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Tendinopathy: does the tennis season deserve such a bad name?

14 Jul 2022

Tennis gets an unfair wrap when it comes to tendinopathies.

More info PDF

Tendinopathy: does the tennis season deserve such a bad name?

Tennis gets an unfair wrap when it comes to tendinopathies.

Tennis gets an unfair wrap when it comes to tendinopathies.

 

They can be caused by any ‘overuse’ activity – painting the fence, extensive pruning, new intensity of sports training or working on a new machine!

 

In this week’s Pearl, we share an approach to tendinopathy and how we need to be detectives, taking an overuse and occupational history to decipher the cause!

 

For more information on taking an overuse history, watch this Red Whale Byte:

 

If you would like to brush up on MSK medicine, you might enjoy our MSK and Chronic Pain course on XXXX or on demand.

 

Drugs: monitored dosing systems

07 Jul 2022

Provision of monitored dosing systems (MDS) was a surprising topic to hit the news in the past few weeks as a well-known high-street pharmacy chain came under fire for stopping provision of these for some patients. This is not really a new story!

More info PDF

Drugs: monitored dosing systems

Provision of monitored dosing systems (MDS) was a surprising topic to hit the news in the past few weeks as a well-known high-street pharmacy chain came under fire for stopping provision of these for some patients. This is not really a new story!

MDS are one tool amongst many to support people with the practicalities of polypharmacy and the danger is that they are used as a panacea for a struggling primary care and social care system. A good quality structured medication review and appropriate social support may be much more impactful.

Many nursing homes and care agencies have already started to move away from a preference for MDS systems, preferring medications in their original boxes. Indeed they have not been considered best practice in nursing home settings since 2017 (read more here!).

If you want to understand why, or you are on the receiving end of complaints or wondering how best to manage the situation in nursing homes on your patch you might find this weeks Pearl helpful.

Or if you prefer, watch this Red Whale Byte taken from our Older People and Frailty course here

 

Spotting colorectal cancer in young people

30 Jun 2022

Dame Deborah James, host of ‘You, Me and the Big C’ podcast, worked tirelessly to raise the profile of colorectal cancer, particularly in young people. She died this week at the age of 40, and has left a legacy of greater awareness of the symptoms of colorectal cancer among the public.

More info PDF

Spotting colorectal cancer in young people

Dame Deborah James, host of ‘You, Me and the Big C’ podcast, worked tirelessly to raise the profile of colorectal cancer, particularly in young people. She died this week at the age of 40, and has left a legacy of greater awareness of the symptoms of colorectal cancer among the public.

We may see more people coming forward having followed her last piece of advice on her podcast and BBC interview: "just check your poo".

There has been a significant increase in the incidence of colorectal cancer in people aged <50 years in high-income countries over the past 20 years, and it now accounts for about 10% of new diagnoses (NEJM 2022;386:1547-58).

Early-onset colorectal cancer tends to be more advanced at diagnosis and may have a more delayed diagnosis. This may be because:

  • Common benign conditions such as irritable bowel syndrome or piles can cause similar symptoms.
  • The referral criteria for 2ww prioritise investigation of older age groups.
  • There is lower public and clinician awareness of colorectal cancer in this age group.
  • It is possible there is more aggressive tumour biology, particularly where associated with an underlying genetic predisposition.

So, can we help to spot it earlier? Probably yes! The simple message is – if in doubt, do a FIT. And this is endorsed by NICE guidance!

You can read more about this in this week’s PEARL on colorectal cancer, click PDF to view this.

 

Will this new medication interact with my pill?

23 Jun 2022

Consultations about contraception can, at times, be a great opportunity to catch up and have a relatively straightforward patient-centred consultation where everyone leaves happy! Winner. But for some women it can be much more complicated.

More info PDF

Will this new medication interact with my pill?

Consultations about contraception can, at times, be a great opportunity to catch up and have a relatively straightforward patient-centred consultation where everyone leaves happy! Winner. But for some women it can be much more complicated.

For some women, particularly those with long-term conditions or who take long-term medication, we may need to think more carefully and consider some pretty complex interactions.

In this week’s Pearl, we share updated guidance on drug interactions and contraception from the FSRH. This focuses on how drugs can affect contraceptive efficacy, how contraception can affect drugs, and where we should consider contraceptive choice more carefully because of potential teratogenicity of medication.

