DEXA – The key to diagnosing osteoporosis

6th June 2024, NIA Diagnostic Imaging

DEXA (Dual-Energy X-ray Absorptiometry), is a non-invasive, quick and simple medical imaging modality used to measure bone mineral density (BMD). It is highly effective in diagnosing osteoporosis or osteopenia, hence enabling managing clinicians to assess the extent of bone loss for their patients. It is considered the “gold standard” by the World Health Organisation (WHO) and is the most accurate and inexpensive test to diagnose osteoporosis.…

Coronary CT Angiogram – should we be ordering more?

10th June 2024, A/Prof Chee L Khoo

coronary CT angiogram

Identification of individuals at high risk of atherosclerotic cardiovascular events is actually quite challenging in practice. There are many predictive algorithms which try to assess the cardiovascular risk of an individual. These scoring systems are based on the traditional risk factors that we all know well – lipids, smoking, hypertension, diabetes, family history of atherosclerotic cardiovascular disease (ASCVD), age and gender but unfortunately, we still don’t fully understand an individual’s susceptibility to the atherogenic vulnerability.…

Muscle loss with weight loss – is there a drug for it?

10th June 2024, A/Prof Chee L Khoo

muscle weakness

There will always be a certain degree of fat free mass (i.e. muscle) loss with any weight loss. While the makers of the GLP1/GIP agonists will tell you that overall, there is more fat loss than muscle loss, it is still a concern for the long term health of patients who lose muscles which may not be restored.…

Breast Imaging at Spectrum Medical Imaging

31st May 2024, Spectrum Medical Imaging

When you have to further investigate any breast conditions including breast lesions, the imaging modalities can be many. You want to refer a patient to a radiology service which can offer a whole array of imaging modalities. Spectrum Medical Imaging is the first practice for breast screening in NSW to offer personalised risk assessment and screening recommendations.…

Testosterone replacement – is it cardio safe?

31st May 2024, A/Prof Chee L Khoo

Testosterone Replacement

It’s coming to almost 10 years now when suddenly, we were not able to prescribe testosterone replacement therapy (TRT) to men with hypogonadism or low testosterone levels under the PBS. This came on the back of a decision by the US FDA in March 2015 to restrict the prescription of TRT (1).…

The 4th Pillar in treatment of CKD

31st May 2024, A/Prof Chee L Khoo


Renin-angiotensin system (RAS) inhibitors and SGLT2 inhibitors have been the cornerstone treatment of chronic kidney disease (CKD) for many years now. They have been shown to protect kidneys and at the same time reduce adverse cardiovascular outcomes. Finerenone was recently shown to do the same. These three agents are now the guideline-directed three pillars in the treatment of CKD.…

Paediatric ultrasound – developmental hip dysplasia

12th May 2024, NIA Diagnostic Imaging

Developmental dysplasia of the hip (DDH) stands out as one of the most prevalent musculoskeletal disorders manifesting in neonates and infants (Charlton et al., 2017). Owing to the dynamic potential for hip remodelling, hip dysplasia at birth may either resolve spontaneously or progress as the child grows (Loh & Wollett, 2021). DDH encompasses a spectrum of hip conditions, including abnormal acetabular development and hip dislocation causing disruption to the typical alignment of the femoral head and acetabulum as a stable ball-and-socket joint (Landes, 2011).…

Colchicine to reduce CVD – is it prime time yet?

12th May 2024, A/Prof Chee L Khoo


We are used to using colchicine for acute treatment of gout but colchicine has also proven itself a key pharmacotherapy in the treatment of cardiovascular conditions such as pericardial disease (1), post-operative atrial fibrillation (2) and coronary artery disease (3). Colchicine disrupts the inflammatory response in acute gout but the inflammatory pathways that colchicine acts on are also found in other inflammatory diseases including coronary artery disease.…

Omega-3 supplements in pregnancy for leaner kids?

11th May 2024, A/Prof Chee L Khoo

Omega-3 supplements?

I recall reading somewhere that increasing fish intake during pregnancy results in leaner offsprings. It all makes sense as we know that ω-3 fatty acid (ω-3 FA) is beneficial for adults (also read somewhere). It must be good for babies then. Is there data on those claims? Well, sort of. We shall look into them.…

Which risk factors in T2D increase infection risk?

27th April 2024, A/Prof Chee L Khoo

glucose variability

We know that suboptimal HbA1c increases the risk of micro and macrovascular complications in people with diabetes. We also know that suboptimal HbA1c increases infection risks in these people. There is increasing evidence that glucose variability is a potent predictor of complications. There are two ways to look at glucose variability – day to day variation as seen on continuous glucose monitoring and variability in HbA1c measured over years.…

Ankle BP may predict future peripheral artery disease

27th April 2024, A/Prof Chee L Khoo

Ankle BP

PAD is associated with a high incidence of future lower-limb amputations, physical disability, cardiovascular outcomes, other serious health outcomes, reduced quality of life, and mortality (3–8). Some GPs are lucky to have tool that can easily perform ankle brachial index (ABI) as part of a cardiovascular assessment. It is a very simple tool that can detect peripheral arterial disease (PAD).…

Metformin for diabetes in pregnancy?

27th April 2024, A/Prof Chee L Khoo

Metformin has microvascular (and perhaps, macrovascular) benefits in people with type 2 diabetes (T2D). It crosses the placenta and as with all medications used in pregnancy, we always worry about its potential effects on the offspring in utero. We worry about the metabolic effects of reduced nutrients to the growing baby in there. Current recommendations (RACGP handbook) says that the pros and cons of metformin in pregnancy for women with diabetes (not GDM) are unclear (1).…