No abstract

GPs make up the majority of our referrals for CTS, and they obtain EDX testing prior to consultation in two-thirds of referrals. GPs appear to accurately utilize EDX testing to confirm their diagnosis prior to referral and have a low rate of normal testing where symptoms are more readily explained by an alternative diagnosis.

Medullary thyroid cancer is uncommon and patients typically present with advanced disease. Treatment options for patients with progressive, metastatic medullary thyroid cancer had been limited until recently. Tyrosine kinase inhibitors have garnered increasing interest in this subset of patients. The US Food and Drug Administration recently approved cabozantinib, a tyrosine kinase inhibitor, after promising results were shown in a large Phase III clinical trial. This review summarizes the clinical pharmacology, clinical trials, and safety data for cabozantinib and concludes with a discussion of possible future directions for the treatment of medullary thyroid cancer.

While the ulnar sesamoid bone of the thumb and the ulnar collateral ligament (UCL) are in close anatomic proximity, concurrent injury to these structures has not been reported. We report a case of such an injury in a 53-year-old male after an altercation. He was treated with surgical repair of the UCL, postoperative immobilization, and a graduated rehabilitation program consisting of range of motion and strengthening exercises. After review of the literature, we recommend that clinicians consider not just a volar plate injury, but also a UCL injury, in patients presenting with radiographic evidence of a sesamoid fracture. Clinicians should have a low threshold for advanced imaging in these patients to confirm any suspected ligamentous injury.

Invasive fungal flexor tenosynovitis caused by Candida species is a rare diagnosis, with only a very small number of case reports in the literature to date. We present only the fifth case reported in the literature of flexor tenosynovitis caused by Candida species. Only one other case reported Candida parapsilosis as the causative organism. Fungal flexor tenosynovitis typically presents in a subacute or chronic fashion. This is the only reported case of fungal flexor tenosynovitis caused by Candida to present acutely. Clinicians should consider fungal etiologies in invasive hand infections in both immunocompetent and immunosuppressed patients.