Summer Giveaway
Dear Friend,
Hope you have been enjoying the sunshine this week. This week, I give my greetings from China – my summer holidays have officially started.
To celebrate the end of my on-calls, my publishers are running another GIVEAWAY – a chance to win a free copy of my textbook, “The Revision Guide to Core Clinical Medicine.” This textbook has sold over 300 copies and received great reviews online. It is designed for medical students and junior doctors, and can be used in preparation for the MSRA and MRCP.
For a chance to win a free copy of my medical textbook, The Revision Guide to Core Clinical Medicine. All you have to do is the following:
- Follow the In2Med Instagram page – @in2meduk
- Like the Summer Giveaway Post
- Tag 3 of your friends
- (Bonus entry if you also share the post on your story)
The deadline to enter is June 29th. And the winner will be announced on June 30th
That’s all from me this week.
Drug of the week
Doxazosin
Doxazosin is a medication used to treat symptoms of benign prostatic hyperplasia, hypertension, and post-traumatic stress disorder.
It is an alpha -1-selective antagonists, which lead to vasodilation.
They do not cause a reflex tachycardia but can contribute to postural hypotension.
A Brain Teaser
A 13-year-old girl presents to clinic with right knee pain. She is a keen hockey player but has had no recent injuries. On examination there is a painful swelling over the tibial tubercle.
What is the most likely diagnosis?
A: Chrondomalacia patellae
B: Osteosarcoma
C: Osgood-Schlatter disease
D: Osteochondritis dissecans
E: Juvenile idiopathic arthritis
Answers
The answer is C – Osgood-Schlatter disease
The correct answer is Osgood-Schlatter disease. This condition is a common cause of knee pain in growing adolescents, typically aged between 10 and 15 years old. It is an inflammation of the area just below the knee where the tendon from the kneecap (patellar tendon) attaches to the shinbone (tibia). The symptoms usually include pain and swelling over the tibial tubercle, which can be exacerbated by physical activity such as hockey. The condition tends to resolve itself with time, once the child has stopped growing.
Chondromalacia patellae, often called ‘runner’s knee,’ is a condition where the cartilage on the undersurface of the patella (kneecap) deteriorates and softens. This condition is most common among young athletes but can also occur in older adults who have arthritis of the knee. However, it would not typically present with swelling over the tibial tubercle.
Osteosarcoma is a type of bone cancer that often affects teenagers. While osteosarcoma can occur in any bone, it most commonly affects longer bones like those in arms and legs near growth areas (metaphysis), including around the knees. However, this condition would normally present with more systemic symptoms such as weight loss or fever and not just localised pain and swelling.
Osteochondritis dissecans involves a loss of blood supply to a part of bone underneath a joint surface which leads to small fragments of bone and cartilage loosening and causing pain. It occurs most commonly in children and adolescents who are highly active in sports. Although this could potentially affect her age group, Osgood-Schlatter disease fits her presentation better as Osteochondritis dissecans often causes joint effusion which isn’t reported here.
Finally, Juvenile idiopathic arthritis could theoretically cause these symptoms but it generally presents with more prolonged stiffness after rest or upon awakening; other joints are usually involved too such as hands or feet – not solely one knee.
Therefore based on this girl’s age, symptoms, lack of recent trauma or injury history, and her involvement in sports activities; Osgood-Schlatter disease remains the most likely diagnosis.
