Important knowledge

⚡️Humerus # association ▪︎greater tuberosity # ...... anterior shoulder dislocation ▪︎lesser tuberosity # ....... posterior shoulder dislocation

⚡️ the most common type of Salter-Harris fracture is type 2

GIANT-CELL TUMOUR ▪︎benign ▪︎Age: adult ▪︎Site : end of a long bone eccentrically ▪︎Mx : curettage & bone graft or cement

ANEURYSMAL BONE CYST ▪︎benign ▪︎Age : young adults ▪︎site : metaphysis ( trabeculated) ▪︎Mx: curettage & bone graft or cement (carefully )

SIMPLE BONE CYST ▪︎benign ▪︎Age : children ▪︎Site : metaphysis of long bones (common in proximal humerus & femur) ▪︎presentation : asymptomatic & rarely pathological fracture ▪︎Mx : follow up or curettage & bone graft if enlrging or pathological fracture

OSTEOCHONDROMA (CARTILAGE-CAPPED EXOSTOSIS) ▪︎benign (with malignant potential ) ▪︎site : metaphysis as exostosis (multiple if hereditary) of 1- fast-growing ends of long bones 2- the crest of the ilium. ▪︎Mx :asymptomatic = follow up Symptomatic = excision

CHONDROMYXOID FIBROMA ▪︎benign ▪︎Age : adolescents & young adults. ▪︎site :eccentrically in the metaphysis ▪︎Mx : curettage & bone graft

CHONDROBLASTOMA ▪︎benign ▪︎age : children ▪︎site : epiphysis ( proximal humerus, femur or tibia ) ▪︎Mx : curettage & bone graft

ENCHONDROMA ▪︎benign ( low risk of Ca change) ▪︎Age: Adult ▪︎presentation : incidentally , pathological fracture ▪︎Site: junction of metaphysis and diaphysis of metacarpals , metatarsals ,phalgess (hand&foot) ▪︎Mx : curettage & bone graft or cement (only follow up for asymptomatic)

OSTEOBLASTOMA (GIANT OSTEOID OSTEOMA) ▪︎benign >1cm ▪︎presentation: as osteoid osteoma (night pain relive by aspirin) ▪︎site: spine & flat bones. ▪︎Mx :wide excision & bone grafting

OSTEOID OSTEOMA ▪︎ benign ▪︎Age : children & adolescent ▪︎ presentation: pain at night & relieved aspirin ▪︎ site : diaphysis / cortex of long bone ▪︎ Mx : marginal or wide excision

Asymptomatic Gallstones Need Only Follow Up By U/S , But What’s The Indication For Cholecystectomy In Asymptomatic Gallstones ? = Prophylactic Cholecystectomy 1- Diabetic Patients 2- Vagotomy 3- Bariatric Sx 4- Hemato. Diz. Like Spherocytosis / SCA 5- Typhoid Carrier Pt. 6- Incidentally found during sx 7- Large stone >3cm 8- Stone in CBD 9- Gallbladder Polyps >1cm diameter 10- Risk of CA 11- Calcification of wall ( Porcelain ) 12- Liver Transplant pt. 13- some ethinic groups with high index of malignancy

⚡️Causes of retrograde ejaculation -‐----------------------- ▪︎alpha blocker using in BPH ▪︎total prostatectomy in prostate Ca ▪︎DM pt. due to autonomic neuropathy

⚡️Hematospermia (Blood with ejaculation) ------------------------ ▪︎young = benign resolve spontaneously ▪︎orderly = suspects prostate ca (send PSA )

Causes of SPLENIC ATROPHY: -sickle cell anaemia -coeliac disease جاي امسيكيو العام

⚡️Struvite stones = MAP stone = infection stone = staghorn stone

⚡️reduction in stool frequency is not always a sign of improvement in patients with severe UC