OA Knee FAQs
Osteoarthritis (OA), the most
common form of arthritis, is a
chronic, degenerative, joint
disease that affects mostly
middle-aged and older adults. It is characterised by the breakdown of joint cartilage and adjacent bone. Several risk factors are associated with osteoarthritis, including: heredity, obesity, injury, and overuse. Knee osteoarthritis is not curable, but manageable. There are several specific treatments for osteoarthritis and they are chosen based on: your age, overall health, and medical history, extent of the condition, your tolerance for specific medications, procedures, and therapies, expectation for the course of the condition, and your opinion or preference.
A colonoscopy is an examination of
the inside lining of the large
bowel. Any abnormalities will be
visualised on the monitor screen.
Small polyps are usually removed at the same time, or biopsies of large polyps, tumours or inflammation will be taken for further evaluation. It is recommended to undergo colonoscopy at age of 50, or if you have symptoms like bleeding from the back passage, persistent abdominal pain, change in bowel habits, unusual diarrhoea, etc.
The New Concept and the Latest Advances in Stroke Management
The old concept of
‘Cerebrovascular Accident” is
recently replaced by the new
concept of “Brain Attack”. Just
like heart attack, brain attack is also an acute cardiovascular disease. Both heart attack and brain attack are of similar aetiologies. Vascular Neurosurgeon also prefers Percutaneous Cerebral Intervention (Neuro-PCI), rather than iv rtPA. The Neuro-PCI has to be performed within 8 hours after symptom onset. This is thus the new Golden-8-hours Concept for brain attack.
Scoliosis: a common condition which is frequently misunderstood
Scoliosis, being one of the most
prevalent back deformities
affecting growing children, with
potentially dire consequences,
stirs notable anxiety among patients and their families. There are three common types of scoliosis that affect children: idiopathic scoliosis, congenital scoliosis, and neuromuscular scoliosis. Three evidence-based treatment options include: Observation, Brace treatment, and surgery. Surgery for scoliosis has been made very safe by major advances in surgical techniques including surgical navigation and the use of intraoperative spinal cord monitoring.
Investigations for Colorectal Cancers
Colorectal cancers (CRC) are among
the most common cancers in
developed countries. In Hong Kong,
1,981 people died from CRC in 2013
. These deaths are unnecessary as we now know CRC are largely “preventable”! Most of the CRC in fact develop from adenomatous polyps. So early detection and removal of the polyps would have prevented the disease. The key question is how these polyps and early cancers can be detected and when should the tests be done.
Lumbar Disc Replacement FAQs
The ‘intervertebral discs’ are
the shock absorbers between the
bones of the spine. Unfortunately,
they often degenerate – tearing,
bursting, or just wearing out. They can cause back or neck pain.
The low back is known as the ‘lumbar’ region.
The usual treatment is rest and painkillers, followed by core muscle (Pilates) exercises. If pain is a problem despite this treatment, one option is to have an operation.
Fusion operation is the conventional approach. In a fusion, some or all of the disc is removed and replaced with bone, which joins to the bones above and below the disc together.
It is the gold standard for comparing all other operations, including the new operation of lumbar disc replacement.
Clavicle Fracture FAQs
Fractures of the collar bone
(clavicle) are common and seen in
all age groups. Most are due to a
fall onto the shoulder. Clavicle
fractures are divided into medial, mid-shaft and lateral fractures, in which mid-shaft are the most common (80%). Non-operative treatment has traditionally been the norm for treating mid-shaft, operative treatment is indicated for severely displaced, comminuted ('shattered') fractures, especially if associated with high-energy trauma. Almost all displaced lateral clavicle fractures should be operated, as they have a very high rate of non-union, and the non-unions are very difficult to treat. Medial clavicle fractures are not very common (2%).
Treatment of Cervical Disc Hernia or Degeneration
Cervical disc hernia with spinal
cord or nerve root compression is a
common disease. It is common
younger population including those
without special risk factors. Surgical treatment has good outcomes if conservative treatment fails. The surgical risk is not high. There are newer technology to overcome the problem of the past in reducing the surgical risk and speeding recovery. First line treatment for most cervical disc problems is pain control and physical therapies. Second line treatment includes injections and radiofrequency neurotomy. If this approach fails, or if there is significant neurological deficit, surgical treatment is appropriate.
Achilles Tendinopathy FAQs
Achilles tendinopathy refers to
diseases of the Achilles tendon,
which often caused by degenerative
problems with combination of
intrinsic and extrinsic factors. This article will focus on non-insertional Achilles tendinopathy. Non-operative treatments are often preferred over conservative treatment which echoes the histological evidence of a degenerative disease process that has poor capacity for healing.
Investigation of a New Breast Symptom: A Guide for Family Physicians
The National Breast Cancer Centre
(NBCC) of Australia has developed
this guide to maximise the
effectiveness of investigation of
women who present to their family physician with a new breast symptom. The triple test approach is the recommended approach to maximise diagnostic accuracy in the investigation of breast changes, which includes the following components: medical history and clinical breast examination, imaging – mammography and/or ultrasound, non-excision biopsy – fine needle aspiration (FNA) cytology and/or core biopsy. Ultrasound and/or mammography should be conducted regularly from the age of 25.