to-EPL tendon transfer reconstruction.
- Extensor Tendon Injuries β Comprehensive guide to extensor tendon injuries: mallet finger, boutonniere deformity, sagittal band rupture and zone-based management
- Felon β Closed-space infection of the pulp of the distal phalanx - surgical emergency requiring urgent drainage to prevent osteomyelitis, septic arthritis, and flexor tenosynovitis
- Fingertip Injuries & Amputations β Comprehensive guide to the management of fingertip injuries, including nail bed repair, local flaps (Atasoy, Moberg, Cross-Finger), and subungual hematomas.
- Flexor Carpi Radialis (FCR) Tendinitis β Fellowship-level guide to flexor carpi radialis (FCR) tendinopathy/tendinitis - a volar-radial wrist pain syndrome arising where the FCR runs in its tight fibro-osseous tunnel against the trapezial ridge and scaphoid tuberosity, often associated with trapeziometacarpal (basal thumb) osteoarthritis and seen as a complication of trapeziometacarpal suspension arthroplasty - covering its anatomy, the differential with de Quervain's and scaphotrapezial arthritis, and a non-operative-first management with surgery (tunnel release/debridement) for refractory cases.
- Flexor Carpi Radialis Anatomy β Surgical anatomy of flexor carpi radialis: its own fibro-osseous tunnel over the trapezium, the FCR approach to the volar distal radius and scaphoid, FCR tendinopathy, and its use as a graft in ligament reconstruction and LRTI.
- Flexor Carpi Ulnaris Anatomy β Surgical anatomy of flexor carpi ulnaris: the two heads that roof the cubital tunnel, its status as the only entirely ulnar-innervated wrist flexor, its role as the landmark of Guyon canal, the Green transfer, and calcific tendinitis at the pisiform.
- Flexor Digiti Minimi Brevis β Surgical anatomy of flexor digiti minimi brevis β hypothenar attachments, its fibrous arch of origin as a compression point for the deep ulnar motor branch, Guyon canal zoning, and donor considerations for the Huber transfer.
- Flexor Digitorum Profundus Anatomy β Surgical anatomy of flexor digitorum profundus: the dual innervation and common ulnar belly that produces the quadriga effect, the lumbrical origin, jersey finger with the Leddy-Packer classification, the Verdan zones and FDP testing.
- Flexor Digitorum Superficialis Anatomy β Surgical anatomy of flexor digitorum superficialis: the independent index belly, the FDS arcade as a median nerve compression point, Camper chiasm, zone II flexor anatomy, and FDS slip harvest for pulley reconstruction and opponensplasty.
- Flexor Pollicis Brevis Anatomy β Surgical anatomy of flexor pollicis brevis: the dual median and ulnar innervation that explains confusing thumb palsy findings, the Riche-Cannieu anastomosis, thenar muscle anatomy for carpal tunnel release safe zones, and the Lanz recurrent motor branch variants.
- Flexor Pollicis Longus Anatomy β Surgical anatomy of flexor pollicis longus: the only flexor of the thumb interphalangeal joint, its anterior interosseous innervation and the OK-sign test, the Linburg-Comstock anomaly, rupture over a prominent volar plate and the rheumatoid Mannerfelt lesion, and reconstruction options.
- Flexor Tendon Lacerations β Comprehensive guide to flexor tendon injury zones, repair techniques and rehabilitation protocols
- Flexor Tendon Rehabilitation β Evidence-based rehabilitation protocols for flexor tendon repairs across all zones, including early active mobilization, passive motion, and place-and-hold techniques
- Flexor Tendon Repair Techniques β Detailed guide to flexor tendon repair, focusing on suture techniques (Kessler, Adelaide), strand numbers, and zone-specific management.
- Flexor Tenosynovitis β Comprehensive guide to suppurative flexor tenosynovitis: Kanavel signs, sheath anatomy, irrigation technique and prognosis
- Flexor-Pronator Mass Strain / Tendinopathy β Fellowship-level guide to flexor-pronator mass injury at the medial elbow - strain, tendinopathy ('golfer's/medial epicondylitis') or, in throwers, partial tearing of the common flexor-pronator origin - covering its role as a dynamic stabiliser against valgus stress (protecting the ulnar collateral ligament), the overlap and crucial distinction from UCL injury and ulnar neuritis in the throwing athlete, the diagnosis, and management from rest/rehabilitation to (rarely) surgery.
- Frostbite (Cold Injury) β Advanced orthopaedic guide to frostbite of the hand and foot, covering pathophysiology, the freeze-thaw injury, field and hospital rewarming, classification, thrombolysis and iloprost, bone scanning, delayed amputation and rehabilitation.
- Gamekeeper's Thumb β Comprehensive guide to thumb UCL injuries for Orthopaedic examination
- Ganglion Cysts β Comprehensive guide to ganglion cyst diagnosis, aspiration, and surgical excision
- Glomus Tumour of the Hand β Comprehensive guide to subungual and digital glomus tumours - benign neuromyoarterial hamartomas causing the classic triad of pain, cold sensitivity and pinpoint tenderness, with Love and Hildreth clinical signs, MRI and marginal excision.
- HAGL Lesions β Comprehensive guide to Humeral Avulsion of the Glenohumeral Ligament (HAGL), including the MRI 'J Sign', West Point Classification, and surgical management.
- Hand Examination and Clinical Localisation β An advanced orthopaedic guide to examining the hand and localising pathology from clinical findings, including tendon testing, nerve localisation, sensory testing, deformity analysis, investigations and urgent decision-making.
- Herpetic Whitlow β Fellowship-level guide to herpetic whitlow: a herpes simplex virus infection of the fingertip that mimics a felon or paronychia but must NOT be incised - covering the HSV-1/HSV-2 aetiology and at-risk groups, the grouped-vesicle presentation, the critical differentiation from a bacterial felon, diagnosis, supportive/antiviral management, and complications including autoinoculation and recurrence.
- High-Pressure Injection Injury of the Hand β Advanced orthopaedic guide to high-pressure injection injury of the hand, including recognition, material risk, imaging, emergency management, operative debridement, complications and rehabilitation.
- Human Bites & Fight Bites β Comprehensive guide to the management of human bites, specifically 'Fight Bites' (Clenched Fist Injuries), outlining the unique microbiology and surgical urgency.
- Hypothenar Hammer Syndrome β Fellowship-level guide to hypothenar hammer syndrome: repetitive blunt trauma to the ulnar artery over the hook of hamate causing thrombosis, aneurysm and digital embolisation - the occupational vascular cause of ulnar-sided digital ischaemia, its workup (Allen's test, angiography, the corkscrew sign) and management.
- Inflammatory Arthritis of the Shoulder β Comprehensive guide to Rheumatoid Arthritis and other inflammatory conditions of the shoulder - pathology, classification, and surgical management
- Infraspinatus Anatomy β Surgical anatomy of the infraspinatus: the posterior arm of the transverse force couple, suprascapular nerve at the spinoglenoid notch, external rotation lag and drop signs, Goutallier and Patte staging, and the infraspinatus-teres minor internervous interval.
- Intersection Syndrome β Comprehensive guide to proximal and distal intersection syndrome of the dorsal wrist - an overuse tenosynovitis distinct from de Quervain disease
- Jersey Finger β Comprehensive guide to Jersey Finger (FDP Avulsion), including Leddy-Packer classification, surgical repair techniques, and rehabilitation.
- KienbΓΆck's Disease β Comprehensive guide to KienbΓΆck's disease including staging, pathophysiology, investigation with MRI, and treatment options from immobilization to salvage procedures.
- Latarjet Procedure β Comprehensive guide to the Latarjet coracoid transfer for recurrent anterior shoulder instability with glenoid bone loss - the triple-blocking effect of Patte, glenoid bone-loss thresholds and the glenoid track, the Instability Severity Index Score (ISIS), deltopectoral approach, operative technique, complications and long-term outcomes
- Lateral Elbow Pain: Pattern and Differential β Structured approach to lateral elbow pain β discriminating tennis elbow from radial tunnel, PLRI, radiocapitellar arthritis, plica and referred cervical pain, with confirmatory tests.
- Latissimus Dorsi (and Teres Major) Rupture β Fellowship-level guide to latissimus dorsi and teres major tendon ruptures - uncommon injuries of the posterior axillary fold seen in throwing/overhead and high-demand athletes (and water-skiers), presenting with acute posterior-axillary pain, bruising and a palpable defect/weakness of extension/adduction/internal rotation - covering the spectrum from strain to complete avulsion, the role of MRI, and the management debate, in which the cohort evidence favours non-operative treatment even for avulsions in professional pitchers, with repair a good option rather than a demand-driven necessity.
- Latissimus Dorsi Anatomy β Surgical anatomy of the latissimus dorsi: thoracodorsal nerve and pedicle anatomy, the spiralling insertion into the floor of the bicipital groove, transfer for irreparable posterosuperior cuff tear, pedicled and free flap use, and its role in the internal rotation contracture of brachial plexus birth palsy.
- Levator Scapulae Anatomy β Surgical anatomy of levator scapulae, its dual C3-C4 and dorsal scapular innervation, its role as a downward rotator of the scapula, and its central place in snapping scapula and superomedial angle resection.
- Long Thoracic Nerve Anatomy β Fellowship-level anatomy of the long thoracic nerve: C5-C7 origin, its long superficial course on serratus anterior, why it is vulnerable, and the medial scapular winging that follows injury.
- Lumbrical Muscles of the Hand β Surgical anatomy of the four lumbricals β the only muscles with both origin and insertion on tendon, dual median and ulnar innervation, lumbrical-plus finger, quadriga, and lumbrical canal infection.
- Macrodactyly β Rare congenital anomaly characterized by localized gigantism of digits, requiring staged surgical management and multidisciplinary care
- Madelung Deformity β Exam-focused guide to Madelung deformity of the wrist: the abnormal distal radial physis and Vickers ligament, the link with Leri-Weill dyschondrosteosis and SHOX gene defects, how the radius deforms in three planes, the classic radiographic measurements, and how treatment is chosen between Vickers ligament release with physiolysis in the growing child and dome osteotomy or salvage in the mature wrist.
- Mallet Finger β Comprehensive guide to the diagnosis and management of Mallet Finger (Tendinous and Bony), including splinting protocols and surgical indications.
- Massive Rotator Cuff Tears β Comprehensive guide to massive rotator cuff tears and treatment options
- MCP Joint Arthritis β Comprehensive guide to MCP joint arthritis including rheumatoid arthritis, post-traumatic arthritis, primary OA, clinical presentation, non-operative management, and surgical options including arthroplasty and arthrodesis for orthopaedic fellowship exam preparation.
- Median Nerve Anatomy β Comprehensive guide to the anatomy, compression syndromes, and clinical pathology of the Median Nerve
- Meralgia Paraesthetica β Compression neuropathy of the lateral femoral cutaneous nerve causing burning numbness and paraesthesia over the anterolateral thigh
- Metacarpal Fractures β Comprehensive guide to metacarpal fractures for Orthopaedic examination
- Midcarpal Arthritis β Comprehensive examination guide to midcarpal arthritis patterns, diagnostic evaluation, and surgical management including limited wrist fusions and total wrist arthroplasty
- Midcarpal Instability β Non-dissociative carpal instability with abnormal motion between the proximal and distal carpal rows, presenting with a painful catch-up clunk and requiring dynamic clinical and fluoroscopic assessment
- Milwaukee Shoulder (BCP Crystal Arthropathy) β Comprehensive guide to Milwaukee shoulder syndrome - a rapidly destructive basic calcium phosphate (hydroxyapatite) crystal arthropathy of the shoulder in elderly women, covering crystal biology, alizarin red diagnosis, large bloody non-inflammatory effusions and management for fellowship exam preparation.
- Mucous Cysts (Digital Mucoid Cysts) β Comprehensive guide to digital mucous cysts including pathophysiology, diagnosis, and surgical excision techniques with osteophyte removal
- Musculocutaneous Nerve Anatomy β Fellowship-level anatomy of the musculocutaneous nerve: lateral cord origin (C5-C7), its course through coracobrachialis, the anterior-arm flexors it supplies, the lateral cutaneous nerve of the forearm, and its role in elbow-flexion nerve transfers.
- Nerve Repair Principles β Comprehensive guide to Peripheral Nerve Repair, including biology, classification, surgical techniques, and rehabilitation.
- Nerve Transfers β Principles and common techniques for Nerve Transfer (Neurotization) in peripheral nerve and brachial plexus surgery.
- Neuroma Management β Pathophysiology, diagnosis, and management of painful neuromas, including modern techniques like RPNI and TMR.
- Oligodactyly β Paediatric hand oligodactyly β definition and place within the Oberg-Manske-Tonkin classification, transverse versus longitudinal deficiency, symbrachydactyly, syndromic screening, function-first assessment, toe phalanx and microvascular toe transfer, prosthetics and parental counselling.
- Opponens Digiti Minimi Anatomy β Surgical anatomy of opponens digiti minimi β hypothenar attachments, the deep ulnar motor branch course, Guyon canal zones and the deficits each produces, and its relevance to the Huber transfer and hypothenar hammer syndrome.
- Opponens Pollicis Anatomy β Surgical anatomy of opponens pollicis β the recurrent motor branch of the median nerve and Lanz variants, the mechanics of opposition, opponensplasty selection (Camitz, Huber, Bunnell, EIP) and the Kapandji score.
- Osteochondritis Dissecans of the Capitellum β Comprehensive guide to osteochondritis dissecans (OCD) of the capitellum in adolescent overhead athletes, including differentiation from Panner disease, MRI staging, and management from conservative rest to surgical fixation and cartilage restoration.
- Palmar Interossei of the Hand β Surgical anatomy of the palmar interossei β PAD, unipennate architecture, the Bouvier test, intrinsic-minus versus intrinsic-plus posture, the Finochietto-Bunnell intrinsic tightness test, claw hand and the ulnar paradox.
- Palmar Lump β Pattern and differential for a lump in the palm: discriminators separating Dupuytren nodule, giant cell tumour of tendon sheath, ganglion, ulnar artery aneurysm and epithelioid sarcoma.
- Palmaris Brevis Anatomy β Surgical anatomy of palmaris brevis: the only muscle supplied by the superficial branch of the ulnar nerve, its role as the muscular roof of Guyon canal, palmaris brevis spasm syndrome, and its relevance in hypothenar hammer syndrome and as a turnover flap.
- Palmaris Longus Anatomy β Surgical anatomy of palmaris longus: agenesis prevalence and side, its role as the classic tendon graft donor, its relation to the median nerve at the wrist as the landmark for carpal tunnel incision placement, and the Schaeffer test.
- Paronychia (Acute & Chronic) β Fellowship-level guide to the commonest hand infection: acute bacterial paronychia versus chronic inflammatory paronychia, the run-around abscess, drainage technique, distinguishing herpetic whitlow and felon, and the chronic-paronychia management ladder.
- Parsonage-Turner Syndrome (Neuralgic Amyotrophy) β Comprehensive guide to Parsonage-Turner syndrome (neuralgic amyotrophy): the classic painful-onset patchy upper-limb palsy, hourglass fascicular constrictions, MRI denervation, and observation-first management.
- Pectoralis Major Anatomy β Surgical anatomy of the pectoralis major: the clavicular and sternocostal heads, the bilaminar twisted insertion and why the inferior lamina ruptures first, rupture classification and repair, transfer for subscapularis insufficiency and the musculocutaneous nerve, and Poland syndrome.
- Pectoralis Major Rupture β Comprehensive guide to pectoralis major tendon rupture including mechanism, Tietjen classification, clinical assessment, imaging, and surgical management.
- Pectoralis Minor Anatomy β Surgical anatomy of the pectoralis minor: the medial coracoid insertion, its role in scapular protraction and anterior tilt, pectoralis minor tightness in scapular dyskinesis, the retropectoralis minor space and pectoralis minor syndrome, and its release during the Latarjet procedure.
