Explore the common condition known as Tennis Elbow, or Lateral Epicondylitis, drawing from our sources. Learn about the typical symptoms like sharp, intermittent pain over the lateral elbow that can radiate down the forearm, often aggravated by simple activities like gripping or using a screwdriver.

Understand the likely cause – microtrauma and tendinosis, particularly at the origin of the Extensor carpi radialis brevis (ECRB) muscle. We'll also discuss what doctors look for during an examination, including tenderness at the lateral epicondyle, increased pain with resisted wrist extension, and specific tests like the Coffee cup test, Mills' test, and Maudsley's test.

Beyond the Diagnosis: Treating Your Tennis Elbow Dive into how Tennis Elbow is diagnosed and managed, according to our sources. While imaging studies like X-rays and MRIs are rarely the primary diagnostic tool but can help exclude other causes, the diagnosis is mainly based on clinical findings. Learn about potential conditions that can mimic Tennis Elbow, including nerve issues like Radiculopathy or Posterior Interosseus Syndrome, or joint problems like Osteoarthritis or Osteochondritis dissecans.

We'll then cover the wide range of management options, starting with conservative approaches like activity cessation, ice, bracing, and medications like NSAIDs or short-term corticosteroid injections.Discover the importance of Physiotherapy with its various techniques, noted for its high success rate. Finally, understand when surgical intervention is considered (usually after 6 months of failed conservative management), and explore different surgical techniques discussed in the sources, including arthroscopic, open, and percutaneous needle procedures.

Explore Aortic Stenosis (AS), a significant heart valve condition discussed in our sources. Learn about the classic symptoms, including angina (chest pain), syncope (fainting), and signs of heart failure.

Discover why the appearance of symptoms like angina or syncope is a critical turning point, often indicating a significantly reduced average survival without intervention. We'll also touch on the physical examination findings that can hint at AS, such as a characteristic small volume slow rising pulse, a forceful apex beat, and the distinctive ejection systolic murmur that often radiates to the carotid arteries.

Delve into the diagnosis and management of Aortic Stenosis based on the sources. Understand the role of key investigations like Chest X-ray (CXR), Electrocardiogram (ECG), and especially the critical information provided by a 2D Echocardiogram, which can visualize the valve, assess left ventricular hypertrophy, and determine the pressure gradient and valve area.

We'll discuss the differential diagnoses to consider. Finally, learn about the general management strategies, including treating associated conditions like anemia and heart failure, and the specific treatments like Aortic Valve Replacement (AVR), which is often recommended for symptomatic patients and can significantly improve survival, as well as temporary measures like balloon valvotomy.

Join us for an in-depth episode exploring Myasthenia Gravis, an autoimmune disorder characterized by muscle weakness due to antibodies affecting neuromuscular junction transmission. This condition can present with a range of symptoms, often fluctuating in severity and worsening with exertion.

We'll delve into the key ways Myasthenia Gravis manifests:

• Drooping eyelids (Ptosis): Often unilateral or bilateral and sometimes asymmetrical, worsening in the evening or after exertion.
• Double vision (Diplopia): Caused by fatigue of the extra-ocular muscles.
• Difficulties with chewing and swallowing due to involvement of the muscles of mastication and bulbar muscles.
• Weakness in the shoulder and pelvic girdle muscles, leading to difficulty lifting objects or standing.
• Breathing difficulty, which can escalate into a life-threatening Myasthenic crisis involving severe weakness of oropharyngeal, diaphragm, and accessory respiratory muscles.
• A deteriorating voice on counting, reflecting weakness in bulbar muscles involved in phonation.
• Potentially muscle wasting in long-standing disease due to chronic acetylcholine depletion.

We'll also touch upon some of the interesting physical examination findings associated with the condition, such as the positive peek sign and Cogan lid twitch sign, and how reflexes may fatigue on repetitive elicitation.

Understanding the diagnosis involves various investigations:

• Testing for serum anti-Acetylcholine receptor and anti-MuSK antibodies. Anti-AChR antibodies are found in 90% of generalized and 75% of ocular cases, while anti-MuSK antibodies are present in many generalized cases without AChR antibodies.
• Electrophysiological tests like Repetitive Nerve Stimulation (RNS), which may show a decrement in muscle potential.
• Single Fiber Electromyography (SFEMG), highlighted as the most sensitive test, showing variability called "Jitter".
• Bedside tests like the Positive Tensilon test (transient improvement with edrophonium) and the Positive Ice test (relieving ptosis with ice).
• Imaging like Mediastinal CT to check for thymic hyperplasia or thymoma, which are common findings.
• Crucially, we'll discuss the approaches to managing Myasthenia Gravis:

Identifying and treating causes or removing triggers for relapse, such as infections, certain drugs, or stress.

• Using oral anti-Cholinesterases like Pyridostigmine for symptomatic relief by increasing acetylcholine availability.
• Employing Immunosuppressants like Prednisolone, Azathioprine, and Mycophenolate for treatment relapse or lack of response to anti-cholinesterases.
• Considering Thymectomy (surgical removal of the thymus), which can improve prognosis, especially in certain patient groups.
• Utilizing Plasmapheresis and IV Immunoglobulin during exacerbations or a Myasthenic crisis to rapidly remove antibodies.