A meningioma is a benign tumour that arises from the meninges. Meningiomas are often slow-growing, however in some instances, they may be fast-growing and their effects on 
adjacent brain tissue, nerves or vessels may cause serious disability. Timely access to a Bulk Billable MRI scan can enable a quick diagnosis and appropriate referral for neurosurgery without the patient requiring a CT scan with the associated ionizing radiation, especially relevant given the patient’s age.…
Paediatric
kids and young adults
Paediatric MRIs – which ones are Medicare rebatable?
One of the problems of MRIs coming on and coming off Medicare rebates over time is the immense confusion to us GPs. This is especially so in the area of Paediatric MRIs. Fortunately, our colleagues at Spectrum Radiology has put together a quick reference guide for use in practice. The guide is now available under GP Resources and Tips.…
Groin pain in adolescents – is that slipped capital femoral epiphysis?
22nd April 2019, Dr Chee L Khoo
One of the diagnoses I dread to miss in general practice is slipped capital femoral epiphysis (SCFE). It is not common (yet) but most general practitioners will encounter (or miss) a few of these in their life time. They are mostly seen during the adolescent years and are more prevalent although not exclusively, in the overweight and obese.…
Low birth weight and future cardiovascular risk – how are they connected?
13th April 2019, Dr Chee L Khoo
We know that overweight children have higher future risk of cardiovascular disease and diabetes. Ironically, babies who are small at birth or during infancy also have increased rates of cardiovascular disease and diabetes as adults. It is thought that foetal undernutrition at different stages of gestation are somehow link to this increased risk, but the underlying mechanism is not fully understood.…
Congenital nasolacrimal duct obstruction – when to probe?
13th February 2019, Dr Chee L Khoo
Nasolacrimal duct obstruction in infants is not uncommon. Up to 10% of infants will present with watery, teary eyes which sometimes become purulent necessitating antibiotic drops. We know that “most” spontaneously resolve as the infant grows older. In the meantime, we generally recommend massaging of the duct and topical antibiotics when required. Up to 1 in 4 congenital nasolacrimal duct obstruction (CNLDO) does not resolve spontaneously.…
Oral steroids for glue ear?
1st September 2018, Dr Chee L Khoo
After acute otitis media, the middle ear effusion usually resolves within days although it may take up to 3 months in some children. However, in up to 8% of kids, the effusion persist beyond the 3 months and it becomes chronic otitis media with effusion (COME). Why these 8% is the key research question.…
Tonsillectomy – do they affect future immunity?
July 1st, 2018, Dr Chee L Khoo
I am sure you have been asked by parents of young patients about to undergo tonsillectomy +/- adenoidectomy whether the removal of the tonsils will affect future immunity since the tonsils and adenoids are integral to the body’s immune response. I have had those questions asked of me and the answer used to be “Of course not.…
Prescribing antibiotics for influenza – are you one of them?
June 15, 2018, Dr Chee L Khoo
The most recent stats tell us that antibiotics prescription for viral URTIs have come down. It certainly gives us that warm and fuzzy feel good feeling that finally, the message is getting through in primary care. Well, are antibiotic prescription rates for influenza infections really coming down? How come I still come across many of patients being prescribed antibiotics for the “flu” after they were seen on the weekend.…
Metformin in pregnancy – where are we now?
April 2018, Dr Chee L Khoo
Another day, another study published on the good or bad about metformin use in pregnancy. There is a lot of confusion and unknowns about the benefit or safety of metformin to the mother-to-be or to the long-term outcome of the baby. When there is a lot of conflicting data coming our way, we need to sit back and look at the overall picture of hyperglycaemia in pregnancy and its management before we can make sense of these studies.…
Congenital Hip Dysplasia – how useful is the “click”?
February 2018, Dr Chee L Khoo
Congenital hip dysplasia (CDH) is a common fear when we examine newborns. A clicky hip is a common reason for further investigations. CDH is actually not very common but how often does a clicky hip lead to a diagnosis of CDH? In other words, how useful is the “click”?
A 20-year prospective, longitudinal, observational study was undertaken to assess the relationship between the presence of a neonatal clicky hip and pathological CDH.…
To err is human… actually, it’s now manslaughter!
February 2018, Dr Chee L Khoo
I am sure you have read about Dr Bawa-Garba who was “thrown under the bus” by the system for her treatment of a 6 year old child with Down’s syndrome who died of sepsis while being treated in hospital. . There have been many discussions in UK and internationally about the ramifications of the court and tribunal’s decisions but what can GPs in Australia learn from this case?…