- PIP Joint Arthritis β Comprehensive guide to PIP joint arthritis including anatomy, etiology, clinical assessment, conservative management, silicone arthroplasty, surface replacement, and arthrodesis.
- Polydactyly β Comprehensive guide to polydactyly including preaxial thumb duplication, postaxial types, Wassel classification, and surgical management for Orthopaedic examination.
- Posterior Interosseous Nerve Anatomy β Surgical anatomy of the posterior interosseous nerve: the radial tunnel, the five compression points, finger drop with preserved sensation, and the safe zone for proximal radius exposure.
- Posterior Interosseous Syndrome β Comprehensive guide to Posterior Interosseous Nerve (PIN) compression, including anatomy (Arcade of Frohse), clinical presentation (Finger Drop), and surgical decompression.
- Posterior Shoulder Spaces and Intervals β Surgical anatomy of the quadrangular space, triangular space and triangular interval, their contents, quadrilateral space syndrome, and how each is used or endangered in posterior shoulder approaches.
- Posterolateral Rotatory Instability of the Elbow (PLRI) β Comprehensive guide to posterolateral rotatory instability of the elbow, including LUCL insufficiency, Horii circle injury pattern, clinical tests, imaging, and ligament reconstruction.
- Preiser Disease β Comprehensive exam guide to Preiser disease (idiopathic osteonecrosis of the scaphoid): pathophysiology, Herbert-Lanzetta and Kalainov classifications, MRI diagnosis, and stage-based treatment from immobilization to vascularized bone graft and salvage.
- Pronator Quadratus Anatomy β Surgical anatomy of pronator quadratus: its two heads and role as a distal radioulnar joint stabiliser, the terminal anterior interosseous nerve branch, the distal window of the volar Henry approach, and the pronator quadratus repair debate in volar plating of the distal radius.
- Pronator Syndrome β Comprehensive guide to pronator syndrome including differentiation from carpal tunnel syndrome, compression sites, and surgical treatment.
- Pronator Teres Anatomy β Surgical anatomy of pronator teres: two heads with the median nerve passing between them, pronator syndrome versus anterior interosseous nerve syndrome, its use as a tendon transfer to extensor carpi radialis brevis in radial nerve palsy, and its release in the Henry approach.
- Proximal Biceps Ruptures β Comprehensive guide to proximal long-head biceps rupture: anatomy, Popeye deformity, associated cuff and pulley disease, imaging, non-operative care, and selected reconstruction
- Proximal Row Carpectomy β Comprehensive guide to proximal row carpectomy (PRC) for SLAC and SNAC wrist arthritis and Kienbock disease - principle of capitate seating into lunate fossa, dorsal surgical approach, indications requiring intact capitate head and lunate fossa cartilage, PIN neurectomy, outcomes versus four-corner fusion, conversion to total wrist fusion, and evidence-based outcomes
- Psoriatic Arthritis - Hand β Comprehensive examination guide to psoriatic arthritis affecting the hand and upper extremity, including diagnostic criteria, radiographic patterns, and surgical management strategies
- Quadrangular & Triangular Spaces β Detailed anatomy of the posterior shoulder spaces, their boundaries, contents, and clinical syndromes.
- Quadriga Effect & Lumbrical-Plus Finger β Fellowship-level guide to two classic flexor-tendon imbalance phenomena that share a common anatomical basis (the flexor digitorum profundus tendons arising from one common muscle belly, with lumbricals originating from the FDP tendons): the QUADRIGA effect - loss of active flexion and grip in the other fingers when one FDP is over-advanced, tethered or amputated - and the LUMBRICAL-PLUS finger - paradoxical IP-joint extension on attempted flexion when an FDP is divided, over-lengthened or grafted too long so its pull is transmitted through the lumbrical to the extensor mechanism.
- Radial Nerve Anatomy β Comprehensive guide to the anatomy, course, branches, and clinical correlations of the Radial Nerve
- Radial Tunnel Syndrome β Comprehensive guide to radial tunnel syndrome including PIN entrapment sites, clinical differentiation from lateral epicondylitis, diagnostic approach, and surgical decompression techniques for orthopaedic exam
- Radial-Sided Wrist Pain β Pattern and differential for radial-sided wrist pain: de Quervain's, scaphoid fracture, SLAC/SNAC, CMC arthritis, intersection syndrome and Wartenberg's, with discriminators.
- Raynaud's Phenomenon (Hand) β Fellowship-level guide to Raynaud's phenomenon of the hand: the triphasic colour change of digital vasospasm, the crucial distinction between primary Raynaud's disease and secondary Raynaud's phenomenon (especially systemic sclerosis), red flags and nailfold capillaroscopy/autoantibody workup, and a stepwise management from cold avoidance through calcium-channel blockers to prostacyclin and surgery for digital ischaemia.
- Recurrent & Revision Carpal Tunnel Syndrome (and Endoscopic Release) β Fellowship-level guide to persistent, recurrent and revision carpal tunnel syndrome and to endoscopic carpal tunnel release - covering the three failure patterns (persistent = never resolved, often incomplete release; recurrent = relief then return, often perineural scarring; new/iatrogenic = nerve/branch injury), the systematic work-up of the failed release (re-confirm the diagnosis, re-image, electrodiagnostics), and revision options (complete open re-release with external neurolysis, and vascularised flap coverage for scarred nerves), plus the evidence on endoscopic versus open release.
- Remplissage Procedure β Comprehensive guide to the arthroscopic remplissage procedure for engaging Hill-Sachs lesions in anterior shoulder instability, including glenoid track assessment, surgical technique, combined Bankart repair, outcomes, and stiffness.
- Revision Total Elbow Arthroplasty β Fellowship-level guide to revision total elbow arthroplasty: why primary TEAs fail (aseptic loosening, polyethylene bushing wear, periprosthetic fracture, infection and instability), the central problem of periprosthetic bone loss, the reconstruction options from bushing exchange and re-stemming to impaction grafting and allograft-prosthetic composite, the high complication burden, and the principles of managing the infected TEA.
- Rheumatoid Arthritis of the Hand β Comprehensive guide to rheumatoid arthritis affecting the hand - pathophysiology, classification, medical and surgical management including synovectomy, arthroplasty, and arthrodesis
- Rhomboids β Surgical anatomy of rhomboid minor and major, the dorsal scapular nerve from C5, rhomboid palsy and its subtle winging, and the medial parascapular interval used in the posterior approach to the scapula.
- Ring Avulsion Injury β Fellowship-level guide to ring avulsion injuries of the finger: the traction-degloving mechanism, the Urbaniak (and Kay) classification, the prognostic importance of an intact PIP joint and FDS, the extended zone of vascular injury requiring vein grafts, and the decision between microvascular revascularisation/replantation and completion amputation.
- Sagittal Band Injuries β Comprehensive guide to sagittal band injuries of the hand, including diagnosis, surgical repair techniques, and rehabilitation protocols for Orthopaedic exam preparation.
- Scalene Muscles β Surgical anatomy of the anterior, middle and posterior scalene muscles, the interscalene triangle and its contents, thoracic outlet syndrome and cervical rib, the interscalene block and phrenic nerve palsy, and the supraclavicular approach.
- Scaphoid Excision and Four-Corner Fusion β Comprehensive guide to scaphoidectomy and four-corner fusion for SLAC and SNAC wrist arthritis - indications, surgical technique including dorsal approach and fixation options (circular plate, K-wires, screws), preservation of radiolunate motion, outcomes compared with proximal row carpectomy, complications including nonunion and dorsal impingement, and evidence-based results
- Serratus Anterior β Surgical anatomy of serratus anterior, the long superficial course of the long thoracic nerve, medial scapular winging and the wall-push test, pectoralis major transfer for chronic palsy, and the serratus flap.
- Shoulder (Humeral Head) Resurfacing Arthroplasty β Fellowship-level guide to humeral head resurfacing arthroplasty: a bone-preserving, stemless cap that resurfaces the humeral head while keeping the metaphysis and shaft, its appeal in younger patients, the technical pitfalls (oversizing/overstuffing and excessive lateral offset that accelerate glenoid wear), the dominant failure mode of glenoid erosion and pain when metal articulates with native glenoid, registry survivorship including pyrocarbon, and the relatively straightforward conversion to a stemmed implant.
- SLAC Wrist β Comprehensive guide to SLAC wrist - scapholunate advanced collapse including Watson staging, pathophysiology, surgical treatment options, four-corner fusion, and proximal row carpectomy for orthopaedic fellowship examination.
- Small Joint Arthroplasty of the Hand β Comprehensive guide to metacarpophalangeal (MCP), proximal interphalangeal (PIP), and carpometacarpal (CMC) joint arthroplasty including silicone Swanson implants, surface replacement, pyrocarbon designs, indications, surgical techniques, and complications
- Snapping / Subluxing Extensor Carpi Ulnaris (ECU) β Fellowship-level guide to extensor carpi ulnaris (ECU) tendon instability: subluxation/dislocation of the ECU out of its groove on the dorsal ulna when the subsheath tears, causing painful dorsoulnar snapping on supination - covering the anatomy, the provocative supination/ulnar-deviation test, dynamic ultrasound, conservative immobilisation in pronation, and subsheath repair/reconstruction.
- Stemless / Short-Stem Shoulder Arthroplasty β Fellowship-level guide to stemless and short-stem humeral components in anatomic total shoulder arthroplasty: the bone-preserving, metaphyseal-fixation rationale (preserve humeral bone, shorten operative time, avoid diaphyseal stem complications and stress shielding), the requirement for adequate proximal humeral bone quality, the comparable clinical outcomes with fewer radiolucent lines, and the ease of conversion to a stemmed implant at revision.
- Sternoclavicular Joint Dislocation β Comprehensive guide to sternoclavicular joint dislocation, including anterior versus posterior types, mediastinal compromise in posterior dislocations, CT diagnosis, closed reduction, and reconstruction risks.
- Subcoracoid Impingement β Fellowship-level guide to subcoracoid impingement of the shoulder: anterior shoulder pain from narrowing of the coracohumeral interval, with the subscapularis caught between the coracoid tip and the lesser tuberosity; its anatomy and the 'roller-wringer' effect, the coracohumeral distance on MRI, the provocative tests, the genuine controversy over whether it causes subscapularis tears, and the conservative-then-arthroscopic-coracoplasty management.
- Subscapularis Anatomy β Detailed anatomy of the Subscapularis muscle, its critical role in shoulder stability, innervation, and clinical pathology.
- Superficial Radial Nerve Anatomy β Surgical anatomy of the superficial branch of the radial nerve: emergence between brachioradialis and extensor carpi radialis longus, Wartenberg syndrome, and the nerve most often injured in wrist and thumb base surgery.
- Supinator Anatomy β Surgical anatomy of supinator: the arcade of Frohse and posterior interosseous nerve compression, radial tunnel syndrome versus posterior interosseous nerve palsy, the safe zone for the Thompson approach and proximal radius plating, and supinator motor branch nerve transfer.
- Suprascapular Nerve Entrapment β Comprehensive guide to suprascapular nerve entrapment at the suprascapular and spinoglenoid notches, including ganglion cyst association, clinical presentation with infraspinatus wasting, EMG diagnosis, and surgical decompression techniques.
- Supraspinatus Anatomy β Surgical anatomy of the supraspinatus: greater tuberosity footprint dimensions, the critical zone, suprascapular nerve constraints, the rotator cable and crescent, and tear patterns with their repair configurations.
- Swan Neck Deformity β Comprehensive guide to Swan Neck Deformity, covering Nalebuff classification, intrinsic tightness testing, and management strategies.
- Symphalangism β Fellowship-level guide to symphalangism - a congenital failure of differentiation of the finger (or toe) joints producing ankylosis/stiffness of the interphalangeal joints, most often the proximal interphalangeal joint - covering its forms (proximal/true vs distal symphalangism, isolated vs syndromic), the genetics and syndromic associations, the characteristic clinical and radiographic features (absent flexion crease, no IP-joint motion), and the largely supportive management given the lack of a true joint to reconstruct.
- Syndactyly β Comprehensive guide to syndactyly including classification, surgical timing, web space reconstruction, and associated syndromes for Orthopaedic examination.
- Teres Major Anatomy β Surgical anatomy of the teres major: the medial lip insertion, the lower subscapular nerve, its role as the floor of the quadrangular and triangular spaces and the roof of the triangular interval, the posterior axillary fold, and the L'Episcopo family of external rotation transfers.
- Teres Minor Anatomy β Surgical anatomy of the teres minor: its axillary nerve supply and pseudoganglion, the inferior facet insertion, its role as the roof of the quadrangular space, hornblower's sign, and why its preservation predicts external rotation after reverse arthroplasty.
- TFCC and Ulnar-Sided Wrist Pain β Advanced orthopaedic guide to triangular fibrocartilage complex injury and ulnar-sided wrist pain, including anatomy, clinical localisation, imaging, Palmer and arthroscopic classifications, DRUJ stability, operative decision-making and rehabilitation.
- The Intrinsic Hand: Intrinsic-Minus (Claw) and Intrinsic-Plus Deformity β Fellowship-level guide to intrinsic muscle function and the two opposite deformities: intrinsic-MINUS (claw hand - MCP hyperextension + IP flexion from intrinsic paralysis, e.g. ulnar palsy/leprosy) and intrinsic-PLUS (MCP flexion + IP extension from intrinsic tightness/spasticity) - covering the ulnar paradox, the Bouvier and Bunnell tests, and the splinting/tendon-transfer/release management.
- The Six Dorsal Extensor Compartments of the Wrist β Fellowship-level anatomy reference for the six dorsal wrist extensor compartments beneath the extensor retinaculum: their tendon contents (1 APL/EPB, 2 ECRL/ECRB, 3 EPL, 4 EDC/EIP, 5 EDM, 6 ECU), Lister's tubercle, and the high-yield clinical correlations - de Quervain's (compartment 1), intersection syndrome, EPL rupture at the third-compartment watershed, and the ECU of the sixth compartment.
- Thoracic Outlet Syndrome β Comprehensive guide to Thoracic Outlet Syndrome (TOS), including Neurogenic, Venous, and Arterial types, anatomy of the thoracic outlet, and management strategies.
- Thromboangiitis Obliterans (Buerger's Disease) β Fellowship-level guide to thromboangiitis obliterans (Buerger's disease) - a non-atherosclerotic, segmental, inflammatory occlusive disease of the small and medium arteries and veins of the extremities, strongly tied to tobacco, presenting in young smokers with distal ischaemia, digital ulceration/gangrene and migratory thrombophlebitis - covering its diagnosis (clinical criteria and the corkscrew-collateral angiogram), the absolute primacy of complete smoking cessation, and the role and limits of revascularisation and amputation in the hand and foot.
- Thumb CMC Arthritis β Comprehensive guide to thumb carpometacarpal arthritis - anatomy, Eaton-Littler classification, grind test, trapeziectomy, LRTI, CMC arthroplasty, and surgical decision-making for orthopaedic exam
- Thumb Hypoplasia β Comprehensive guide to thumb hypoplasia including Blauth classification, associated syndromes, clinical assessment, reconstruction versus pollicization, and surgical management for Orthopaedic examination.
- Total Wrist Arthroplasty vs Arthrodesis (Wrist OA Reconstruction) β Fellowship-level guide to reconstruction of the arthritic wrist: the decision between total wrist ARTHRODESIS (the durable, reliable fusion - the historical benchmark for high-demand patients and salvage) and total wrist ARTHROPLASTY (motion-preserving, improved with fourth-generation implants but with loosening/instability risks and not for heavy manual labour); indications, the patient factors that drive the choice, outcomes, and the failed-arthroplasty-to-fusion conversion.
