Pulled/nursemaid’s elbow

Nursemaid’s elbow is a radial head subluxation caused by axial traction on the extended arm while the forearm is pronated, allowing for slippage of the radial head. A 2-year-old boy presented with pain, swelling and reduced range of movement of the right elbow for 4 days. The mother noted that the child was moving the right upper limb less often and there was tenderness over the right elbow. X-ray of the right elbow showed subluxation of the elbow joint with no obvious fracture. A trial of conservative management was decided upon and the patient was placed on a right elbow backslab with the right forearm in a supine position. On follow-up, there was no swelling, tenderness or neurological deficit noted. A repeate x-ray revealed normal findings.

Chronic heel pain: It could be tuberculosis

: Heel pain is a common presentation at a primary care setting. The majority of these cases are benign and self limiting in nature. Common differential diagnoses include plantar fasciitis and peroneal muscle sprains. However, certain conditions—if undetected early—may cause significant morbidity to the patient. A high index of suspicion and early referral for further investigations are needed to prevent long-term morbidities.