For more discussion on contraception, why not join us for our live hosted Women's Health Together Course

Bariatric surgery: are people getting the follow-up they need?

16 Jun 2022

Bariatric surgery is the single most effective method of achieving weight loss for people with obesity. It works by reducing calorie intake and by altering hunger through changes in gastrointestinal and endocrine signalling to the hypothalamus.

More info PDF

Bariatric surgery: are people getting the follow-up they need?

Bariatric surgery is the single most effective method of achieving weight loss for people with obesity. It works by reducing calorie intake and by altering hunger through changes in gastrointestinal and endocrine signalling to the hypothalamus.

It reduces the risk of diabetes and can put diabetes into remission.

It also places people at increased risk of nutritional deficiencies. Lifelong monitoring and vitamin supplementation are needed.

The first 2 years of monitoring should be under specialist follow-up but, after this, most people are discharged to primary care. At present, there is no specific funding in place to support this work in primary care and this is a particular issue where people living with obesity have this surgery privately, because they cannot access it through the NHS, and may not receive this secondary care monitoring in the first 2 years. The consequences of NOT receiving monitoring are potentially serious.

A recent study showed that most people in the UK who have had bariatric surgery are not getting the monitoring they need.

Consider:

  • Do you have a register of people who have had bariatric surgery?
  • Are they having annual review?
  • Who is best placed to offer these reviews? If you are lucky enough to have easy access to community dietician support (or even a dietician working in the PCN team!), may there be a better care pathway to develop?


In this week’s PEARL, we share a summary of the monitoring and vitamin supplement recommendations.

Not in love with the summertime? Itchy eyes!

09 Jun 2022

“Laugh at the tears you’re crying, smile while your head explodes.” This Divine Comedy song resonated with many fellow hay fever sufferers, and we are in peak grass pollen season at the moment.

More info PDF

Not in love with the summertime? Itchy eyes!

“Laugh at the tears you’re crying, smile while your head explodes.” This Divine Comedy song resonated with many fellow hay fever sufferers, and we are in peak grass pollen season at the moment.

Hopefully, most people will self-manage their symptoms with over-the-counter preparations (yes, even fexofenadine now!), but allergic eye symptoms do sometimes pitch up in our consultation rooms and urgent care.

In this week’s Pearl, we consider allergic eye disease and offer a reminder of:

  • The differential diagnosis (would you spot the rarer ones?).
  • Red flags (the usual suspects – beware photophobia, blurred or lost vision and the contact lens wearer!).
  • Strategies for management (some require patience – mast cell stabilisers take several weeks to work).

Feet: time to get them out?

01 Jun 2022

Feet – not the most glamorous area of the body, but essential and easily forgotten. In this week’s Pearl, we look at how to assess foot problems in diabetes. Watch a Red Whale Byte on red flags in diabetic foot problems.

More info PDF

Feet: time to get them out?

Feet – not the most glamorous area of the body, but essential and easily forgotten. In this week’s Pearl, we look at how to assess foot problems in diabetes. Watch a Red Whale Byte on red flags in diabetic foot problems.

This week's Pearl is for the whole team, so please do share with any colleagues who might find it useful.

We cover:

  • 3 key elements in a foot review (inspection, neuropathy and vascular assessment).
  • How to risk stratify foot problems.
  • Red flags and when to refer.
  • Use of antibiotics.

Click PDF to read our Pearl. 

Please do share this with nursing and pharmacist colleagues, who can sign up for our free PEARLs.

And, if diabetes is something you find tricky and you don’t feel on top of the recent big changes in care, you might find our Type 2 Diabetes Demystified half day webinar or the GP Update course helpful.
 

Monkeypox

26 May 2022

Just when you thought you’d had quite enough of pandemics, monkeypox arrived! What do we in primary care need to know?

More info PDF

Monkeypox

Just when you thought you’d had quite enough of pandemics, monkeypox arrived! What do we in primary care need to know?

Click PDF for a short summary!

Breast cancer: genetic risk and how to reduce it!

19 May 2022

Uptake of the NICE guideline on familial breast cancer has been slow, and concern remains that women who could potentially benefit from preventative medication are not receiving it. Watch our video Byte on breast cancer genetics.

More info PDF

Breast cancer: genetic risk and how to reduce it!

Uptake of the NICE guideline on familial breast cancer has been slow, and concern remains that women who could potentially benefit from preventative medication are not receiving it. Watch our video Byte on breast cancer genetics.