- Trapezius Anatomy β Surgical anatomy of the trapezius, the course of the spinal accessory nerve in the posterior triangle, trapezius palsy with lateral scapular winging, and the Eden-Lange and trapezius transfers.
- Triceps Brachii Anatomy β Surgical anatomy of triceps brachii: three heads with separate radial nerve innervation, the radial nerve in the spiral groove, the triceps-splitting, Bryan-Morrey triceps-reflecting and olecranon osteotomy exposures of the distal humerus, and triceps insufficiency after total elbow arthroplasty.
- Trigger Finger (Stenosing Tenosynovitis) β Comprehensive guide to trigger finger including diagnosis, Green classification, injection technique, and surgical release.
- Trigger Thumb (Pediatric) β Comprehensive Exam-ready guide to pediatric trigger thumb including Notta's node pathophysiology, observation vs surgical decision-making, A1 pulley release technique, and exam scenarios
- Triscaphe Arthritis (STT Arthritis) β Degenerative arthritis of the scaphotrapeziotrapezoid joint causing radial-sided wrist pain, managed with activity modification, injections, or surgical options including excision arthroplasty and arthrodesis
- Ulnar Club Hand (Ulnar Longitudinal Deficiency) β Complete guide to ulnar club hand including classification, surgical management, and functional outcomes in longitudinal upper limb deficiencies
- Ulnar Impaction Syndrome β Comprehensive guide to ulnar impaction syndrome including positive ulnar variance, TFCC tears, ulnar shortening osteotomy, and wafer procedures.
- Ulnar Nerve Anatomy β Comprehensive guide to the anatomy, course, branches, and compression syndromes of the Ulnar Nerve
- Ulnar Nerve Palsy β Comprehensive guide to Cubital Tunnel Syndrome, Guyon's Canal Syndrome, and Ulnar Nerve mechanics.
- Ulnar Tunnel Syndrome (Guyon's Canal) β Comprehensive guide to ulnar tunnel syndrome including anatomy of Guyon's canal, classification zones, diagnosis, and surgical decompression techniques.
- Ulnar-Sided Wrist Pain β Pattern-based differential for ulnar-sided wrist pain: TFCC tear, ulnar impaction, ECU instability, LT injury, DRUJ instability, pisotriquetral arthritis and hook of hamate fracture.
- Valgus Extension Overload of the Elbow β Comprehensive guide to posteromedial olecranon osteophyte impingement in throwing athletes, UCL insufficiency relationship, imaging, and surgical debridement considerations.
- Wartenberg's Syndrome β Comprehensive guide to Wartenberg's Syndrome (Cheiralgia Paresthetica), involving entrapment of the Superficial Radial Nerve, identifying clinical features, and distinguishing it from De Quervain's Tenosynovitis.
- Wrist Arthroplasty β Comprehensive guide to total wrist arthroplasty - indications (RA, OA), implant types (Universal 2, Maestro, ReMotion), surgical technique, complications, and outcomes vs arthrodesis
- Wrist Ligament Instability β Advanced orthopaedic guide to wrist ligament instability: examination technique, radiographic measurements, staging, arthroscopy, acute repair, chronic reconstruction, lunotriquetral instability and salvage surgery.
Spine β 85 topics
- ACDF - Anterior Cervical Discectomy and Fusion β Comprehensive guide to anterior cervical discectomy and fusion including indications, surgical technique, complications, and outcomes for Orthopaedic examination
- Adjacent Segment Disease β Comprehensive guide to adjacent segment disease after spinal fusion including pathophysiology, risk factors, prevention, and surgical management for Orthopaedic examination
- Adult Spinal Deformity β Comprehensive guide to adult spinal deformity including SRS-Schwab classification, sagittal balance parameters, surgical planning, osteotomies, and outcomes for orthopaedic exam
- Ankylosing Spondylitis β Comprehensive guide to ankylosing spondylitis - inflammatory spondyloarthropathy, HLA-B27 association, spinal manifestations, fracture management, and orthopaedic considerations for fellowship exam preparation
- Atlanto-Occipital Dislocation β Comprehensive guide to atlanto-occipital dislocation including Traynelis classification, radiographic measurements (Powers ratio, CCI, BDI), immediate management, and occipitocervical fusion.
- Atlantoaxial (C1-C2) Fusion β Indications, vertebral artery anatomy, and technique comparison for C1-C2 fusion: Gallie, Brooks, Magerl transarticular screws and the Goel-Harms construct.
- Atlantoaxial Arthritis β Degenerative or inflammatory arthritis of the C1-C2 articulation causing occipitocervical pain and potential instability
- Atlantoaxial Rotatory Subluxation β Comprehensive exam guide to atlantoaxial rotatory subluxation and fixation (AARS/AARF) - cock-robin torticollis, Grisel syndrome, Fielding-Hawkins and Pang classifications, dynamic CT diagnosis, traction reduction and C1-C2 fusion for orthopaedic exam
- Baastrup Disease (Kissing Spine Syndrome) β Baastrup disease (kissing spines): imaging features, why the finding is often incidental, the diagnostic infiltration test, and management.
- Basilar Invagination β Comprehensive guide to basilar invagination and basilar impression: cranial migration of the odontoid process into the foramen magnum, congenital and acquired aetiologies, radiographic lines, myelopathic presentation, and occipitocervical fusion.
- Bertolotti Syndrome (Lumbosacral Transitional Vertebra) β Bertolotti syndrome: Castellvi classification, why a lumbosacral transitional vertebra is not proof of the pain source, correct level numbering, and management.
- Blood Loss Management in Spine Surgery β Fellowship-level guide to patient blood management in spine surgery: why spine (especially deformity) surgery causes high blood loss and the highest transfusion rates in orthopaedics, and the evidence-based multimodal strategy across the preoperative (anaemia/iron optimisation), intraoperative (tranexamic acid, hypotensive anaesthesia, prone positioning, haemostasis, cell salvage, staging) and postoperative (restrictive transfusion) phases.
- Brucellosis of the Spine (Spinal Brucellosis) β Comprehensive guide to spinal brucellosis - endemic zoonosis causing spondylodiscitis, Pedro Pons sign, diagnosis with serology, prolonged antibiotic treatment for orthopaedic exam
- Cauda Equina Syndrome β Comprehensive guide to cauda equina syndrome - red flags, imaging, and the urgency of decompression
- Cervical Disc Disease β Comprehensive exam-ready guide to cervical radiculopathy and disc herniation - diagnosis and management
- Cervical Facet Arthropathy β Comprehensive guide to Cervical Facet Joint Syndrome, diagnosis via Medial Branch Blocks, and Radiofrequency Ablation.
- Cervical Instability β Comprehensive guide to cervical instability including atlantoaxial instability, occipitoatlantal dislocation, subaxial instability, and surgical stabilization techniques.
- Cervical Lateral Mass Fracture-Separation (Floating Lateral Mass) β Fellowship-level guide to the floating lateral mass (FLM) fracture of the subaxial cervical spine: a fracture through both the ipsilateral lamina and pedicle that disconnects the lateral mass (and its superior and inferior articular processes) from the vertebra, producing a highly unstable, often rotationally malaligned segment; its recognition on CT, the risk of blunt cerebrovascular (vertebral artery) injury, and operative versus selected non-operative management.
- Cervical Myelopathy β Comprehensive guide to cervical myelopathy - cord compression, upper motor neuron signs, Nurick classification, surgical timing, anterior vs posterior approaches, and clinical decision-making for orthopaedic exam
- Cervical Radiculopathy β Comprehensive Orthopaedic exam guide to cervical radiculopathy - nerve root compression syndromes, dermatomal patterns, examination findings, imaging interpretation, conservative management, and surgical techniques including ACDF and posterior foraminotomy.
- Cervical Spondylolisthesis β Comprehensive guide to cervical vertebral subluxation including degenerative, traumatic, and iatrogenic causes, with classification and fusion techniques.
- Cervical Spondylosis β Comprehensive Orthopaedic exam guide to cervical spondylosis - degenerative disc disease, osteophyte formation, natural history, clinical presentation, imaging interpretation, and management strategies for age-related cervical spine degeneration.
- Chiari Malformation (Orthopaedic Relevance) β Exam-focused guide to Chiari I malformation for the orthopaedic surgeon: what it is, why the cerebellar tonsils matter for the spine, the syringomyelia link that drives atypical scoliosis and neuropathic (Charcot) joints, when to MRI the whole spine in scoliosis, the role of posterior fossa decompression before fusion, and the red flags you must not miss.
- Coccydynia β Comprehensive guide to coccygeal pain including aetiology, dynamic radiographic assessment, injection therapy, and coccygectomy for refractory cases.
- Conus Medullaris Syndrome β Comprehensive guide to conus medullaris syndrome: L1-L2 cord-tip lesion, early symmetric saddle anaesthesia, mixed UMN/LMN signs, and acute sphincter dysfunction.
- Degenerative Disc Disease β Comprehensive guide to lumbar degenerative disc disease including diagnosis, conservative management, and surgical options.
- Degenerative Spondylolisthesis β Comprehensive guide to degenerative spondylolisthesis: pathophysiology, classification, and management.
- Dermatomes, Myotomes & Spinal Nerve Root Anatomy β Fellowship-level guide to dermatomes and myotomes: the ISNCSCI key sensory points and key muscles, reflex levels, radiculopathy localisation, and the ASIA examination.
- Diffuse Idiopathic Skeletal Hyperostosis (DISH) β Exam-focused guide to DISH (Forestier's disease): flowing anterior ossification, the Resnick criteria, the dangerous ankylosed-spine fracture, dysphagia, and how DISH differs from ankylosing spondylitis.
- Discogenic Back Pain β Comprehensive guide to discogenic back pain - pathophysiology, diagnosis, conservative and interventional management including disc decompression and fusion surgery
- Dropped Head Syndrome β Comprehensive guide to dropped head syndrome - diagnosis, classification, pathophysiology, and surgical management of cervical extensor weakness
- Facet Arthropathy β Comprehensive guide to lumbar facet joint osteoarthritis, including biomechanics, clinical presentation, diagnostic criteria, and treatment options from conservative management to surgical fusion.
- Failed Back Surgery Syndrome β Comprehensive Orthopaedic exam guide to failed back surgery syndrome (FBSS) - definition, etiology including wrong level surgery and inadequate decompression, evaluation algorithm, scar tissue vs recurrent disc herniation, pain management, spinal cord stimulation, revision surgery indications, and prevention strategies.
- Flatback Syndrome β Comprehensive guide to flatback syndrome - loss of lumbar lordosis, sagittal imbalance, pathophysiology, radiographic assessment (SVA, PI-LL mismatch), conservative management, and surgical correction with Smith-Petersen, PSO, and VCR osteotomies.
- Fungal Spine Infections β Comprehensive guide to diagnosis and management of fungal spondylodiscitis including Aspergillus, Candida, and endemic mycoses
- Halo Vest Application and Management β Fellowship-level guide to halo-thoracic orthosis: indications, pin-site anatomy and safe zones, torque protocols, vest fitting, complications, weaning, and the paradigm shift away from halo use in the elderly.
- Hangman's Fracture β Traumatic spondylolisthesis of the axis (C2) - comprehensive guide covering mechanism, Levine-Edwards classification, stability assessment, and management for Orthopaedic examination
- Intradural Extramedullary Tumors β Comprehensive guide to intradural extramedullary spinal tumors including schwannoma, meningioma, and neurofibroma - diagnosis, MRI features, and surgical management
- Intramedullary Spinal Tumors β Comprehensive guide to intramedullary spinal cord tumors including ependymoma, astrocytoma, and hemangioblastoma with surgical management
- Isthmic Spondylolisthesis β Comprehensive guide to isthmic spondylolisthesis - pars defect, Wiltse classification, Meyerding grading, and management
- Jefferson Fracture β Burst fracture of the C1 ring from axial loading - comprehensive guide covering biomechanics, classification, stability assessment, and management strategies for Orthopaedic examination
- Low Back Pain: Assessment & Non-operative Management (Overview) β Fellowship-level overview of low back pain: the diagnostic triage (non-specific mechanical vs radicular vs serious pathology), the RED FLAGS for serious disease (including cauda equina), the yellow flags that predict chronicity, why routine imaging is harmful, and evidence-based non-operative management with the biopsychosocial model.
- Lumbar Disc Arthroplasty (Total Disc Replacement) β Comprehensive guide to lumbar total disc replacement - indications, contraindications, implant designs, surgical technique, complications, and outcomes
- Lumbar Disc Herniation β Comprehensive guide to lumbar disc herniation - epidemiology, disc anatomy, herniation types, radiculopathy, conservative vs surgical management, microdiscectomy technique, and recurrence prevention
- Lumbar Fusion Techniques β Comprehensive guide to lumbar fusion approaches - PLIF, TLIF, ALIF, lateral interbody fusion - indications, techniques, outcomes, and complications for orthopaedic surgery exam preparation
- Lumbar Instability β Comprehensive guide to lumbar instability, including White and Panjabi criteria, radiographic assessment, clinical correlation, and fusion indications
- Lumbar Laminectomy β Comprehensive guide to lumbar laminectomy for spinal stenosis - patient selection, surgical technique, with or without fusion decision, outcomes, and complications for orthopaedic surgery exam preparation
- Lumbar Microdiscectomy β Comprehensive guide to lumbar microdiscectomy for disc herniation - patient selection, surgical technique, outcomes, recurrence, and complications for orthopaedic surgery exam preparation
- Lumbar Radiculopathy β Comprehensive guide to lumbar radiculopathy - nerve root patterns, dermatomal distributions, diagnosis, and management
- Lumbar Spinal Stenosis β Comprehensive Orthopaedic exam guide to lumbar spinal stenosis - pathophysiology, neurogenic claudication, clinical assessment, imaging interpretation, conservative management, and surgical techniques including laminectomy, laminoplasty, and interspinous process devices.
- Lumbosacral Plexus Anatomy β Detailed anatomy of the Lumbar and Sacral Plexuses, their branches, relations to Psoas/Piriformis, and clinical implications.
- Metastatic Spine Disease β Comprehensive guide to metastatic spine disease including SINS classification, NOMS framework, Bilsky grading, surgical indications, and management
- Multiple Myeloma of the Spine β Comprehensive guide to multiple myeloma spinal involvement including diagnosis, imaging criteria, IMWG guidelines, and orthopaedic management
- Navigation & Robotics in Spine Surgery β Fellowship-level guide to image-guided navigation and robotic assistance for spinal instrumentation: how they improve pedicle-screw accuracy (Gertzbein-Robbins grading) over freehand and fluoroscopy, the comparison between navigation and robotics, the reduction in reoperation and surgeon radiation, and the trade-offs of cost, operative time, registration/line-of-sight error and the learning curve.
- Nerve Sheath Tumors of the Spine β Comprehensive guide to schwannomas and neurofibromas of the spine including diagnosis, surgical resection techniques, and management of neurofibromatosis
- Occipitocervical / Craniocervical Junction Instability β Fellowship-level guide to craniocervical junction instability: the ligament-dependent anatomy, traumatic atlanto-occipital dissociation (highly lethal) and atraumatic causes (rheumatoid arthritis, Down syndrome, congenital), the CT measurements (CCI, BDI/BAI, Powers ratio) used to diagnose it, the avoid-traction caution, and occipitocervical fusion.
- Occipitocervical Fusion β Indications, occipital and cervical fixation strategies, the critical occipito-cervical angle, reduction of basilar invagination, and complication management in O-C fusion.
- Ossification of the Posterior Longitudinal Ligament (OPLL) β Comprehensive guide to OPLL causing cervical canal stenosis and myelopathy, covering epidemiology, CT classification (K-line), dural ossification risk, and anterior versus posterior surgical decompression.
