The ‘Unwilling or Unable’ Test: Has it Been, and Could it be, Accepted?

Could it be Lyme neuroborreliosis?

Aortic Dissection or MI? It could be both

Acute aortic dissection is a potentially lethal vascular emergency that involves the rapid development of a false blood channel within the media of the aorta. If left untreated, approximately 50% of patients die in the first 48 hours, and the mortality rate increases by 1% to 3% per hour [1,2]. Despite recent advances in diagnostic methods, misdiagnosis occurs in 25%-50% of patients on initial ...

It is NOT the gastrocnemius, soleus, or Achilles …. What could it Be? A plantaris muscle injury.

The plantaris muscle originates from the lateral supracondylar line of the femur in the posterior of the knee and courses distally in an inferomedial direction near the medial head of the gastrocnemius and along themedial border of the Achilles tendon. The tendon of the plantaris muscle either inserts with the Achilles tendon or can have its own independent insertion on the calcaneus (4). The m...

Could it be a secondary hypertension?

• No family history of hypertension in a thin child • Age younger than 10 years and prepubertal stage • Acute rise in blood pressure previously normal • Severe hypertension (SBP/DBP ≥ 99th percentile plus 5 mmHg) • Mild hypertension (SBP/DBP ≥ 95th percentile plus 5 mmHg) in systemic disease • Nocturnal hypertension, reduced nocturnal dipping or diastolic hypertension at 24-hour BP monitoring •...

Chronic heel pain: It could be tuberculosis.

INTRODUCTION Heel pain is a common presentation at a primary care setting. The majority of these cases are benign and self limiting in nature. Common differential diagnoses include plantar fasciitis and peroneal muscle sprains. However, certain conditions-if undetected early-may cause significant morbidity to the patient. A high index of suspicion and early referral for further investigations a...