Dr looby

Gadolinium is toxic in its free form and must be bound to a ligand. at normal doses it is never
nephrotoxic. At high doses It can be nephrotoxic. nephrogenic systemic fibrosis, NSF, has not
been seen since 2012 as patients with chronic kidney disease are generally not given the agent.
if contrast is needed they are not giving the full dose and are dialyzed afterwards, for example
in the setting of high-grade glioma.

there are no known adverse effects to the fetus, but the fetal blood brain barrier, kidneys and
liver are immature. the pregnant patient is consented for contrast administration. 1% of
gadolinium will end up with in the breast milk, patients you are breast-feeding are advised to
pump and dump for 24 hours.

adverse contrast reactions are divided into acute and late.

if more than 5 injections of gadolinium contrast are given, retention of contract may be seen in
the dentate nuclei of the cerebellum and the globus pallidus. contracts retention is only seen
with linear gadolinium agents which are loosely bound. macrocyclic agents are more tightly
bound and this phenomenon of retention does not occur with them. gadolinium has also been
demonstrated in the bones, liver and kidneys. it can be detected post mortem. linear
gadolinium agents have been withdrawn in Europe.

Professor Clive Lee

acronym for the cruciate ligaments L.A.M.P. - lateral anterior medial posterior.

the pes ancerinus attaches to the medial surface of the tibia - Formed from the combined
tendons of the sartorius, gracilis and semitendinosus muscles. there is a small bursa adjacent
to it which can become inflamed. ankle joint only performs plantar and dorsiflexion, any other
movement in the ankle is between the talus and talo calcaneonavicular joint. The iliofemoral
ligament allows us to “ stand at ease” o'donoghue's unhappy triad of the knee is An injury to:
the anterior cruciate, medial collateral ligaments and meniscus.

Pott’s fracture medial spring ligament injury.

the plantar aponeurosis is like the cross Beam in an A-frame.

the upper leg has three compartments: anterior, posterior and medial.

subsartorial canal transmits the saphenous nerve and superficial femoral artery.

the popliteal fossa is in fact above and behind the knee.