- Paraspinal Abscess β Comprehensive guide to paraspinal abscess including diagnosis, management, and surgical drainage techniques
- Posterior Vertebral Apophyseal Ring Fracture β Adolescent posterior limbus/apophyseal ring avulsion of the lumbar vertebral body, mimicking disc herniation, with CT diagnosis and surgical excision of the fragment and associated disc.
- Primary Bone Tumors of the Spine β Comprehensive guide to primary malignant spine tumors including chordoma, chondrosarcoma, osteosarcoma, Ewing sarcoma - diagnosis, imaging, staging and surgical management for orthopaedic fellowship and board examination preparation
- Proximal Junctional Kyphosis (PJK) β Comprehensive guide to proximal junctional kyphosis including definition, classification, risk factors, prevention strategies, and management for orthopaedic fellowship exam
- Pseudarthrosis of the Spine β Comprehensive guide to spinal pseudarthrosis: risk factors, diagnosis with CT imaging, prevention strategies, and revision surgery principles
- Pseudosubluxation of the Cervical Spine (Paediatric) β Fellowship-level guide to physiological pseudosubluxation of the paediatric cervical spine: the normal anterior displacement of C2 on C3 (and C3 on C4) seen in young children, why it occurs, how the Swischuk posterior cervical line distinguishes it from a true injury, the other paediatric cervical radiographic variants that mimic trauma, and the practical approach to the child with a possible cervical injury.
- Pyogenic Discitis & Osteomyelitis β Comprehensive guide to spinal infection, focusing on diagnosis (MRI, Biopsy) and antimicrobial management.
- Revision Deformity Surgery β Comprehensive guide to revision surgery for failed adult spinal deformity correction, including etiology, assessment, complex surgical techniques, and complication management for this challenging patient population.
- Rod Fractures in Spinal Instrumentation β Comprehensive guide to rod fractures following spinal fusion surgery, including risk factors, biomechanical principles, diagnosis, and management strategies for this significant complication.
- Sacral Insufficiency / Stress Fracture β Fellowship-level guide to sacral insufficiency fractures: the osteoporotic 'great mimicker' in the elderly, the H-shaped (Honda sign) fracture pattern, why radiographs miss it and MRI is most sensitive, the imperative to exclude malignancy and treat the osteoporosis, and conservative-versus-surgical (sacroplasty/fixation) management.
- Sacroiliac Joint Dysfunction β Comprehensive guide to sacroiliac joint dysfunction diagnosis and management
- Sacropelvic Fixation (S2-Alar-Iliac & Iliac Screws) β Fellowship-level guide to sacropelvic fixation in long spinal constructs: why fixation must extend to the pelvis to protect S1 screws and the lumbosacral junction, the iliac screw versus the S2-alar-iliac (S2AI) screw (in-line trajectory crossing the SI joint, fewer offset connectors), the biomechanical rationale, accuracy with robotic/navigated guidance, and the recognised complications including sacroiliac joint pain and screw failure.
- Sagittal Balance Parameters β Comprehensive guide to spinopelvic sagittal balance parameters including pelvic incidence, sacral slope, pelvic tilt, SVA, lumbar lordosis, and their clinical applications for orthopaedic fellowship exam
- Spinal Cord Monitoring (Intraoperative Neuromonitoring: SSEP, MEP, EMG, Wake-up Test) β Fellowship-level guide to intraoperative neuromonitoring in spine surgery: what SSEP, MEP and EMG each monitor and their alarm criteria, why multimodal monitoring is standard, the anaesthetic requirements (TIVA, no paralytics for MEP), the structured response to a signal change, and the Stagnara wake-up test.
- Spinal Epidural Abscess β Comprehensive guide to spinal epidural abscess including the diagnostic triad, risk factors, urgent MRI evaluation, and emergent surgical decompression plus antibiotics.
- Spinal Tuberculosis (Pott's Disease) β Comprehensive guide to spinal tuberculosis including diagnosis, imaging, medical and surgical management, and outcomes for orthopaedic fellowship exam
- Spinopelvic Parameters β Comprehensive guide to spinopelvic parameters - pelvic incidence, lumbar lordosis, sagittal vertical axis, and their role in spinal alignment, deformity correction, and total hip arthroplasty stability.
- Split Cord Malformation (Diastematomyelia) β Comprehensive guide to split cord malformation including Pang classification, tethered cord association, cutaneous markers, congenital scoliosis links, and mandatory MRI evaluation before deformity correction.
- Spondylolisthesis β Comprehensive exam-ready guide to spondylolisthesis - classification, assessment, and surgical management
- Synovial Cysts (Spine) β Comprehensive guide to Lumbar Synovial Cysts, including pathophysiology, MRI appearance, and the surgical management debate (Decompression vs Fusion).
- Syringomyelia β Comprehensive guide to syringomyelia and its orthopaedic manifestations, including cape-distribution dissociated sensory loss, Charcot joints, and syrinx-associated scoliosis.
- Tethered Cord Syndrome β Fellowship-level guide to tethered cord syndrome: abnormal caudal fixation of the spinal cord (a low-lying conus with a thickened/fatty filum terminale) producing progressive neuro-orthopaedic, urological and pain symptoms; the cutaneous stigmata and orthopaedic clues (cavovarus foot, leg-length/atrophy, scoliosis), the role of MRI, and surgical untethering - and why it matters to the orthopaedic surgeon.
- Thoracic Disc Herniation β Comprehensive evidence-based guide to thoracic disc herniation - rare pathology, myelopathy risk, surgical approach selection, and outcomes
- Three-Column Osteotomies β Comprehensive guide to three-column osteotomies including pedicle subtraction osteotomy and vertebral column resection for complex spinal deformity correction
- Torg-Pavlov Ratio for Cervical Stenosis β The canal-to-vertebral-body ratio for detecting cervical spinal stenosis on lateral radiographs β its measurement, thresholds, limitations in athletes, and its role in transient quadriparesis risk stratification.
- Vertebral Artery Injury in Cervical Trauma β Fellowship-level guide to blunt vertebral artery injury in cervical spine trauma: the at-risk anatomy (V2 through the transverse foramina), screening criteria, CT angiography, the Biffl/Denver grading, the risk of posterior-circulation stroke, and antithrombotic-led management - with the orthopaedic imperative to screen before reducing high-risk cervical injuries.
- Vertebroplasty and Kyphoplasty β Comprehensive guide to vertebral augmentation (vertebroplasty and kyphoplasty) for vertebral compression fractures - indications, technique, outcomes, complications, and the sham-controlled vs open-label trial evidence (Kallmes, Buchbinder, VAPOUR, VERTOS, FREE) for orthopaedic exam preparation
Foot & Ankle β 86 topics
- Accessory Soleus Muscle β Exam-focused guide to the accessory soleus: a common congenital variant of the deep posterior compartment that can present as a posteromedial ankle mass, exertional pain, or tarsal tunnel syndrome. Covers insertion classification, MRI diagnosis, when to operate, surgical technique principles, and how to avoid misdiagnosing it as a neoplasm.
- Achilles Tendon Rupture β Acute Achilles tendon rupture diagnosis and management including Thompson test, operative vs non-operative treatment, and surgical repair techniques
- Adductor Hallucis Anatomy β Surgical anatomy of the adductor hallucis, its oblique and transverse heads, the conjoined tendon and lateral sesamoid, and its role as the deforming force in hallux valgus and the target of the modified McBride lateral release.
- Adult Acquired Flatfoot Deformity β Comprehensive guide to adult acquired flatfoot deformity (AAFD) with focus on posterior tibial tendon dysfunction (PTTD), Johnson and Strom classification, surgical reconstruction algorithms, and evidence-based management strategies for Orthopaedic examination preparation.
- Ankle Impingement Syndromes β Anterior and posterior ankle impingement: aetiology, examination, imaging, diagnostic injection and arthroscopic management.
- Anterior Ankle Impingement β Anterior ankle impingement: aetiology, Scranton-McDermott grading, oblique AMI radiography, and arthroscopic debridement with outcomes stratified by joint space.
- Anterior Tibial Tendon Rupture β Anterior tibial tendon rupture: why it is missed, the hypovascular zone, and the repair-versus-reconstruction decision with reported outcomes.
- Baxter Neuropathy β Comprehensive guide to entrapment of the inferior calcaneal nerve (first branch of the lateral plantar nerve), including clinical differentiation from plantar fasciitis, electrodiagnosis, imaging, and surgical decompression.
- Brachymetatarsia / Congenital Short Metatarsal β Fellowship-level guide to brachymetatarsia: a congenitally short metatarsal (most often the fourth, from premature physeal closure) that disrupts the metatarsal parabola and leaves the corresponding toe short and dorsally riding; the associations, the clinical and radiographic features, and the surgical lengthening options - one-stage interpositional bone graft versus gradual distraction osteogenesis (callotasis) - with their trade-offs.
- Bunionette Deformity (Tailor's Bunion) β Comprehensive guide to bunionette deformity: lateral fifth metatarsal prominence, Coughlin classification (Types I-III), surgical decision-making for lateral condylectomy, chevron, and proximal osteotomies.
- Calcaneal Fractures β Comprehensive guide to calcaneal fractures: Sanders CT classification, ORIF via extensile lateral approach, management of wound complications
- Calcaneocuboid Arthritis β Comprehensive guide to calcaneocuboid arthritis covering pathophysiology, clinical assessment, conservative and surgical management for Orthopaedic exam preparation
- Cavovarus Foot Deformity β Comprehensive guide to cavovarus foot deformity including CMT etiology, Coleman block test, staged reconstruction, and outcomes
- Charcot Neuroarthropathy β Comprehensive guide to Charcot neuroarthropathy of the foot and ankle, including Eichenholtz staging, rocker-bottom deformity, total contact casting, and reconstruction versus amputation decision-making.
- Chronic Lateral Ankle Pain β Pattern-based differential for chronic lateral ankle pain after sprain: instability, impingement, peroneal pathology, osteochondral lesions, coalition and occult fracture, with discriminators.
- Claw Toes β Comprehensive guide to claw toe deformity including biomechanics, neurological causes, flexible vs rigid classification, and surgical management strategies.
- Common, Superficial & Deep Peroneal (Fibular) Nerve Anatomy β Fellowship-level anatomy of the common peroneal (fibular) nerve and its superficial and deep branches: sciatic origin, the vulnerable course around the fibular neck, foot drop, and the compartments supplied.
- Congenital Cleft Foot & Overlapping/Underlapping Fifth Toe β Fellowship-level guide to two congenital forefoot conditions: cleft foot (split-foot malformation / ectrodactyly, 'lobster-claw') - a central-ray deficiency that may be isolated or part of a syndrome (e.g. EEC) needing genetic counselling and function-and-cosmesis-tailored surgery - and the overlapping (congenital overriding) and underlapping ('curly') fifth toe, most of which correct or settle with non-operative care, with surgery reserved for persistent symptomatic deformity.
- Crossover Toe Deformity β Comprehensive guide to crossover toe deformity - second toe plantar plate tear, dorsal subluxation mechanism, flexible vs rigid grading, and surgical flexor-extensor balancing techniques
- Deltoid Ligament Injuries β Comprehensive review of deltoid ligament injuries including acute sprains, chronic insufficiency, grading systems, associated fractures, and evidence-based management strategies
- Diabetic Foot Infections β Spectrum of soft tissue and bone infections in diabetic foot, from superficial cellulitis to limb-threatening deep space infections and osteomyelitis
- Diabetic Foot Management β Comprehensive guide to diabetic foot ulcer classification (Wagner, Texas), infection management, amputation indications, and multidisciplinary care
- Diabetic Foot Ulcers β Comprehensive guide to diabetic foot ulcer pathophysiology, Wagner and University of Texas classifications, assessment, offloading, wound care, surgical management, and prevention strategies
- Diabetic Neuropathy β Comprehensive guide to diabetic peripheral neuropathy affecting the foot and ankle, including pathophysiology, monofilament screening, Charcot arthropathy, ulcer prevention, and multidisciplinary management for orthopaedic fellowship exams
- Extensor Tendon Injuries - Foot and Ankle β Comprehensive guide to extensor tendon injuries of the foot - anatomy, mechanism, acute and chronic management, surgical repair techniques, and rehabilitation for orthopaedic exam
- Flexor Digitorum Brevis Anatomy β Surgical anatomy of the flexor digitorum brevis, its origin from the medial calcaneal tuberosity and plantar aponeurosis, the tendon chiasma, and its role in plantar fasciitis and Baxter nerve entrapment.
- Flexor Digitorum Longus Anatomy β Surgical anatomy of flexor digitorum longus: the knot of Henry and its interconnections with flexor hallucis longus, FDL transfer for stage II posterior tibial tendon dysfunction, quadratus plantae and the lumbricals, and its role in lesser toe deformity and flexor tenotomy.
- Flexor Hallucis Brevis Anatomy β Surgical anatomy of the flexor hallucis brevis, the two hallux sesamoids embedded in its tendons, the plantar plate and sesamoid complex, and its relevance to turf toe, sesamoid fracture versus bipartite sesamoid, and hallux rigidus.
- Flexor Hallucis Longus (FHL) Tendinitis β Comprehensive guide to FHL tendinitis including anatomy, clinical presentation, diagnosis, and management strategies
- Flexor Hallucis Longus Anatomy β Surgical anatomy of flexor hallucis longus: the fibro-osseous tunnel behind the talus, posterior ankle impingement and the os trigonum, FHL transfer for chronic Achilles rupture with harvest levels and the medial plantar nerve at risk, hallux saltans, checkrein deformity and the knot of Henry.
- Foot & Ankle Orthotics, Bracing and AFOs β Fellowship-level guide to foot and ankle orthoses: foot orthoses/insoles for support and offloading, the spectrum of ankle-foot orthoses (AFOs) - posterior leaf spring, solid/rigid, hinged, and ground-reaction (floor-reaction) designs - and specialised devices such as the Arizona/gauntlet AFO and the CROW boot for Charcot; the indications matched to the deficit (flexible foot drop, fixed deformity, quadriceps weakness, hindfoot/ankle arthritis, Charcot), and the biomechanical principles.
- Foot Puncture Wounds β Fellowship-level guide to plantar foot puncture wounds: the small but important proportion that develop deep infection and osteomyelitis, the classic Pseudomonas aeruginosa association with punctures through rubber-soled footwear, the role of imaging for retained foreign bodies, tetanus prophylaxis, and the principles of wound care, debridement and culture-directed antibiotics.
- Freiberg Disease (Freiberg Infraction) β Comprehensive guide to Freiberg disease osteochondrosis - diagnosis, staging and management
- Gastrocnemius (Equinus) Contracture & the SilfverskiΓΆld Test β Fellowship-level guide to isolated gastrocnemius contracture: the SilfverskiΓΆld test, why a tight gastrocnemius overloads the forefoot, and gastrocnemius recession versus Achilles lengthening.
- Haglund Syndrome and Insertional Achilles Tendinopathy β Comprehensive guide to posterosuperior calcaneal prominence with retrocalcaneal bursitis and insertional Achilles tendinopathy, covering pump bump, eccentric loading, calcaneal ostectomy, and tendon reattachment.
- Hallux Rigidus β Comprehensive Orthopaedic exam guide to hallux rigidus: classification, grading systems, treatment algorithms comparing cheilectomy vs arthrodesis vs arthroplasty, and surgical decision-making.
- Hallux Valgus β Bunion deformity with lateral deviation of hallux and medial prominence of first metatarsal head. Comprehensive coverage of assessment, osteotomy selection (chevron, scarf, Lapidus), surgical technique, and complications.
- Hallux Varus β Comprehensive guide to hallux varus - definition, etiology, flexible vs rigid deformity, conservative and surgical management including EHL transfer and arthrodesis for orthopaedic exam
- Hammer Toes β Comprehensive guide to hammer toe deformity including classification, flexible vs rigid, surgical correction techniques, and outcomes.