“Ignorant GPs deny patients drugs that ward off cancer”, Daily Mail, 14 February 2017.

A wonderful example of 'post-truth' news! But uptake of the NICE guideline on familial breast cancer has been slow, and concern remains that women who could potentially benefit from preventative medication are not receiving it.

All women need a clinical genetics assessment before starting chemoprevention, and should be enabled to make a shared decision. After this, we can and should prescribe.

In this week’s Pearl, created in association with NHS Innovation, we consider:

  • How to sieve people with a higher-than-population risk of breast cancer.
  • How to take an effective family history.
  • Who to refer.
  • Risk reduction options, including preventative medication and when and how we can prescribe them safely in primary care.

Click PDF to read our Pearl article. You will also find a link in the article to a useful podcast.

Menopause GEMS

12 May 2022

This week we share our handy GEMS which is a go-to guide to HRT prescribing, and includes a list of all formulations so you can find alternatives to preparations that are not available. 

More info PDF

Menopause GEMS

This week we share our handy GEMS which is a go-to guide to HRT prescribing, and includes a list of all formulations so you can find alternatives to preparations that are not available. 

Menopause, HRT and Cognition

12 May 2022

Menopause is in the news again! This time, it’s because demand for HRT – mainly oestrogen gel – is outstripping supply.

More info PDF

Menopause, HRT and Cognition

Menopause is in the news again! This time, it’s because demand for HRT – mainly oestrogen gel – is outstripping supply.

The rise in demand follows increased awareness of menopause due to Davina McCall’s Channel 4 documentary last year. Subsequent media campaigns calling for reduction in prescription charges for HRT and more recognition of the impact of menopause in the workplace have made menopause a high-profile issue. 
 
The second ‘Davina documentary’ broadcast last week focused largely on the mental health and cognitive effects of menopause, and will, no doubt, result in newly-informed women coming forward to seek treatment. To help navigate the management of the mental health and cognitive effects of menopause with our patients, our Pearl covers the role of HRT in managing brain fog and cognitive decline. Click PDF to read the article.
 
At Red Whale, we endorse a holistic and evidence-informed approach to menopause care. We have loads of resources to help make counselling about menopause and decisions about HRT easier, including our enormously successful menopause half day webinar – watch our menopause teaser video to find out more!

Our Women's Health team recently recorded a podcast episode of Boggled Docs with Nik Kendrew, where they all discussed their thoughts on the latest 'Davina documentary'. Listen to the Boggled Docs podcast on menopause, HRT and cognition.

“Can I have some antibiotics to prevent prostate cancer?”

05 May 2022

Have you had an unusual request like this in the last few weeks? It might be down to recent headlines...

More info PDF

“Can I have some antibiotics to prevent prostate cancer?”

Have you had an unusual request like this in the last few weeks? It might be down to recent headlines...

“Discovery of bacteria linked to prostate cancer hailed as potential breakthrough” – The Guardian

“Urine bugs may be a sign of aggressive prostate cancer” – BBC News

“5 types of bacteria linked to aggressive prostate cancer” – Bolton News

At Red Whale, the medical news on 20 April 2022 got us quite excited. Join us as we take a look behind the headlines, unearth the evidence and see how this might change our practice.

Personalised care for people with cancer

28 Apr 2022

This week's Pearl - in association with Macmillan Cancer Care - we are offering you a toolkit to share with your team to build on conversations about how you can implement personalised care for people with cancer. Watch our Bytes on this topic.

More info PDF

Personalised care for people with cancer

This week's Pearl - in association with Macmillan Cancer Care - we are offering you a toolkit to share with your team to build on conversations about how you can implement personalised care for people with cancer. Watch our Bytes on this topic.

Personalised care for people with cancer: How are you doing as a team?

It will come as no surprise that people living with cancer need support at the time of diagnosis and at key points in their treatment and beyond. Yet research, even prior to COVID, identified significant unmet need, particularly around financial, emotional and persistent physical symptom support.

The cancer care review and support phone call are now enshrined in QOF in England, and this care is just as important across the whole of the UK.

This week’s Pearl is a little different.

In association with Macmillan Cancer Support, we are offering you a toolkit to share with your team to build on conversations about how you can implement personalised care for people with cancer. In the article and Red Whale Byte video, we look at:

  • Why cancer care in primary care shouldn’t be like a conveyor belt.
  • How to do an efficient and effective cancer care review (even in these times of high workload).
  • How to identify unmet need.
  • How to develop the roles of ALL primary care team members, including nurses and social prescribing link workers, to support this important work.

