Don’t we all hate the paperwork and the hassle of insurance claims – workers compensation, CTP or similar. And to have to chase after the unpaid invoices months after the case have closed. Since, January this year (I think), there have been some positive changes to the whole NSW Workcover system. Is it just me? I don’t recall being notified about the changes.…
Spectrum
CT and US Guided Injections – what goes where for what conditions
Interventional procedures have evolved and improved over time since epidural injection was first introduced for low back pain and sciatica in 1901. One of the major contributors in the improvement of these interventions is the advancement of imaging guidance technologies. The utilisation of image guidance has dramatically improved the accuracy and safety of these interventions.
It is sometimes confusing to know what injections go where for what conditions?…
Opioids or codeine not recommended? What do we do with patients with severe back and leg pains?
May 1, 2018 Dr Chee L Khoo
Chronic, persistent low back, lower extremity pain, and radicular pain may be secondary to disc herniation, disc disruption, disc degeneration, facet joint disease, spinal stenosis, or post lumbar surgery syndrome resulting in disc-related pain with or without radiculitis. The specificity and sensitivity of the symptoms and signs are low and therefore, not as reliable as we think in getting to the precise diagnosis.…
Prostate Cancer – to screen or not to screen
April 15, 2018, Dr Chee L Khoo
Last fortnight we review the PI-RADS score in relation to prostate MRI and i thought we might go through a real case study and how it relates to general practice. Otherwise well 42 year old gentleman with no family history of prostate cancer or any other hormone related cancers presented for general check-up in 2011 in addition to the usual coughs and colds.…
Prostate MRI – A case study
A 60 year old man presents with a rising PSA despite several previously negative transrectal prostate biopsies. A prostate MRI demonstrates a circumscribed small region of low T2 signal intensity within the left lateral peripheral zone at the gland base. This region demonstrates moderately restricted water diffusion and avid early enhancement after intravenous contrast. This appearance is consistent with a region of high grade prostate cancer.…
A GP guide to understanding prostate MRI – the PI-RADS scoring system
April 2018, Dr Chee L Khoo
Forget about whether PSA screening saves lives or not. What is the next step when a PSA level comes back elevated. Obviously if the PSA is >10 or much higher, they need referral to a urologist for biopsies. What if it is trending high or is significantly higher than the age related reference range? Patients are increasingly having prostate MRIs performed the results are reported as PI-RADS scores.…
Non-invasive prenatal testing – what GPs need to know
February 2018, Dr Chee L Khoo
You would have no doubt come across a few patients enquiring about non-invasive prenatal testing. Obviously, this come on top of the “optional” nuchal translucency (NT) with or without maternal serum analysis which has been around for some years. What does non-invasive prenatal tests (NIPT) exclude and what does it not exclude?
So, what does NIPT test for?…