- Interphalangeal Joint Arthritis (Foot) β Comprehensive guide to hallux IPJ and lesser toe IPJ arthritis - post-traumatic and degenerative causes, conservative vs arthrodesis surgical approach for exam
- Keller Resection Arthroplasty β Fellowship-level guide to the Keller resection arthroplasty of the first metatarsophalangeal joint: excision of the base of the proximal phalanx of the hallux to decompress an arthritic or deformed first MTP joint; its modern niche in the low-demand elderly patient with hallux valgus or hallux rigidus, the trade-off of losing hallux push-off (transfer metatarsalgia, cock-up and flail-toe deformities), and first-MTP arthrodesis as the salvage for a failed Keller.
- Keratotic Disorders of the Plantar Skin (Corns, Calluses, IPK) β Fellowship-level guide to plantar hyperkeratoses: callus (tyloma), hard and soft corns (heloma durum/molle) and the intractable plantar keratosis (IPK) under a metatarsal head - their pressure-related pathogenesis, the key differentiation from a plantar wart (verruca), conservative offloading/debridement, the diabetic pre-ulcer significance, and surgery (condylectomy/metatarsal osteotomy) with the risk of transfer lesions.
- Lateral Ankle Instability β Comprehensive guide to lateral ankle instability including ATFL/CFL anatomy, examination techniques, Brostrom-Gould repair, and anatomic reconstruction options for Orthopaedic examination.
- Lesser MTP Joint Arthritis β Comprehensive review of lesser metatarsophalangeal joint arthritis including pathoanatomy, clinical assessment, conservative and surgical management strategies
- Lesser Toe Deformities β Comprehensive guide to hammer toe, claw toe, and mallet toe: classification, pathomechanics, non-operative management, and surgical correction techniques for Orthopaedic exam
- Lisfranc Injuries β Comprehensive guide to Lisfranc (tarsometatarsal) injuries including Myerson classification, subtle diagnosis (fleck sign), and treatment from ORIF to primary arthrodesis
- Meary Angle (Talo-First Metatarsal Angle) β The Meary angle β the lateral talus-first metatarsal axis measurement for sagittal-plane foot alignment. Normal is approximately zero degrees; apex-plantar in pes planus, apex-dorsal in pes cavus. How to measure, interpret, and act on it.
- Medial Ankle Instability β Deltoid ligament insufficiency causing medial ankle instability, including anatomy, diagnosis, conservative and surgical management of this uncommon but significant ankle pathology
- Metatarsalgia β Comprehensive guide to forefoot pain including primary and secondary causes, biomechanics, examination with drawer test, conservative orthotics management, Weil osteotomy surgical technique, and transfer metatarsalgia prevention
- Midfoot Arthritis β Comprehensive guide to midfoot arthritis diagnosis and management
- Morton's Neuroma β Comprehensive guide to Morton's neuroma including pathophysiology, Mulder's click, conservative management, corticosteroid injection, and surgical neurectomy.
- MΓΌller-Weiss Disease β Spontaneous adult-onset tarsal navicular dysplasia/osteonecrosis producing the paradoxical pes planovarus deformity; diagnosis, Maceira staging and fusion-based management.
- Navicular Stress Fracture β Comprehensive guide to tarsal navicular stress fractures in athletes, including watershed-zone biology, diagnosis with MRI/CT, classification, and evidence-based management with non-weight-bearing immobilisation or internal fixation.
- Onychocryptosis (Ingrown Toenail) and Toenail Disorders β Fellowship-level guide to onychocryptosis (ingrown toenail): pathogenesis and risk factors, the Heifetz/Mozena staging, conservative measures, and the evidence that partial nail avulsion with chemical (phenol) matricectomy gives the lowest recurrence - with a note on related toenail disorders (onychomycosis, onychogryphosis, subungual exostosis).
- Osteochondral Lesion of the Talus β Complete exam guide to osteochondral lesions of the talus (OLT) - aetiology, location, Berndt-Harty and Hepple classification, MRI/CT staging, microfracture, OAT and ACI, the lesion-size decision, and complications for orthopaedic exams
- Painful Accessory Ossicles of the Foot (Os Peroneum & Os Vesalianum) β Fellowship-level guide to the painful accessory ossicles of the foot - chiefly the painful os peroneum syndrome (a spectrum of lateral-foot pain from an os peroneum within the peroneus longus tendon, where a fractured or diastatic ossicle may signal a peroneus longus tear) and the os vesalianum at the fifth metatarsal base - with how to distinguish them from an avulsion fracture, the role of comparison views/MRI, and a non-operative-first management approach (os trigonum and accessory navicular have their own pages).
- Peroneal Tendon Disorders β Comprehensive guide to peroneal tendon pathology including tears, subluxation, and SPR repair - covering anatomy, classification, surgical techniques, and rehabilitation
- Peroneal Tendon Subluxation and Dislocation β Comprehensive guide to peroneal tendon instability, superior peroneal retinaculum tears, and surgical repair techniques
- Peroneal Tendon Tears β Comprehensive guide to peroneal tendon tears - anatomy, Sobel classification, tubular vs split tears, debridement vs reconstruction techniques, and surgical decision-making for orthopaedic exam
- Peroneus Brevis Anatomy β Surgical anatomy of peroneus brevis: the fifth metatarsal base insertion and its role in Jones and avulsion fractures, longitudinal split tears in the fibular groove, superior peroneal retinaculum repair and groove deepening, and harvest for lateral ankle ligament reconstruction.
- Peroneus Longus Anatomy β Surgical anatomy of peroneus longus: the lateral compartment and superficial peroneal nerve, the cuboid tunnel and os peroneum, plantarflexion of the first ray as the driver of cavovarus, the Coleman block test, and peroneal tendon pathology.
- Peroneus Tertius Anatomy β Surgical anatomy of peroneus tertius: an anterior compartment muscle despite its name, deep peroneal innervation, variable presence across populations, and its contribution to dorsiflexion and eversion.
- Plantar Fasciitis Management β Comprehensive guide to plantar fasciitis - anatomy, pathophysiology, diagnosis, conservative management, injection therapies, surgical techniques, and evidence-based treatment for orthopaedic exam
- Plantar Fibromatosis (Ledderhose Disease) β Comprehensive guide to plantar fibromatosis (Ledderhose disease), including pathophysiology, Dupuytren association, high recurrence after excision, and treatment algorithms.
- Plantar Interossei Anatomy β Surgical anatomy of the three plantar interossei, adduction of the lesser toes about the second ray axis, lateral plantar nerve innervation, and the intrinsic-minus foot with claw toes in Charcot-Marie-Tooth disease and diabetic neuropathy.
- Plantar Plate Insufficiency & Lesser MTP Instability β Fellowship-level guide to plantar plate degeneration and tear at the lesser metatarsophalangeal joints: the cause of second-toe crossover deformity, the drawer test, distinguishing it from Morton's neuroma, and direct repair.
- Posterior Ankle Impingement β Comprehensive guide to posterior ankle impingement and os trigonum syndrome
- Quadratus Plantae Anatomy β Surgical anatomy of quadratus plantae (flexor accessorius), how it corrects the oblique pull of flexor digitorum longus, its role in lesser toe deformity, and its relationship to the Baxter nerve and the calcaneal compartment.
- Retrocalcaneal Bursitis β Inflammation of the retrocalcaneal bursa between the Achilles tendon and calcaneus, commonly seen in athletes and associated with Haglund's deformity
- Sesamoid Disorders of the Foot β Comprehensive guide to hallucal sesamoid pathology: sesamoiditis, fractures, bipartite variants, AVN, arthritis. Classification, imaging differentiation, and surgical decision-making including sesamoidectomy.
- Sinus Tarsi Syndrome β Comprehensive guide to sinus tarsi syndrome - anatomy, post-traumatic aetiology, clinical diagnosis, imaging, conservative management, and surgical debridement.
- Soft-Tissue Mass of the Foot β Pattern and differential for a soft-tissue mass in the foot: discriminators separating ganglion, plantar fibroma, Morton's neuroma, synovial sarcoma and vascular malformation.
- Soleus Anatomy β Surgical anatomy of soleus: the soleal arch as a site of popliteal artery and tibial nerve entrapment, the dominant plantarflexor in stance, the Silfverskiold distinction from gastrocnemius, the soleus flap for middle-third tibial cover, and the calf muscle pump.
- The Rheumatoid Foot and Ankle β Comprehensive guide to the spectrum of forefoot, midfoot, hindfoot and ankle involvement in rheumatoid arthritis, with surgical reconstruction principles including Fowler excision arthroplasty, first MTP arthrodesis and triple arthrodesis.
- Spring Ligament Insufficiency β Comprehensive guide to plantar calcaneonavicular (spring) ligament pathology, assessment, and surgical reconstruction in adult flatfoot deformity
- Subtalar Arthritis β Degenerative arthritis of the subtalar joint causing hindfoot pain, loss of inversion/eversion, and altered gait mechanics
- Subungual Exostosis & Subungual Tumours β Fellowship-level guide to the subungual exostosis (Dupuytren's exostosis) - a benign fibrocartilage-capped bony outgrowth from the dorsal distal phalanx, usually of the great toe in adolescents/young adults that elevates and deforms the nail - and the wider differential of subungual tumours (glomus tumour, osteochondroma, and the must-not-miss subungual melanoma); the radiographic diagnosis, marginal excision and the importance of excluding malignancy.
- Superficial Peroneal Nerve Anatomy β Surgical anatomy of the superficial peroneal (superficial fibular) nerve: the lateral compartment, its fascial exit 10 to 12 cm above the lateral malleolus, fasciotomy and ankle arthroscopy portal safety, and its sensory border with the sural nerve.
- Syndesmotic Instability β Comprehensive guide to syndesmotic instability - high ankle sprains, anatomy of AITFL/PITFL/IOL, West Point and Lauge-Hansen classification, clinical tests, radiographic assessment, and fixation options for orthopaedic exam
- Talonavicular Arthritis β Comprehensive guide to talonavicular arthritis covering pathophysiology, clinical assessment, conservative and surgical management, and outcomes for Orthopaedic exam preparation
- Talus Fractures β Comprehensive guide to talus fractures including Hawkins classification, AVN risk stratification, urgent reduction techniques, and surgical approaches for this challenging injury with critical blood supply implications
- Tarsal Tunnel Syndrome β Comprehensive guide to tarsal tunnel syndrome including anatomy, diagnosis, provocative tests, electrodiagnostic studies, and surgical decompression techniques.
- Tarsometatarsal (TMT) Arthritis β Comprehensive guide to TMT joint arthritis: clinical presentation, conservative and surgical management strategies
- Tibial Nerve Anatomy β Fellowship-level anatomy of the tibial nerve: sciatic origin, popliteal fossa and posterior-leg course, the tarsal tunnel, medial and lateral plantar nerves, and injury patterns including the insensate sole.
- Tibialis Anterior Anatomy β Surgical anatomy of tibialis anterior: deep peroneal innervation, the anterior compartment, foot drop and steppage gait, missed tendon rupture in the older patient, and split anterior tibial tendon transfer.
- Tibialis Posterior Anatomy β Surgical anatomy of tibialis posterior: the deepest posterior compartment muscle, its broad navicular and plantar insertion, dynamic arch support, PTTD staging, the tarsal tunnel, and FDL transfer with medial displacement calcaneal osteotomy.
Oncology β 93 topics
- Adamantinoma β Comprehensive guide to adamantinoma - rare low-grade malignant bone tumour with tibial predilection, imaging features, surgical management, and prognosis for orthopaedic exam
- Allograft-Prosthetic Composite (APC) Reconstruction β Principles, technique and evidence for combining massive structural allograft with a stemmed prosthesis to restore bone stock and soft-tissue attachment after tumour resection or failed arthroplasty.
- Alveolar Soft Part Sarcoma β Fellowship-level guide to alveolar soft part sarcoma (ASPS) - a rare soft-tissue sarcoma of young adults, defined by the ASPSCR1-TFE3 gene fusion (nuclear TFE3), that grows slowly but has a striking propensity for early haematogenous metastasis (lung, bone, brain) - covering its painless deep limb mass, the alveolar/organoid histology with PAS-positive crystals, the staging/biopsy work-up, and management with wide surgical resection (chemo-resistant) plus anti-angiogenic/immunotherapy and long-term surveillance for late metastases.
- Aneurysmal Bone Cyst β Comprehensive guide to aneurysmal bone cyst (ABC) - benign expansile bone lesion with fluid-fluid levels, imaging features, treatment options including curettage and denosumab for orthopaedic exam
- Angiosarcoma β Rare aggressive vascular malignancy with poor prognosis, occurring in soft tissue and associated with radiation, lymphedema, and chronic inflammation
- Benign Fibrous Histiocytoma of Bone β Fellowship-level guide to benign fibrous histiocytoma of bone (BFHB) - a rare benign fibrous bone tumour, histologically identical to non-ossifying fibroma (storiform fibroblasts with osteoclast-type giant cells and foamy macrophages) but distinguished by its presentation in atypical sites and older/symptomatic patients - covering the diagnosis, the contested relationship with non-ossifying fibroma, the meaningful local recurrence rate after curettage, and the rare possibility of malignant transformation.
- Benign Notochordal Cell Tumour β Fellowship-level guide to the benign notochordal cell tumour (BNCT) - a benign intraosseous lesion arising from notochordal remnants in the axial skeleton (clivus, vertebrae, sacrum) - covering its typically incidental, sclerotic, non-destructive imaging appearance, the crucial distinction from chordoma (the malignant notochordal tumour it can mimic and may be a precursor to), and the management principle of observation for the benign lesion versus oncological resection for chordoma.
- Biopsy Principles and Techniques in Orthopaedic Oncology β Comprehensive guide to biopsy principles including Mankin errors, needle vs open biopsy, approach planning, specimen handling, and collaboration with tumor centers for orthopaedic exam preparation
- Bizarre Parosteal Osteochondromatous Proliferation (Nora Lesion) β Comprehensive guide to Nora lesion (BPOP), a rare surface-based bone tumour of the hands and feet, including histopathology, differentiation from osteochondroma and parosteal osteosarcoma, and management by marginal excision.
- Bone Island (Enostosis) β Comprehensive guide to bone islands: imaging characteristics, differential diagnosis, clinical significance, and distinguishing from malignant lesions
- Brown Tumour of Hyperparathyroidism β Comprehensive guide to brown tumour (osteitis fibrosa cystica) of hyperparathyroidism - pathophysiology, lytic imaging, the critical giant cell tumour mimic, biochemistry and parathyroidectomy-first management for orthopaedic fellowship exams
- Calcifying Aponeurotic Fibroma β Rare benign fibroblastic tumour of the hands and feet in children and adolescents, with stippled calcification, chondroid nodules on histology, and a high local recurrence rate after marginal excision but no metastatic potential.
- Chondroblastoma β Rare benign cartilage tumor of epiphysis in skeletally immature patients
- Chondrosarcoma β Malignant cartilage-forming tumor - second most common primary bone malignancy with varied biological behavior
- Chordoma β Comprehensive guide to chordoma diagnosis, management, and surgical treatment
- Clear Cell Chondrosarcoma β Rare low-grade epiphyseal cartilage malignancy of the femoral head and proximal humerus in young adults: diagnosis, differentiation from chondroblastoma, wide resection and lifelong surveillance.
- Clear Cell Sarcoma β Rare aggressive soft tissue sarcoma of tendons and aponeuroses with EWSR1-ATF1 fusion and melanocytic differentiation - the melanoma of soft parts in young adults
- Dedifferentiated Chondrosarcoma β Fellowship-level reference on dedifferentiated chondrosarcoma: bimorphic imaging, biopsy of the lytic component, wide resection, chemotherapy controversy and dismal survival.