Click here to view the Red Whale Bytes on ‘Personalised Care for people living with cancer’ and ‘Social prescribing for people living with cancer’. It is designed for the whole clinical team, so please share freely or maybe use it as a springboard for a PHCT or QI meeting?

We would love to hear your stories or examples of great practice in this area. Contact us at mail@red-whale.co.uk

All that itches – is it thrush?

21 Apr 2022

Join our Women’s Health team for this week’s Pearl around assessing and managing thrush. Watch our handy Red Whale Byte on Thrush

More info PDF

All that itches – is it thrush?

Join our Women’s Health team for this week’s Pearl around assessing and managing thrush. Watch our handy Red Whale Byte on Thrush

This week important questions being addressed are:

  • Is this thrush? We should be particularly wary of diagnosing thrush in the postmenopausal woman!
  • Which treatments we should use.
  • What to do if symptoms don’t improve.
  • What if it is recurrent?

Looking for a knowledge boost in women’s health? Join Lucy and Helen for a half-day Menopause Update on Fri 20 May or a full-day Women’s Health Update on Wed 29 June.

Trigeminal Neuralgia

14 Apr 2022

Trigeminal neuralgia can be one of those ‘spot diagnoses’ that is satisfying to make; it is awful to live with, but up to 90% of sufferers can get meaningful pain relief from carbamazepine – although side-effects are common. Watch our Byte on trigeminal neuralgia.

More info PDF

Trigeminal Neuralgia

Trigeminal neuralgia can be one of those ‘spot diagnoses’ that is satisfying to make; it is awful to live with, but up to 90% of sufferers can get meaningful pain relief from carbamazepine – although side-effects are common. Watch our Byte on trigeminal neuralgia.

“I keep getting these awful electric shocks on the left side of my face. It’s the weirdest pain I’ve ever had!”

Trigeminal neuralgia can be one of those ‘spot diagnoses’ that is satisfying to make; it is awful to live with, but up to 90% of sufferers can get meaningful pain relief from carbamazepine – although side-effects are common.

NICE produced its first guideline on trigeminal neuralgia in 2019.

The key recommendation was that carbamazepine should be the first-line and ONLY treatment initiated in primary care. Trigeminal neuralgia does not respond to conventional painkillers, including opiates.

In this week’s Pearl, we consider the diagnosis, red flags and management of trigeminal neuralgia. Click PDF to read our article and watch our short video Byte on trigeminal neuralgia.

Bites: human, animal and insect

07 Apr 2022

As the weather warms up, Easter holidays arrive and people increase their outdoor activities, we are likely to see more bites on the telephone triage list or in minor illness slots.

More info PDF

Bites: human, animal and insect

As the weather warms up, Easter holidays arrive and people increase their outdoor activities, we are likely to see more bites on the telephone triage list or in minor illness slots.

This is probably an area where we have all overprescribed antibiotics in the past, so offers an opportunity to reduce prescribing and repeat consulting.

This week’s Pearl covers NICE guidance on human, animal and insect bites. We address:

  • Which bites are high risk?
  • When are antibiotics needed?
  • Which antibiotics should we choose?

Click PDF to read more.

Meeting ‘targets’ for FIT (faecal immunochemical testing)

31 Mar 2022

We have heard a lot about faecal immunochemical testing (FIT) over the past few years, and it has become a key part of colorectal cancer screening and triage of patients to access colonoscopy for investigation of lower GI symptoms. Watch our Byte on FIT testing.

More info PDF

Meeting ‘targets’ for FIT (faecal immunochemical testing)

We have heard a lot about faecal immunochemical testing (FIT) over the past few years, and it has become a key part of colorectal cancer screening and triage of patients to access colonoscopy for investigation of lower GI symptoms. Watch our Byte on FIT testing.

Wherever you work in the UK, you are likely to be doing more FIT tests. And, if you work in England, you may be getting to grips with the latest iteration of the PCN DES. One of the new indicators is:

‘CAN-10: Percentage of lower gastrointestinal 2 week wait cancer referrals accompanied by a faecal immunochemical test result with the result recorded either 7 days leading up to the referral or fourteen days after the referral’.

It is a good test.

