- A congenital ear condition which often presents as a thickening on the helix at the junction of the upper and middle thirds.
- This atavistic (evolutionary throwback) feature is so called because its description was first published by Charles Darwin in the opening pages of The Descent of Man, as evidence of a vestigial feature indicating common ancestry among primates which have pointy ears.
- However, Darwin himself named it the Woolnerian tip, after Thomas Woolner, a British sculptor who had depicted it in one of his sculptures and had first theorised that it was an atavistic feature.
- Haglund syndrome refers to the triad of:
- Insertional achilles tendinopathy
- Retrocalcaneal bursitis
- Superficial retro tendo achilles bursitis
- This results in a noticeable bump on the back of the heel, pain in the area of the Achilles tendon, swelling to the back of the heel and erythema to that area. Commonly associated with high heels but also nicknamed “pump bump” due to the irritation wearers of sneakers notice due to the rigid backs on some sneakers. [Reference]
- First reports of a healed shoe come from Egypt where butchers would wear them instead of sandals to keep their feet out of the entrails.
- However, there are scattered reports in various civilisations from Mongolia, Persia and Europe of fighters and soldiers at various times throughout history wearing high heels of some description to keep their feet from slipping out of the stirrups.
- It is probably around the 17th century when they became fashionable, King Louis XIV of France decreed that only nobility could wear heels, and that only members of his specific court could wear red ones. [Reference]
While trying to consent a patient for a CT abdo you discuss background radiation exposure. During a google search you find a place that has the equivalent mGy of a CT abdominal as background radiation. Where is this place?
- Ramsar, Iran, it is the most radioactive area inhabited on earth. Average 10 mGy background (CT abdominal 8mGy) [Reference]
- The prevailing model of radiation-induced cancer posits that the risk rises linearly with dose at a rate of 5% per Sv. If this linear no-threshold model is correct, it should be possible to observe an increased incidence of cancer in Ramsar.
- Early anecdotal evidence from local doctors and preliminary cytogenetic studies suggested that there may be no such harmful effect, and possibly even a radioadaptive effect, raising the theory of radiation hormesis.
- Nobel prize winners David Dunning and Justin Kruger noted that those with low ability failed to recognize their ineptitude and evaluate their competence accurately. The corollary to this was, high-ability individuals may underestimate their relative competence and may erroneously assume that tasks which are easy for them are also easy for others. [Reference]
- Commonly experienced in medicine by our increased confidence at PGY2 and then our feelings of imposter syndrome at the end of training.
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