- Dermatofibrosarcoma Protuberans (DFSP) β Fellowship-level guide to dermatofibrosarcoma protuberans: a low-grade cutaneous soft-tissue sarcoma with a storiform CD34-positive histology and the COL1A1-PDGFB fusion from t(17;22), its very high local recurrence from infiltrative margins, the fibrosarcomatous variant's metastatic potential, and treatment by wide excision/Mohs micrographic surgery with imatinib for unresectable or recurrent disease.
- Desmoid Tumor (Aggressive Fibromatosis) β Locally aggressive benign fibroblastic tumor with CTNNB1 mutations, unpredictable behavior requiring surveillance-first approach
- Desmoplastic Fibroma of Bone β Comprehensive guide to desmoplastic fibroma of bone, a rare benign but locally aggressive intraosseous fibromatosis affecting the mandible and long bones, with high recurrence risk and indications for wide excision.
- Elastofibroma Dorsi β Benign fibroelastic pseudotumour beneath the scapular tip with pathognomonic imaging - the soft-tissue mass examiners love to test as a sarcoma mimic
- Enchondroma β Benign intramedullary cartilage tumor, most common tumor of hand bones
- Enchondromatosis (Ollier Disease and Maffucci Syndrome) β Comprehensive guide to multiple enchondromatosis - Ollier disease, Maffucci syndrome, IDH mutations, malignant transformation, and surveillance protocols
- Epithelioid Haemangioma & Haemangioendothelioma of Bone β Fellowship-level guide to the epithelioid vascular tumours of bone - the benign/locally aggressive epithelioid haemangioma and the intermediate-grade, low-to-moderate malignancy epithelioid haemangioendothelioma (EHE) - covering their lytic, often multifocal bone presentation, the vascular endothelial immunophenotype (CD31/ERG, with the WWTR1-CAMTA1 fusion characterising EHE), the differential from the highly malignant angiosarcoma, and management that ranges from curettage to wide resection and systemic therapy by grade and extent.
- Epithelioid Sarcoma β Rare INI1/SMARCB1-deficient soft tissue sarcoma of young adults - the great mimic that favours the distal upper limb, recurs locally, and spreads to nodes, skin and lung
- Erdheim-Chester Disease β Fellowship-level guide to Erdheim-Chester disease (ECD) - a rare non-Langerhans cell histiocytosis driven by MAPK-pathway (notably BRAF V600E) mutations - covering its hallmark bilateral symmetric osteosclerosis of the long-bone metadiaphyses (CD68-positive, CD1a-negative foamy histiocytes), the wide multisystem involvement (cardiovascular, retroperitoneal/'hairy kidney', CNS, orbit), the diagnostic role of bone scan/PET and biopsy with BRAF testing, and the transformation of management by targeted BRAF/MEK inhibition.
- Expandable Prostheses in Pediatric Oncology β Comprehensive guide to expandable endoprostheses for limb salvage in skeletally immature patients with bone tumours - mechanisms, indications, complications, and conversion to adult prosthesis
- Extraskeletal Myxoid Chondrosarcoma β Fellowship-level guide to extraskeletal myxoid chondrosarcoma (EMC) - a rare soft-tissue sarcoma of (despite its name) uncertain/non-cartilaginous differentiation, defined by NR4A3 gene rearrangement (most often EWSR1-NR4A3) - covering its deep proximal-limb mass presentation, the myxoid, multilobular histology with cords of eosinophilic cells, the indolent but relapsing long-term course with late metastases, and management by wide resection with prolonged surveillance (it is relatively chemo/radio-resistant).
- Extraskeletal Osteosarcoma β Fellowship-level guide to extraskeletal osteosarcoma - a rare, high-grade soft-tissue sarcoma that produces osteoid/bone but arises in soft tissue with no attachment to bone or periosteum, typically in older adults - covering its deep soft-tissue (often thigh) mass, the distinction from myositis ossificans and from the surface osteosarcomas, the poor prognosis with high metastatic risk, and management by wide resection, with pooled evidence advising against routine adjuvant chemotherapy.
- Fibrosarcoma of Bone β Primary malignant spindle cell tumor of bone producing collagen without osteoid or chondroid matrix, representing less than 5% of primary bone sarcomas
- Fibrous Dysplasia β Benign fibro-osseous lesion caused by GNAS mutation, monostotic vs polyostotic forms, McCune-Albright and Mazabraud syndromes
- Free Vascularised Fibula Transfer β Fellowship-level guide to free vascularised fibula grafting: peroneal pedicle anatomy, harvest technique, Capanna reconstruction, monitoring, hypertrophy and donor morbidity.
- Giant Cell Reparative Granuloma β Fellowship-level guide to giant cell reparative granuloma (GCRG) - a benign, reactive giant-cell-rich lesion most often of the small bones of the hands and feet (and the jaws) - covering its lytic, expansile presentation, the histology of a fibrous stroma with unevenly distributed giant cells and haemorrhage/reactive bone (now regarded within the 'solid aneurysmal bone cyst'/giant-cell-lesion-of-small-bones spectrum), the crucial distinction from giant cell tumour of bone (which is rare in the hand and locally aggressive), and management by curettage with a recurrence rate.
- Giant Cell Tumor of Bone β Benign but locally aggressive bone tumor characterized by multinucleated giant cells, typically occurring in the epiphysis of skeletally mature patients
- Giant Cell Tumor of Tendon Sheath (GCTTS) β Comprehensive guide to giant cell tumor of tendon sheath (GCTTS), a benign proliferative lesion of the tendon sheath - the extra-articular manifestation of tenosynovial giant cell tumor (TGCT).
- Granular Cell Tumour β Fellowship-level guide to the granular cell tumour - an uncommon, usually benign soft-tissue tumour of Schwann-cell (neural) origin (S100-positive), presenting as a small firm dermal/subcutaneous nodule (classically tongue, but also skin and soft tissue of the limbs) - covering the characteristic granular eosinophilic cytology, the rare malignant variant (size over ~4-5 cm, rapid growth, the dangerous one), the differential, and management by complete excision with clear margins.
- Hemangioma (Soft Tissue) β Comprehensive coverage of soft tissue hemangiomas including classification, clinical presentation, imaging characteristics, management strategies, and complications for orthopaedic surgery examination preparation
- Hemangioma of Bone β Benign vascular tumor of bone, most commonly affecting vertebral bodies and skull, typically asymptomatic and incidental, with characteristic corduroy or polka-dot radiographic appearance
- Hemipelvectomy and Hindquarter Amputation β Comprehensive surgical technique guide to hemipelvectomy - internal (limb-sparing) and external (hindquarter amputation) for pelvic sarcoma resection, Enneking-Dunham classification, vascular control, reconstruction options, flap coverage for orthopaedic fellowship exam preparation
- High-Grade Surface Osteosarcoma β Fellowship-level guide to high-grade surface osteosarcoma - the rarest of the three surface (juxtacortical) osteosarcomas (with parosteal and periosteal), a high-grade malignancy arising on the bone surface that behaves like conventional intramedullary osteosarcoma - covering how it differs from the low-grade parosteal and intermediate-grade periosteal variants, the central role of histological grade in determining treatment, and management with neoadjuvant/adjuvant chemotherapy plus wide resection.
- Hip Disarticulation & Forequarter Amputation β Proximal-level ablative surgery for tumour, infection and trauma: indications, operative technique, oncologic principles, complications and prosthetic reality.
- Internal Hemipelvectomy and Pelvic Reconstruction β Limb-sparing pelvic resection by Enneking-Dunham zone with reconstruction selection, complications and functional outcomes for periacetabular and iliac tumours.
- Intramuscular Myxoma β Benign myxoid soft-tissue tumour of skeletal muscle driven by GNAS mutation; a classic sarcoma mimic and the soft-tissue component of Mazabraud syndrome
- Intraosseous Ganglion β Fellowship-level guide to the intraosseous ganglion - a benign, mucin-filled subchondral bone cyst (a 'bone ganglion') most often found in the carpus (lunate/scaphoid), the medial malleolus, the femoral head/acetabulum and around the knee - covering its well-defined lytic subchondral appearance with a sclerotic rim, the distinction from a degenerative subchondral (geode) cyst and other lytic lesions, and management by observation when asymptomatic and curettage with bone grafting when symptomatic.
- Intraosseous Lipoma β Rare benign intramedullary fat-containing tumor with classic central calcification
- Langerhans Cell Histiocytosis (Eosinophilic Granuloma) β Rare disorder of clonal proliferation of Langerhans cells affecting bone and systemic organs, with spectrum from solitary eosinophilic granuloma to multisystem disease, requiring multidisciplinary management
- Leiomyosarcoma of Soft Tissue β Malignant smooth-muscle sarcoma of soft tissue - aggressive spindle-cell tumour of older adults driven by grade and size, treated with wide excision and chemotherapy reserved for advanced disease
- Leukaemic Involvement of Bone β Fellowship-level guide to the skeletal manifestations of leukaemia: how childhood acute lymphoblastic leukaemia frequently presents with musculoskeletal pain (mimicking JIA, septic arthritis, osteomyelitis or CRMO) before haematological signs, the red flags that should prompt a blood film and marrow examination, the radiographic features (leukaemic lines, osteopenia, permeative lesions), and the orthopaedic role of recognition and referral.
- Limb Salvage Surgery Principles β Comprehensive guide to limb salvage surgery principles for musculoskeletal tumours - Enneking staging, surgical margins, reconstruction options, endoprostheses, allografts, growing prostheses, rotationplasty, and functional outcomes for orthopaedic fellowship exam preparation
- Lipoma β Benign adipocytic tumor - most common soft tissue tumor with excellent prognosis and rare malignant transformation
- Lipoma Arborescens β Fellowship-level guide to lipoma arborescens - a rare benign intra-articular lesion of frond-like (tree-like) villous proliferation of mature fat replacing the synovium, most often in the suprapatellar pouch of the knee - covering its presentation as chronic painless joint swelling with effusion, the pathognomonic MRI appearance (fatty frond-like synovial projections, fat signal on all sequences, suppressing with fat saturation), its association with chronic synovial irritation/arthritis, and management by synovectomy with a good outcome.
- Liposarcoma β Malignant adipocytic tumor - most common soft tissue sarcoma in adults with variable prognosis based on histological subtype
- Malignant Musculoskeletal Tumours - Principles β Fellowship-level principles page for malignant musculoskeletal tumours - how a sarcoma announces itself, the published soft-tissue lump and bone-pain referral thresholds, the staging sequence (local MRI, chest CT) and the Enneking and AJCC systems, the hazards of biopsy quantified by the Musculoskeletal Tumor Society studies, the residual-disease problem after unplanned excision, margin definitions and the modern margin debate, limb salvage versus amputation evidence, which sarcomas are chemosensitive and radiosensitive and which are not, and the specialist-centre and surveillance principles that hold the whole pathway together.
- Malignant Peripheral Nerve Sheath Tumor (MPNST) β Comprehensive guide to malignant peripheral nerve sheath tumor, including NF1 association, imaging, surgical management, and prognosis
- Marjolin's Ulcer β Comprehensive guide to Marjolin's ulcer - aggressive squamous cell carcinoma arising in chronic wounds, scars, sinuses and burns, including latency, biopsy, wide excision, amputation, nodal staging, and prognosis.
- Massive Osteolysis (Gorham-Stout / Vanishing Bone Disease) β Fellowship-level guide to Gorham-Stout disease: a rare disorder of progressive spontaneous massive osteolysis from intraosseous lymphatic/vascular proliferation ('vanishing bone'), its axial predilection, the feared chylothorax complication, the diagnosis of exclusion (progressive osteolysis + characteristic histology) and the treatment options (bisphosphonates, sirolimus, radiotherapy, surgery).
- Mesenchymal Chondrosarcoma β Rare biphasic small round cell and cartilaginous sarcoma of adolescents and young adults, defined by HEY1-NCOA2 fusion, treated with wide resection plus multi-agent chemotherapy and lifelong surveillance.
- Metastatic Bone Disease β Comprehensive guide to metastatic bone disease including common primaries, fracture risk assessment with Mirels score, surgical stabilization options, and palliative management.
- Multiple Myeloma β Plasma cell neoplasm with skeletal manifestations - punched-out lytic lesions without blastic response
- Myxofibrosarcoma β Fellowship-level guide to myxofibrosarcoma: one of the commonest soft-tissue sarcomas of the elderly, its characteristic infiltrative growth along fascial planes (the MRI 'tail sign'), the resulting very high local recurrence, the spectrum from low to high grade, and management by wide excision with generous margins (guided by pre-operative MRI) plus radiotherapy.
- Neurofibroma β Benign peripheral nerve sheath tumor arising from Schwann cells, fibroblasts, and perineural cells - associated with neurofibromatosis type 1
- Nodular Fasciitis β Fellowship-level guide to nodular fasciitis: a benign, self-limiting myofibroblastic proliferation - the classic 'pseudosarcoma' - that grows rapidly and is frequently mistaken for a sarcoma, its USP6 (MYH9-USP6) signature marking it as a transient clonal neoplasm rather than a reactive lesion, the tissue-culture histology, and the importance of accurate diagnosis to allow conservative management and avoid overtreatment.
- Non-Ossifying Fibroma (Fibrous Cortical Defect) β Comprehensive guide to non-ossifying fibroma and fibrous cortical defect, including diagnosis, fracture-risk assessment, differential diagnosis, and management.
- Osteoblastoma β Benign bone-forming tumor representing 1% of primary bone tumors, characterized by osteoid and bone production with active osteoblasts
- Osteofibrous Dysplasia β Rare benign fibro-osseous lesion of long bones, primarily affecting the anterior tibia in children, with characteristic cortical involvement and well-defined radiographic features
- Osteoid Osteoma β Comprehensive guide to osteoid osteoma - diagnosis, imaging characteristics, night pain pattern, surgical excision, and radiofrequency ablation for orthopaedic exam
- Osteopoikilosis β Comprehensive coverage of osteopoikilosis (spotted bone disease) including LEMD3 genetics, Buschke-Ollendorff syndrome, the spotted-bone radiographic pattern, distinguishing it from sclerotic metastases, and management for orthopaedic surgery examination preparation
- Osteosarcoma β Comprehensive guide to osteosarcoma including diagnosis, staging, neoadjuvant chemotherapy, limb salvage surgery, and prognostic factors for Orthopaedic examination.
- Paget's Sarcoma (Sarcomatous Transformation of Paget Disease) β Comprehensive guide to malignant transformation of Paget disease of bone - epidemiology, presentation, imaging, biopsy, multimodal management and prognosis of this aggressive secondary bone sarcoma.
- Parosteal Osteosarcoma β Fellowship-level chapter on parosteal osteosarcoma: surface anatomy and imaging signs, reverse zonation, MDM2/CDK4 amplification, medullary invasion, dedifferentiation and wide en-bloc resection.
- Pathologic Fracture Management β Comprehensive guide to diagnosis, surgical decision-making, and reconstruction techniques for pathologic fractures through benign and malignant bone lesions
- Periosteal Chondrosarcoma β Fellowship-level guide to periosteal (juxtacortical) chondrosarcoma - a rare, usually low-grade malignant cartilage tumour arising on the bone surface, typically at the metaphysis of a long bone - covering its distinction from the benign periosteal chondroma and from surface osteosarcoma, the generally indolent behaviour, the IDH1 mutation, and management by marginal/wide excision with a good prognosis.
- Periosteal Osteosarcoma β Intermediate-grade, chondroblastic surface osteosarcoma of the femoral and tibial diaphysis: imaging signature, biopsy pitfalls, intercalary resection and reconstruction, and the unresolved chemotherapy question.
- Phosphaturic Mesenchymal Tumour and Tumour-Induced Osteomalacia β Fellowship-level guide to phosphaturic mesenchymal tumour: the FGF23-driven biochemical signature, localisation cascade, histology, curative excision and burosumab-era medical management.
