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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.

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.

Stroke Prevention and Management

Stroke is a leading cause of death
worldwide and the commonest cause
of permanent disability in adults.
The death and disability from
stroke is expected to increase in Hong Kong as the population rapidly ages in coming decades. This article highlights the need to reduce the local burden of stroke through the screening of individuals for stroke risk management and through ensuring a prompt and effective treatment response after stroke onset.

Colonoscopy FAQs

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.

Diagnosis of Low Back Pain FAQs

Accurate diagnosis of back pain
isn’t always easy. The human
spine is very complex, so it can be
difficult to pinpoint the exact
cause of low back pain or other symptoms. Additionally, other factors, like depression, anxiety, or stress, can contribute to the symptoms of back pain. MRI scanning is safe and produces outstanding images of the spine, but, unfortunately, it doesn’t show ‘pain’, therefore, in more complex cases of back pain it can often be very helpful to inject X-ray dye and local anaesthetic into the back to identify, and in some cases, treat, the painful structures.

Hallux Rigidus FAQs

Hallux Rigidus is describing the
degeneration of the joint at the
base of the big toe – called
metatarsophalangeal, or MTP joint.
It is the most common site of arthritis in the foot region. It is usually develops in adults at the ages between 30 and 60 years. No exact cause is agreed so far. There are numerous non-surgical treatments and surgical treatments, which is chosen based on the severity.

Interventional Pain Management

Pain is a multidimensional
experience. Chronic pain differs
from acute pain in that it lasts
for more than 3-6 months, and there
may not be obvious tissue injury leading to the pain. The pathway leading from stimulus to perception may be sensitised. There is often associated depression. Management of chronic pain therefore requires a holistic multi-disciplinary approach. In addition to pharmacological treatment, psychosocial support, physiotherapy and operative treatment, interventional techniques may benefit some patients by defining the pain generator and offers prolonged relief.

OGD FAQs

OGD is the examination of the
oesophagus, stomach and duodenum
by a gastroscope, which has its own
camera lens and light source. It
is most often used to evaluate symptoms of indigestion such as upper abdominal pain, nausea, vomiting or swallowing difficulty. It can also be used to look for the cause of bleeding from the upper gastrointestinal tract. OGD also allows your doctor to obtain biopsies from the lining of the upper gastrointestinal tract for laboratory testing. OGD can even be used to remove polyps (usually benign growths) or treat bleeding.

Is it really frozen shoulder?

Shoulder pain is commonly labelled
as 'frozen shoulder'. Frozen
shoulder affects about two percent
of the general population. It
commonly affects people between the ages of 40 and 60 years, with no clear predisposition based on sex and arm dominance. Frozen shoulder is a poorly understood condition characterised by inflammation within the shoulder joint with progressive tightening and thickening joint capsule, giving rise to pain and reduced range of motion. The cardinal sign of frozen shoulder is loss of external rotation. The natural history of frozen shoulder typically goes through three phases: 'freezing' phase, 'frozen' phase, and 'thawing' phase.

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.