Knee Osteoarthritis – is jogging good or bad?

24th May 2020, Dr Chee L Khoo

In primary care, we are frequently preventing disease or at least we try to. Apart from lifestyle measures, we prescribe statins, anti-hypertensive, aspirin and beta-blockers to reduce cardiovascular events. What about arthritis? In patients who do not have arthritis (yet) but are at high risk of degenerative osteoarthritis, is there something we can do to reduce the patients’ risk of progressing to full blown arthritis?…

Aspirin – which cancers will it benefit?

The US Preventive Services Task Force (USPSTF) recommends low-dose aspirin use for the prevention of cardiovascular disease among average-risk individuals aged 50 to 59 years with a 10% or greater 10-year risk of cardiovascular disease (1). Long-term regular aspirin use is also associated with reduced risk of obesity- and inflammation-associated cancers, particularly colorectal cancer (CRC) (2,3). Numerous follow up trials have consistently demonstrated significant reductions in risk in GI cancers – the NIH-AARP (4), the Nurses Health Study (5) and the Health Professionals Follow-up study (6,7).…

Osteomyelitis – diagnosis is not always straight forward

26th November 2019

The symptoms of acute osteomyelitis include pain, swelling, warmth and redness over the affected part. Sometimes, there are systemic signs of fever and fatigue. Plain xrays may review osteolytic lesions, periosteal reaction or may be totally normal. Sometimes, we may need to resort to MRI to clinch the diagnosis. This month’s case illustrate the difficulty with diagnosis when the symptoms and signs are not straight forward.…

Helicobacter pylori and gastric cancer – is there a point of no return?

23rd November 2019, Dr Chee L Khoo

Treatment of helicobacter pylori infection (HPi) has been shown to reduce the incidence of gastric cancer (GC) worldwide (1,2). HPi may cause chronic inflammation which can lead to precancerous conditions. Since HPi is not always symptomatic and many patients may have untreated HPi for decades. Surely, if you have untreated HPi for decades, you might still be at risk of GC years down the track despite eradication of the infection.…

Prostate Artery Embolisation

PAE is an embolisation procedure. It is a new application of a longstanding tried and tested technology. Embolisation is the deliberate occlusion of vessels in the body, in this case the arteries to the prostate.  The objective of PAE is to stem the blood flow to the prostate, targeting the enlarging tissue and rendering it ischaemic (reduced supply of oxygenated blood).…

Pancreatic cancer and T2D – how are they related?

6th October 2019. Dr Chee L Khoo

Last month we looked at the state of play with screening for the deadly disease, pancreatic ductal adenocarcinoma (PDAC). We saw how it may not be useful to screen the general population with the technology that we have but there are select higher risk groups where screening may be useful. Long standing type 2 diabetes (T2DM) is a modest risk factor for PDAC.…

Diagnosis of breast invasive ductal carcinoma – a case study

26th September 2019. Spectrum Medical Imaging

Breast cancer is the most common cancer affecting women. In 2019, it is estimated that 19,535 Australians will be diagnosed with breast cancer. However it is important to remember that most women survive breast cancer. Diagnosis of breast cancer patients in early stages is one of important aspects of breast cancer treatment. Among of many diagnostic platforms, imaging techniques are main diagnostic approaches which could provide valuable data on patients with breast cancer.…

Breast cancer – should we offer risk reducing medications?

26th September 2019. Dr Chee L Khoo

We put patients at high risk of cardiovascular events on statins as primary prevention. We sometimes put patients with high risk of cerebrovascular disease on aspirin to prevent strokes. What about patients who are at high risk of breast cancer? Now, these are not patients who already had breast cancer. We are talking about patients who have not had cancer but are at higher than average risk of developing breast cancer.…

Pancreatic cancer screening – why are we not there yet?

10th September, 2019. Dr Chee L Khoo

Let’s face it. We all dread the diagnosis of pancreatic cancer in any of our patients. There aren’t too many red flags that we can rely on to warn us that something is not right with this deep seated abdominal organ. Many of the symptoms are either subtle or non-specific like nausea, intermittent epigastric pain, nausea, weight loss, loss of appetite or back pain.…

Abbreviated breast MRI – what is it?

22nd June 2019, Spectrum Medical Imaging

Dynamic contrast enhanced breast – MRI must contain a minimal number of MRI sequences that is necessary to detect small enhancing breast lesions. What if we cut down the number of sequences but yet have enough accuracy to detect small early cancers? That’s what AB-MRI is – less number of sequences but yet enough to detect small lesions. …

Paediatric intracranial tumours – ordering the right test

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.…