- Pigmented Villonodular Synovitis (PVNS) β Comprehensive guide to pigmented villonodular synovitis (PVNS), a benign proliferative synovial disorder causing joint destruction through local invasion.
- Primary Bone Lymphoma β Non-Hodgkin lymphoma arising in bone with no nodal or visceral disease - a permeative round cell tumour treated by chemotherapy, not wide resection
- Radiotherapy in Musculoskeletal Tumours β Fellowship-level guide to radiotherapy in orthopaedic oncology: radiosensitive (Ewing sarcoma, lymphoma, myeloma, metastases) versus radioresistant (osteosarcoma, chondrosarcoma) tumours, the role of neoadjuvant versus adjuvant radiotherapy in limb-sparing soft-tissue sarcoma surgery, palliative radiotherapy for bone metastases, the modalities (EBRT/IMRT, brachytherapy, proton beam), and complications including wound problems, fibrosis and radiation-induced sarcoma.
- Rhabdomyosarcoma β Most common soft tissue sarcoma of childhood - skeletal-muscle differentiation, embryonal vs alveolar histology, PAX-FOXO1 fusion status drives risk, treated by multimodal chemotherapy, surgery and radiotherapy
- Rotationplasty β Comprehensive guide to rotationplasty (Van Nes/Borggreve procedure) - limb-salvage technique converting ankle to knee joint for distal femur and proximal tibia tumours in paediatric patients
- Sacrectomy for Primary Sacral Tumours β Oncologic principles, level-based classification, root-sacrifice neurology, staged approaches, spinopelvic reconstruction and complications of sacrectomy for chordoma and other sacral tumours.
- Schwannoma (Neurilemmoma) β Benign peripheral nerve sheath tumor arising from Schwann cells - eccentric growth allows enucleation without nerve sacrifice
- Soft Tissue Masses and Sarcoma Referral Pathway β Advanced orthopaedic guide to soft tissue masses and sarcoma referral: red flags, clinical assessment, MRI interpretation, staging, biopsy principles, unplanned excision, MDT management and counselling.
- Soft-Tissue & Bone Tumours of the Foot & Ankle (Overview) β Fellowship-level overview of tumours of the foot and ankle - benign lesions (ganglion, plantar fibroma, giant-cell tumour of tendon sheath, synovial chondromatosis, simple/aneurysmal bone cysts, osteochondroma, enchondroma) and the rare but dangerous malignancies (synovial sarcoma the commonest soft-tissue sarcoma here, with osteosarcoma the commonest bone malignancy) - and the cardinal principle that a foot mass is malignant until proven otherwise: image and biopsy properly before excision, because an unplanned 'whoops' excision worsens recurrence and survival.
- Solitary Plasmacytoma of Bone β Fellowship-level guide to solitary plasmacytoma of bone: a single localized plasma-cell tumour with no systemic myeloma, its diagnostic criteria, the mandatory workup to exclude occult multiple myeloma, radiotherapy as the treatment of choice, the role of surgery for structural lesions, and the high rate of progression to multiple myeloma.
- Subungual Melanoma β Comprehensive guide to subungual (acral lentiginous) melanoma of the nail unit, including Hutchinson sign, ABCDEF nail rules, nail-bed biopsy techniques, wide excision and amputation, and prognosis.
- Synovial Chondromatosis β Comprehensive exam guide to synovial (osteo)chondromatosis - a benign cartilaginous metaplasia of the synovium producing multiple loose bodies, its Milgram staging, imaging, surgical management, and the small but important risk of malignant transformation to secondary synovial chondrosarcoma.
- Synovial Cyst (Ganglion and Joint-Based Cysts) β Comprehensive guide to synovial cysts including ganglion cysts, popliteal (Baker's) cysts, and spinal synovial cysts - benign fluid-filled lesions arising from joint capsule or tendon sheath.
- Synovial Sarcoma β Malignant soft tissue sarcoma defined by the t(X;18) SS18-SSX translocation - about 5-10% of soft tissue sarcomas, arising near joints in young adults despite a name that does not reflect its origin
- Tumoral Calcinosis β Comprehensive guide to tumoral calcinosis - periarticular lobulated calcific masses, hyperphosphataemic (familial GALNT3/FGF23) vs secondary (renal) disease, differential from myositis ossificans, and surgical management.
- Undifferentiated Pleomorphic Sarcoma (MFH) β High-grade pleomorphic sarcoma of soft tissue and bone, formerly malignant fibrous histiocytoma, now a diagnosis of exclusion defined by the absence of any specific line of differentiation
- Unicameral (Simple) Bone Cyst β Comprehensive guide to unicameral (simple) bone cysts in children, including the fallen-fragment sign, pathological fracture management, aspiration and steroid injection, and surgical treatment options.
- Vertebral Haemangioma β Benign vascular lesion of the vertebra, usually incidental, occasionally aggressive with epidural extension and spinal cord compression - imaging signs, classification, staging and management
General β 28 topics
- Atypical Mycobacterial Infection β Comprehensive guide to Non-Tuberculous Mycobacteria (NTM) in orthopaedic practice including M. marinum fish tank granuloma, M. avium complex, rapidly growing mycobacteria, rice body tenosynovitis, diagnosis with AFB culture and PCR, and prolonged multi-drug treatment for fellowship exam preparation
- Bone Transport Techniques β Comprehensive guide to bone transport - segmental bone defect management, distraction osteogenesis, docking site management for fellowship exam preparation
- Chronic Sclerosing Osteomyelitis of GarrΓ© β Fellowship-level guide to chronic sclerosing osteomyelitis of GarrΓ©: dense cortical sclerosis without sequestrum, its overlap with sterile autoinflammatory bone disease, tumour mimics, biopsy strategy and medical-first management.
- Deformity Analysis - CORA and MAD β Comprehensive guide to deformity analysis - mechanical axis deviation, centre of rotation of angulation, joint orientation angles and osteotomy planning
- Fungal Osteomyelitis β Comprehensive guide to fungal osteomyelitis - Candida, Aspergillus, endemic mycoses (Coccidioides, Blastomyces, Histoplasma), Cryptococcus, risk factors, diagnosis with tissue biopsy, 1,3-beta-D-glucan, and prolonged antifungal therapy for orthopaedic fellowship examinations
- Gout and Crystal Arthropathy β Comprehensive guide to gout and crystal-induced arthropathies - monosodium urate crystals, acute attacks, chronic tophaceous gout, and orthopaedic management for fellowship exam preparation
- Hydatid Disease of Bone (Skeletal Echinococcosis) β Skeletal hydatid disease β endemic parasitic osteolysis that behaves like a locally aggressive tumour, its imaging mimics, biopsy safety rules, radical excision principles and relapsing long-term course.
- Ilizarov External Fixation β Comprehensive guide to Ilizarov external fixation - circular frame principles, wire tensioning, ring construction, and applications for fellowship exam preparation
- Limb Lengthening Principles β Comprehensive guide to limb lengthening - distraction osteogenesis, Ilizarov principles, indications, techniques, and complications for fellowship exam preparation
- Lyme Disease - Musculoskeletal Manifestations β Comprehensive guide to Lyme arthritis and musculoskeletal manifestations of Borrelia burgdorferi infection - erythema migrans, migratory arthralgia, Lyme arthritis, two-tier testing, and orthopaedic management for fellowship exam preparation
- Melorheostosis β Comprehensive coverage of melorheostosis including pathophysiology, MAP2K1 mutations, dripping candle wax radiographic appearance, sclerotomal distribution, management strategies, and surgical complications for orthopaedic surgery examination preparation
- Mycetoma (Madura Foot): Orthopaedic Assessment and Management β Fellowship-level guide to mycetoma β the diagnostic triad, eumycetoma versus actinomycetoma, dot-in-circle imaging, deep biopsy, medical cure versus wide excision, and amputation thresholds.
- Necrotizing Fasciitis β Comprehensive guide to necrotising fasciitis - classification, LRINEC score, hard vs soft signs, surgical debridement, and antibiotic management for orthopaedic exam
- Orthotic Prescription Principles β Comprehensive guide to orthotic prescription including nomenclature, biomechanics, AFO types, spinal orthoses, and clinical applications
- Osteomalacia β Adult vitamin D deficiency bone disease causing defective mineralization, with orthopaedic manifestations including pathological fractures and bone pain
- Osteoporosis β Comprehensive guide to osteoporosis including diagnosis, DEXA interpretation, FRAX risk assessment, and pharmacological management.
- Prosthetic Limb Components β Comprehensive guide to prosthetic limb components - socket types (PTB, TSB, quadrilateral, ischial containment), suspension systems, knee units (single-axis, polycentric, microprocessor), prosthetic feet (SACH, dynamic response), upper limb prosthetics, K-levels for orthopaedic exam
- Pseudogout and CPPD Disease β Comprehensive guide to calcium pyrophosphate deposition disease - crystal identification, acute pseudogout attacks, chronic pyrophosphate arthropathy, and orthopaedic management for fellowship exam preparation
- Pyomyositis (Tropical Pyomyositis) β Fellowship-level guide to pyomyositis - a primary bacterial infection of skeletal muscle with intramuscular abscess formation, classically tropical and paediatric but increasingly seen in temperate climates and adults, most often caused by Staphylococcus aureus (including MRSA) - covering the three clinical stages (invasive, suppurative, late/septic), the central role of MRI in diagnosis, and management by antibiotics plus drainage/debridement of the abscess, with awareness of progression to osteomyelitis and sepsis.
- Reactive Arthritis (Reiter Syndrome) β Comprehensive guide to reactive arthritis - post-infectious seronegative spondyloarthropathy, urethritis-arthritis-conjunctivitis triad, HLA-B27 association, and orthopaedic management for fellowship exam preparation
- Renal Osteodystrophy β Comprehensive guide to renal osteodystrophy in chronic kidney disease - pathophysiology, bone disease spectrum, rugger jersey spine, fracture risk, medical and surgical management for orthopaedic fellowship exams
- Rickets β Childhood vitamin D deficiency causing defective endochondral ossification, with skeletal deformities and growth disturbance
- SAPHO Syndrome β Synovitis, acne, pustulosis, hyperostosis and osteitis β the sterile autoinflammatory bone disease that mimics infection and tumour, its anterior chest wall signature, imaging, and medical management ladder.
- Stainless Steel β Comprehensive guide to stainless steel biomaterials - 316L composition, properties and orthopaedic applications
- Tantalum β Comprehensive guide to tantalum biomaterials - trabecular metal, porous structure and clinical applications
- Taylor Spatial Frame β Comprehensive guide to the Taylor Spatial Frame hexapod system for multiplanar deformity correction - Stewart platform kinematics, mounting parameters, software planning, and clinical applications for fellowship exam preparation
- Venous Thromboembolism β Venous thromboembolism in orthopaedic practice - Virchow's triad, risk stratification (Caprini, NICE), prophylaxis protocols (mechanical vs chemical), LMWH vs DOACs vs aspirin, PE diagnosis and management, post-thrombotic syndrome, and clinical practice guidelines
- Vitamin D Deficiency β Comprehensive guide to vitamin D deficiency - pathophysiology, skeletal manifestations, rickets, osteomalacia, diagnosis, replacement protocols for orthopaedic fellowship exams
Radiology β 70 topics
- Ankle & Foot Imaging: Systematic Interpretation β Systematic approach to ankle and foot imaging including plain radiography, CT, and MRI for trauma, arthritis, osteochondral lesions, and soft tissue pathology.
- CT Imaging Principles β Comprehensive guide to CT imaging principles covering physics of acquisition, image reconstruction, Hounsfield units, radiation dose considerations, and systematic orthopaedic applications for fellowship exam preparation.
- Fluoroscopy Principles β Comprehensive guide to fluoroscopy principles covering image generation, radiation exposure, dose reduction strategies, and intraoperative orthopaedic applications for fellowship exam preparation.
- Imaging the Knee β Comprehensive guide to systematic knee imaging covering standard radiographic views, weight-bearing assessment, MRI for ligaments and menisci, and clinical applications for fellowship exam preparation.
- Imaging the Pelvis and Hip β Comprehensive guide to systematic pelvis and hip imaging covering AP pelvis assessment, Shenton line, neck of femur fracture detection, AVN staging, and hip labral evaluation for fellowship exam preparation.
- Imaging the Shoulder β Comprehensive guide to systematic shoulder imaging covering standard radiographic views, MRI sequences, rotator cuff assessment, instability imaging, and clinical decision-making for fellowship exam preparation.
- Imaging the Spine β Comprehensive guide to systematic spine imaging covering radiographic alignment assessment, MRI for disc herniation and cord compression, fracture characterisation, and red flag detection for fellowship exam preparation.
- MRI Bone Marrow Signal β Comprehensive guide to MRI bone marrow signal interpretation including normal marrow conversion, red vs yellow marrow, pathological signal patterns, and systematic differential diagnosis of marrow lesions for fellowship exam preparation.
- MRI Imaging Principles β Comprehensive guide to MRI physics including magnetic field principles, signal generation, T1 and T2 relaxation, pulse sequences, and systematic orthopaedic applications for fellowship exam preparation.
- MRI Sequences β Comprehensive guide to MRI pulse sequences used in orthopaedic practice including T1, T2, PD, STIR, GRE, and advanced techniques with clinical applications and protocol selection for fellowship exam preparation.
- Plain Radiography Principles β Comprehensive guide to plain radiography principles including X-ray production physics, image formation, systematic interpretation approaches, radiation safety, and quality optimisation for orthopaedic fellowship exam preparation.
- Radiation Safety β Comprehensive guide to radiation safety for orthopaedic surgeons covering ionising radiation biology, occupational exposure, dose limits, protection equipment, and ALARA implementation for fellowship exam preparation.
- Radiological Signs in Bone Tumours β Comprehensive guide to radiological signs in bone tumours covering aggressive vs non-aggressive features, periosteal reactions, matrix mineralisation, tumour location, and staging imaging for fellowship exam preparation.
- Radiological Signs in Paediatric Orthopaedics β Comprehensive guide to radiological signs in paediatric orthopaedics covering DDH assessment lines, SUFE Klein line, Perthes staging, Salter-Harris classification, and growth plate imaging for fellowship exam preparation.
- Radiological Signs in Trauma β Comprehensive guide to classic radiological signs in musculoskeletal trauma covering named fractures, pathognomonic signs, and pattern recognition for fellowship exam preparation.
- Trauma Imaging β Systematic approach to trauma imaging including modality selection, ATLS principles, polytrauma protocols, and imaging pitfalls in the acute setting.
- Tumour Imaging: ABCDS Approach β Systematic approach to musculoskeletal tumour imaging using the ABCDS framework, including characteristic features of common benign and malignant lesions for fellowship exam preparation.
- Arthrography Techniques β Comprehensive guide to arthrography techniques in orthopaedic imaging covering direct and indirect MR arthrography, CT arthrography, joint injection protocols, and clinical applications for fellowship exam preparation.
- Arthroplasty Imaging: Assessment & Complications β Comprehensive guide to imaging assessment of joint arthroplasty including component position, alignment, and recognition of complications such as loosening, infection, wear, and instability.
- Bone Scan Interpretation β Comprehensive guide to bone scan interpretation covering systematic reading approach, classic uptake patterns, anatomical correlation, and clinical applications in orthopaedic practice for fellowship exam preparation.
- Classic Radiological Signs: Arthritis β Collection of classic radiological signs in arthritis and inflammatory conditions including OA, RA, gout, and seronegative arthropathies.
- Contrast Agents and Safety β Comprehensive guide to contrast agents used in orthopaedic imaging covering iodinated CT contrast, gadolinium MRI contrast, allergic reactions, contrast-induced nephropathy, and safety protocols for fellowship exam preparation.
- DEXA Bone Densitometry β Comprehensive guide to DXA bone densitometry covering physics, T-score and Z-score interpretation, WHO classification, FRAX risk assessment, and clinical decision-making for osteoporosis management in fellowship exam preparation.
