Clinical medicine (London, England)
-
Frailty is a prevalent condition in urgent care settings associated with an increased risk of adverse events. Frailty commonly presents on the acute medical take in the form of geriatric syndromes, which include falls, delirium and immobility. Comprehensive geriatric assessment is the evidence-based holistic approach to assessing and managing people with frailty. This multidimensional and interdisciplinary process is generally specialist led, however, acute medical teams can make important contributions through early identification and grading of frailty, and proactive management of geriatric syndromes.
-
Oligoarticular juvenile idiopathic arthritis (JIA) and tubercular arthritis in children can present in a similar way as monoarthritis. Patients with musculoskeletal tuberculosis may not have the classical constitutional symptoms. Moreover, microbiological evidence of infection may not be found in all patients. ⋯ The suspicion of tuberculosis was strengthened by the presence of left hilar lymphadenopathy on chest X-ray and positive result on tuberculin skin sensitivity test. The patient showed remarkable clinical and radiological recovery with anti-tubercular therapy. Peculiar features on imaging may help in differentiating infections from inflammatory arthritides, even in the absence of microbiological evidence of infection.