But to use it to its best advantage it is helpful to understand how it works. This is the subject of this Cancer Pearl and key headlines are:

  • A negative FIT test through the national screening programme does not rule out cancer in a symptomatic person.
  • NICE updated its guidance on when we should do a FIT test in early 2021 – we should be doing more!
  • FIT has a role in triaging HIGH RISK people who already meet NG12 criteria for urgent referral.
  • It is not a perfect test – we need to safety net carefully and follow-up FIT-negative people who remain symptomatic.

You can explore this further in this week's Pearl - click PDF to read it.

Or, for a simple overview, watch this Red Whale Byte on FIT testing.

Visual aura of migraine…or something else?

24 Mar 2022

In this week’s Pearl, join us on the Red Whale sofa to consider how we might go about separating out symptoms that could be migraine or could be TIA.

More info PDF

Visual aura of migraine…or something else?

In this week’s Pearl, join us on the Red Whale sofa to consider how we might go about separating out symptoms that could be migraine or could be TIA.

This call is on your triage list:

“Mrs Khan (58 years old) – her vision went funny an hour ago and she doesn’t feel right. She thinks it might be a migraine but she’s not had one before.”

In this week’s Pearl, we'll consider how we might go about separating out symptoms that could be migraine or could be TIA using a framework to guide us that includes:

  • Types of symptoms.
  • Speed of onset.
  • Frequency.

Watch a 5-minute Red Whale Byte on separating out symptoms that could be migraine or could be TIA.

Click PDF to read our article.

For more engaging primary care education, from long-term conditions to red flags not-to-miss, and prescribing dilemmas and common conundrums that no one else will teach you about in quite the same way, join us for our new season of GP Update courses.

 

Spinal cord compression/cauda equina

17 Mar 2022

In primary and urgent care settings, we see a lot of back pain. We have talked in recent Red Whale courses about the ‘3Ns’ approach as a mental sieve to separate presentations into Nasty, Nerve irritation and Non-specific.

More info PDF

Spinal cord compression/cauda equina

In primary and urgent care settings, we see a lot of back pain. We have talked in recent Red Whale courses about the ‘3Ns’ approach as a mental sieve to separate presentations into Nasty, Nerve irritation and Non-specific.

In this week’s Pearl, we focus specifically on asking the right questions to pick up early spinal cord compression and cauda equina syndrome.

The classical textbook descriptions of saddle anaesthesia, weakness and motor signs, and incontinence are late signs.

Asking about earlier signs such as change of sensation when passing urine, change in erections or vaginal sensations may be more sensitive for early compression.

Click PDF to read more.

For more engaging primary care education, from long-term conditions to red flags not-to-miss, and prescribing dilemmas and common conundrums that no one else will teach you about in quite the same way, join us for our new season of GP Update courses.

Gynaecomastia

10 Mar 2022

Moobs (man-boobs) entered the English dictionary in 2016 but gynaecomastia is not a new issue. ‘Apparent’ gynaecomastia is increasing as the prevalence of obesity increases. Watch our video byte on gynaecomastia.

More info PDF

Gynaecomastia

Moobs (man-boobs) entered the English dictionary in 2016 but gynaecomastia is not a new issue. ‘Apparent’ gynaecomastia is increasing as the prevalence of obesity increases. Watch our video byte on gynaecomastia.

“I’ve got back on the bike, like you suggested. I’ve even lost 3kg, but the blokes are giving me a hard time about my moobs. Is there anything you can do?”

Gynaecomastia is important for 3 reasons:

  • As a marker of poor cardiometabolic health.
  • As a presenting feature of serious disease, e.g. liver disease, testicular tumours and endocrine disorders.
  • As a cause of psychological morbidity for some men that may contribute to mental health problems and eating disorders, particularly in adolescents.

 So, how should we approach these consultations?

This week’s Pearl reveals all – click PDF to read our article.

For more engaging primary care education, from long-term conditions to red flags not-to-miss, and prescribing dilemmas and common conundrums that no one else will teach you about in quite the same way, join us for our new season of Face to Face GP Update courses or the GP Update Together online.

Eating disorders

03 Mar 2022

The COVID-19 pandemic has had a particular impact on people with and at risk from eating disorders. The incidence has increased and it is harder to access timely help. Primary care has a really important role to play.

More info PDF

Eating disorders

The COVID-19 pandemic has had a particular impact on people with and at risk from eating disorders. The incidence has increased and it is harder to access timely help. Primary care has a really important role to play.