- Imaging in Pregnancy: Safety and Decision-Making β Evidence-based guide to imaging pregnant orthopaedic patients, covering radiation risk, modality choice, contrast use, and emergency imaging decisions.
- Imaging Musculoskeletal Infection β Comprehensive guide to systematic imaging of musculoskeletal infection covering osteomyelitis, septic arthritis, PJI, and spinal infection with modality selection and MRI interpretation for fellowship exam preparation.
- Imaging the Elbow β Comprehensive guide to systematic elbow imaging covering standard radiographic views, fat pad signs, MRI assessment, and clinical applications for fractures, ligament injury, and epicondylar pathology.
- Metabolic Bone Disease: Imaging Features β Comprehensive guide to imaging features of metabolic bone diseases including osteoporosis, Paget's disease, hyperparathyroidism, and renal osteodystrophy for fellowship exam preparation.
- MRI Cartilage Assessment β Comprehensive guide to MRI cartilage assessment including optimal sequences, grading systems, cartilage repair monitoring, and clinical decision-making for fellowship exam preparation.
- MRI Contraindications and Implants β Comprehensive guide to MRI safety in patients with orthopaedic and non-orthopaedic implants, covering absolute and relative contraindications, MRI-conditional labelling, and artefact reduction strategies for fellowship exam preparation.
- MRI Soft Tissue Interpretation β Guide to MRI interpretation of soft tissue structures including muscles, tendons, ligaments, and soft tissue masses with signal characteristics and pathological patterns.
- Nuclear Medicine β Comprehensive guide to nuclear medicine imaging in orthopaedics covering bone scintigraphy, three-phase bone scan, PET-CT, labelled white cell scans, and clinical applications for infection, tumour, and metabolic bone disease evaluation.
- Paediatric Imaging Principles β Comprehensive guide to paediatric imaging principles covering radiation safety, ALARA, modality selection for the growing skeleton, ossification centre assessment, and age-appropriate imaging protocols for fellowship exam preparation.
- Ultrasound in Musculoskeletal Practice β Comprehensive guide to musculoskeletal ultrasound covering physics, transducer selection, systematic examination technique, common orthopaedic applications, and ultrasound-guided interventions for fellowship exam preparation.
- Wrist & Hand Imaging: Systematic Interpretation β Systematic approach to wrist and hand imaging including plain radiography, CT, and MRI for trauma, carpal instability, and soft tissue pathology.
- Labelled White Cell Scanning for Infection β Evidence-based guide to labelled white cell scintigraphy for osteomyelitis and prosthetic joint infection, including protocol, interpretation, and limitations.
- MRI Metal Artefact Reduction (MARS) β Comprehensive guide to MRI metal artefact reduction techniques for imaging patients with orthopaedic implants including MARS sequences, protocol optimisation, and clinical applications.
- PET-CT in Orthopaedic Oncology β Guide to PET-CT applications in orthopaedic oncology including staging, treatment response assessment, and detection of recurrence for fellowship exam preparation.
- Weight-Bearing CT: Principles & Applications β Evidence-based guide to weight-bearing CT in orthopaedics, covering technique, indications, systematic interpretation, and current foot-and-ankle applications.
- 3D Printing from Imaging: Surgical Planning β Guide to 3D printing applications in orthopaedic surgery including patient-specific models, surgical guides, and custom implants derived from imaging data.
- Acro-osteolysis β Pattern and differential for acro-osteolysis: distinguishing tuft from band-like resorption, and the discriminators separating scleroderma, psoriasis, hyperparathyroidism, neuropathy and PVC exposure.
- AI in Orthopaedic Radiology β Overview of artificial intelligence applications in orthopaedic radiology including fracture detection, arthroplasty planning, and image analysis for fellowship exam awareness.
- Anterior Vertebral Beaking β Pattern and differential for anterior vertebral beaking on lateral spine radiographs: central versus inferior beak, dysostosis multiplex, hypothyroidism and the discriminators that separate them.
- Arthritis on Radiographs β Pattern-based approach to arthritis on plain films: distribution, erosions, joint space, bone density and new bone formation as the discriminators between the arthritides.
- Bone-in-Bone Vertebra β Pattern and differential for the bone-in-bone (vertebra within a vertebra) sign: physiological neonatal, bisphosphonate therapy, osteopetrosis, growth arrest and the mimics.
- Chondrocalcinosis β Pattern and differential page for chondrocalcinosis: how to confirm cartilage calcification, discriminate CPPD from haemochromatosis, hyperparathyroidism and gout, and what to test next.
- CT Physics, Radiation Dose & Hounsfield Units β Fellowship-level guide to the physics of computed tomography for the orthopaedic surgeon - how a rotating X-ray tube and detectors reconstruct cross-sectional images from attenuation data, the Hounsfield (CT-number) scale referenced to water and air with windowing, the key acquisition parameters (kVp, mAs, pitch, slice thickness) and how they trade image quality against radiation dose, dose metrics (CTDIvol, DLP, effective dose) and the ALARA principle - with the practical message of low-dose protocols, harmonisation and protecting young patients/women of childbearing age.
- Describing a Bone Tumour Radiograph β A pattern-and-differential approach to the bone lesion radiograph: Lodwick grade, zone of transition, periosteal reaction, matrix and site β with the discriminator for each cause.
- Diaphyseal Bone Lesion β Pattern and differential for a lesion centred on the shaft of a long bone: how to describe it, the discriminators that separate each cause, and the next test.
- Epiphyseal Bone Lesion β Pattern and differential for a lucent lesion centred on the epiphysis or subarticular bone: age-based discriminators, must-not-miss causes and the next investigation.
- Erlenmeyer Flask Deformity β Pattern and differential for the Erlenmeyer flask deformity: how to confirm the sign, the discriminators that separate Gaucher, thalassaemia, osteopetrosis and Pyle disease, and the next test.
- Generalised Osteopenia β Pattern and differential for generalised osteopenia on radiographs: separating osteoporosis from osteomalacia, hyperparathyroidism, myeloma and marrow infiltration by discriminating features.
- Generalised Osteosclerosis β Pattern and differential for diffusely dense bones on radiograph: how to confirm true generalised sclerosis, the discriminators separating myelofibrosis, sclerotic metastases, renal osteodystrophy and osteopetrosis.
- Ivory Vertebra: Pattern and Differential β A single diffusely sclerotic vertebral body β how to confirm the sign, separate metastasis from lymphoma from Paget's disease, and choose the next investigation.
- Lucent Bone Lesion β Pattern and differential for the lucent (radiolucent) bone lesion: how to describe it, the FEGNOMASHIC differential with real discriminators, and how to narrow by age, site and zone of transition.
- Lytic Lesion with a Sclerotic Rim β Pattern and differential for a lytic bone lesion with a sclerotic margin: how to confirm a genuine narrow zone of transition, the discriminators for each cause, and when to stop imaging.
- MRI Neurography: Peripheral Nerve Imaging β Guide to MRI neurography for peripheral nerve imaging including techniques, normal anatomy, and pathological patterns for fellowship exam preparation.
- Multiloculated (Bubbly) Bone Lesion β Pattern-based approach to the multiloculated soap-bubble bone lesion: discriminators for ABC, GCT, NOF, chondromyxoid fibroma, fibrous dysplasia and telangiectatic osteosarcoma.
- Periosteal Reaction Patterns β How to read periosteal reaction on plain film: continuous versus interrupted, Codman triangle, onion-skin and sunburst, and the differential each pattern generates.
- Platyspondyly β Pattern and differential for platyspondyly: how to confirm flattened vertebrae, discriminate universal from focal forms, and the imaging that separates dysplasia from malignancy.
- Polyostotic Bone Lesions β Pattern and differential for multiple bone lesions: metastases, myeloma, fibrous dysplasia, Langerhans cell histiocytosis, enchondromatosis and infection, with the discriminator for each.
- Predicting Bone Tumour by Age β Age is the single most powerful discriminator in bone tumour radiology. A pattern page for generating and narrowing a lesion differential by decade, site and matrix.
- Regional (Local) Osteopenia β Pattern and differential for regional osteopenia on radiographs: disuse, CRPS, transient osteoporosis, infection, inflammatory arthritis and permeative tumour, with discriminators.
- Schmorl Node β Pattern and differential for the Schmorl node β vertebral endplate depression on radiograph and MRI, how to confirm it, and how to separate benign herniation from infection, metastasis and fracture.
- Sclerotic Bone Lesion β Pattern and differential for the sclerotic bone lesion: bone island vs osteoblastic metastasis vs osteosarcoma, with discriminators, algorithm and viva scenarios.
- Sclerotic Cortical Lesion β Pattern and differential for a sclerotic cortical bone lesion: discriminators separating osteoid osteoma, stress fracture, Brodie's abscess, adamantinoma and cortical osteosarcoma.
- Small Round Blue Cell Tumours of Bone β Pattern and differential page for the small round blue cell tumour of bone: Ewing sarcoma, lymphoma, metastatic neuroblastoma, LCH and osteomyelitis, with the discriminator for each.
- Soft-Tissue Calcification versus Ossification β A pattern-based approach to distinguishing soft-tissue calcification from heterotopic ossification on radiographs, with discriminators for each cause and the next test that changes management.
- SPECT-CT Applications β Comprehensive guide to SPECT-CT in orthopaedics covering technology principles, clinical applications for arthritis, prosthetic assessment, infection, and tumour evaluation for fellowship exam preparation.
- Ultrasound Physics (Principles, Transducers, Doppler & Artefacts) β Fellowship-level guide to the physics of diagnostic (musculoskeletal) ultrasound - high-frequency sound generated by a piezoelectric transducer, the pulse-echo principle and the fundamental frequency-resolution-penetration trade-off, image modes (A/B/M-mode) and Doppler (colour, power, spectral), and the common artefacts (anisotropy, acoustic shadowing, posterior enhancement, reverberation, mirror image) - emphasising how recognising artefacts (especially anisotropy) avoids misdiagnosis and how to optimise the image, for the orthopaedic exam.
- Vertebra Plana β Pattern and differential for vertebra plana: how to confirm complete vertebral body collapse, discriminate LCH from malignancy and infection, and choose the next investigation.
Infection β 3 topics
- Antibiotic Pharmacology and Resistance Mechanisms (incl. Biofilm) β Fellowship-level guide to antibiotics for the orthopaedic surgeon: the major classes by mechanism (cell wall, protein synthesis, DNA/RNA, folate), bactericidal vs bacteriostatic and concentration- vs time-dependent killing, the mechanisms of bacterial resistance (enzymatic, target modification, efflux, reduced uptake), and the central role of BIOFILM tolerance in periprosthetic joint infection and osteomyelitis - with rifampicin's biofilm penetration.
- Septic Bursitis (Olecranon / Prepatellar) β Fellowship-level guide to septic bursitis of the superficial olecranon and prepatellar bursae: the distinction from septic arthritis and from non-septic bursitis, the role of bursal aspiration (Staph aureus predominates), and the evidence that most cases resolve with antibiotics alone - with surgery reserved for abscess, foreign body or failed medical therapy.
- Tuberculous Arthritis (Peripheral Joint TB) β Fellowship-level guide to tuberculous arthritis of peripheral joints (hip and knee most common): the indolent granulomatous monoarthritis, the Phemister radiographic triad, the diagnostic value of synovial biopsy/culture/PCR, the anti-tuberculous chemotherapy mainstay with adjunctive surgery, and the destructive sequelae (ankylosis) distinguishing it from pyogenic septic arthritis.
Professionalism & Ethics β 15 topics
- Communication, Teamwork and Crew Resource Management β Crew resource management for the orthopaedic operating theatre β the principles drawn from aviation, closed-loop communication, briefings and the WHO Surgical Safety Checklist, speaking up across the authority gradient, and the legal and ethical duties that good teamwork discharges.
- Conflicts of Interest and Industry Relationships β How the orthopaedic surgeon recognises, discloses and manages financial and non-financial conflicts of interest β from industry gifts and consulting to royalties, equity and research sponsorship β so that patient welfare and scientific integrity remain the primary interest.
- Core Bioethics Principles in Orthopaedic Practice β The four-principles framework β autonomy, beneficence, non-maleficence and justice β that frames every ethical decision in orthopaedic practice, how those principles conflict at the operating table, and the legal and professional standards (Montgomery, Bolam, the WHO checklist) examiners expect you to apply.
- Decision-Making Capacity, Surrogates and End-of-Life β The legal and ethical framework for capacity, surrogate decision-making and end-of-life care as it applies to orthopaedic practice β from the four criteria of capacity and best-interests reasoning to advance directives, withholding versus withdrawing treatment, and applying it all to the demented hip-fracture patient.
- Disclosure of Complications and Adverse Events β Open disclosure and the duty of candour for orthopaedic surgeons β how to tell a patient when a complication or error has caused harm, deliver a sincere apology, document the facts, and learn from the system rather than the individual. Framed by Montgomery, the GMC duty of candour and Reason's system approach to error.
- Informed Consent and Shared Decision-Making β The elements of valid consent, the material-risk standard (Montgomery), and shared decision-making β with the framework an examiner wants for emergencies, minors, and patients who lack capacity.
- Medical Error, Root-Cause Analysis and Quality Improvement β How orthopaedic surgeons classify medical error, learn from it through root-cause analysis and mortality-and-morbidity review, and close the loop with quality-improvement cycles β framed by just culture and the legal duties of candour and consent.
- Medicolegal Principles and Negligence β The legal framework a surgeon must understand when a patient is harmed: the four elements of negligence, the Bolam and Bolitho standard of care, and the Montgomery shift to patient-centred consent. Covers what defensible documentation and communication look like.
- Patient Safety and Wrong-Site Surgery Prevention β Wrong-site surgery β operating on the wrong patient, side, site, level or procedure β is a wholly preventable never event. This page covers the Universal Protocol and WHO Surgical Safety Checklist that prevent it, the human-factors science (Reason's Swiss cheese model) that explains why safeguards fail, and the consent and duty-of-candour law (Bolam, Bolitho, Montgomery) that frames professional accountability.
- Professional Boundaries, Confidentiality and Social Media β The fiduciary duty of confidentiality, the professional boundaries that protect the doctor-patient relationship, and the rules for using social media without breaching either. Covers the legal framework (Bolam, Bolitho, Montgomery), when disclosure is permitted or required, dual relationships, and the global codes (GMC, AAOS, WMA) examiners expect you to apply.
- Research Ethics and Integrity β The principles, codes and legal duties that govern ethical research in orthopaedic surgery β the Declaration of Helsinki, ethics-committee approval, valid informed consent, equipoise, research misconduct, and the ICMJE rules of authorship and publication β and what fellowship examiners expect you to know and, more importantly, to do.
- Systems-Based Practice and Safety Culture β How high-reliability organisations, just culture, incident reporting and the second-victim phenomenon apply to orthopaedic surgery β the systems-thinking framework an examiner wants, alongside the legal and professional standards (Montgomery, Bolam/Bolitho, WHO checklist, Helsinki, GMC, AAOS) that frame safe practice.
- The Impaired or Disruptive Colleague β How to recognise and respond to an impaired or disruptive colleague β the duty to act, the framework an examiner wants, escalation pathways, fitness to practise and protecting patients. A professionalism and patient-safety topic.
- Transitions of Care and Safe Handover β How professional responsibility is transferred between clinicians and the structured tools β ISBAR/SBAR, I-PASS, closed-loop communication, the WHO Surgical Safety Checklist β that prevent patients from falling through the gaps at shift change, transfer, the perioperative handover, and discharge.
- Value-Based Care and Resource Stewardship β How orthopaedic surgeons deliver the right care at the right cost β the value equation of outcomes over cost, appropriate-use and Choosing Wisely, registry-based measurement, and the justice of allocating scarce theatre time, implants and investigations fairly.