Wrist and distal forearm x-ray
Radiograph of the wrist showing fracture of the distal radius with dorsal angulation (Colles’ fracture). The reverse would constitute a Smith’s fracture. Radiograph of the right hand showing a widening…
Foot and ankle x-ray
DP and oblique x-rays of a normal foot, with normal alignment lines and review areas. Line A shows the medial margin of the second MT lining up with the medial…
Examination of the carotid artery
A longitudinal carotid endarterectomy scar is placed on the anterior aspect of the sternocleidomastoid muscle. The middle of the incision is situated at the level of the carotid bifurcation, which…
Facial x-ray
Mandible radiograph showing an oblique fracture of the left mandible at the angle (arrow). Examination notes What are the three McGrigor’s lines? Line 1 Upper lines: zygomaticofrontal sutures (laterally), upper…
Principles of surgical practice
Principles of diagnosis How is a diagnosis reached? Three steps: 1. History taking 2. Physical examination 3. Investigations Differential diagnoses How can a differential diagnosis be made? A logical differential…
Examination of the ear
Down’s syndromeAchondroplasiaTurner’s syndromeSee aboveSensorineural hearing loss (SNHL),SNHL, low hairline, webbed neckTall statureMarfan’s syndromeMixed hearing loss, arachnodactylyChanges in skin – loss of pigmentation – café-au-lait spots – depigmented patchesAlbinismNeurofibromatosis type 2VitiligoSNHLBilateral…
Examination of the heart and great vessels
Common scars in cardiac surgery: (A) median sternotomy scar; (B) three chest drain scars associated with cardiac surgery (one draining the pericardial space and one in each pleural cavity); (C)…
Examination of the scrotum
What are the causes of a scrotal mass? Scrotal mass (by pathology) Congenital: hydrocoele, epididymal cyst Inflammatory/infective: epidiymo-orchitis, scrotal abscess
Pelvis and hip x-ray
AP radiograph of the pelvis, summarising the lines to review when excluding subtle fractures: sacral arcuate lines, iliopectineal line (sciatic notch, along superior pubic ramus to symphysis pubis), ilioischial line…
Examination of an abdominal aortic aneurysm
What are the differences between a normal palpable aorta and an aneurysmal aorta? A normal aorta is pulsatile (displaces palpating hands vertically), whilst an aneurysmal aorta is expansile (displaces hands…