This week is Eating Disorders Awareness Week in the UK.

So, in this week’s Pearl, we share our article on eating disorders, particularly:

  • How to use the SCOFF tool to help with diagnosis.
  • Why early referral is important – we don’t have to wait for an underweight BMI.
  • Specific medical needs of people with eating disorders.

We will be covering this topic and lots more, including depression, anxiety, mental wellbeing with long COVID, supporting people with persistent physical symptoms and, perhaps most importantly, how to look after ourselves in our Mental Health Together course on Thur 10 Mar. Join Lee David on the Red Whale sofa from the comfort of your own home!

Depression in Older People

24 Feb 2022

Depression in older people is common but can be easily missed. How does depression present differently in older people? How should treatment differ in this group? Watch our Byte on Depression in Older People.

More info PDF

Depression in Older People

Depression in older people is common but can be easily missed. How does depression present differently in older people? How should treatment differ in this group? Watch our Byte on Depression in Older People.

In this weeks PEARL we consider:

  • How physical presentations, memory problems and anhedonia can be more common.
  • Tips on differentiating depression and dementia.
  • How treatment may differ and why we should be proactive about psychological therapies.

If you would like to explore some more important mental health topics, including how to look after yourself and your colleagues, join Lee David on the Red Whale sofa for our Mental Health Together event on Thur 10 March.

Obesity: the science and the landscape

17 Feb 2022

This week’s Pearl is a ‘long read’ about the evolving science around obesity and overweight.

More info PDF

Obesity: the science and the landscape

This week’s Pearl is a ‘long read’ about the evolving science around obesity and overweight.

Spoiler alert: this may be very different from what we learned at university. From genetics to environment, set-points to gut microbiota… we share all!

I’m sooo busy…should I bother?

Well, it might just change your thinking – it did ours!

Here are some of the headlines:

  • ‘Eat less, exercise more’ doesn’t work. It induces shame, which never helps anyone.
  • We are not well-placed to tackle population-level obesity – this is complex and requires political and system change to make a significant impact.
  • We ARE well-placed to help individuals, and this article will help us to:
    • Reframe conversations about obesity.
    • Redefine what success looks like.
    • Recognise the need for multi-professional support for complex obesity and, where we can, refer sooner.

So, to find out more, grab a cuppa and click PDF to read our Pearl.

All our fully-updated obesity articles can be found on GPCPD.com, along with more than 900 other primary care topics!

Sudden hearing loss in adults

10 Feb 2022

Sudden hearing loss can be an ‘otological emergency’. Get a 2-minute overview of sudden sensorineural hearing loss by taking a look at our Red Whale Byte.

More info PDF

Sudden hearing loss in adults

Sudden hearing loss can be an ‘otological emergency’. Get a 2-minute overview of sudden sensorineural hearing loss by taking a look at our Red Whale Byte.

Sudden hearing loss can easily get lost in the telephone triage list; ‘hearing problems’ doesn’t feel that urgent, does it?

This week’s Pearl reminds us, when seeing an adult with NEW hearing loss:

  • How to assess.
  • When to refer.
  • When to use steroids.
  • What to do if you can’t find your tuning fork!

Click PDF to read more in our Hearing loss GEMS.

Non-traumatic knee pain

03 Feb 2022

How confident are you at assessing non-traumatic knee pain? This week’s Pearl offers you a quick reminder about non-traumatic knee pain. Watch our video on this topic.

More info PDF

Non-traumatic knee pain

How confident are you at assessing non-traumatic knee pain? This week’s Pearl offers you a quick reminder about non-traumatic knee pain. Watch our video on this topic.

“I’ve been trying to do couch to 5k. It was going brilliantly but I’m now on week 5 and the outside of my knee is starting to hurt every time I run – help!”

What’s going on here? How confident are you at assessing non-traumatic knee pain? Many of us find this tricky. A quick and accurate diagnosis and appropriate management plan increase the chance that we help people to stay confident in keeping active.

Did you spot the most likely diagnosis?  This is probably ilotibial band friction syndrome – a really satisfying spot diagnosis! If this is new to you, you might enjoy this Red Whale Byte video clip.

And if you want to boost your confidence with a comprehensive overview of all things primary care MSK, why not join Mike and Giles on the Red Whale sofa on Thur 10 Feb for the MSK & Chronic Pain Together.

Click PDF to read our full Pearl.

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