GPnotebook Podcast

Cauda equina syndrome (CES) is caused by compression of the lumbosacral nerve roots that extend below the spinal cord. The most common cause is disc prolapse at the L4/5 or L5/S1 level and stenosis of the spinal canal. Less commonly, compression may be due to pathology in a higher disc or to a tumour, infection or trauma. Typical symptoms and signs of CES include leg and/or back pain, together wit...

In the first of a two-episode series on chronic kidney disease (CKD), Dr Hannah Rosa is joined by Dr Will Hinchliffe, a Consultant in Renal and General Medicine working in the North East and North Cumbria. They discuss which people are at risk of CKD, how to test for it and diagnose it and, lastly, which patients require a referral to secondary care. This episode is mostly based on the NICE guidel...

Ankylosing spondylitis (AS) is a chronic, immune-mediated inflammatory disorder that predominantly targets the axial skeleton, especially the spine and sacroiliac joints. This condition evolves insidiously, often beginning in young adulthood, and gradually imposes limitations on spinal mobility, eventually leading to fusion in advanced cases. Beyond its skeletal manifestations, AS can also extend...

Post-herpetic neuralgia (PHN) is the most common complication following an episode of shingles and can affect up to one in five people. Pain is typically described as burning or like an electric shock and is often associated with allodynia and hyperalgesia. It can have significant effects on both physical and psychological well-being, with sleep disturbance and depression being frequently describe...

What if one of the most misunderstood diagnoses of the past is now one of the most manageable chronic conditions? How can GPs play a pivotal role in tackling stigma, increasing testing and improving outcomes for people living with HIV? Dr James Waldron is joined by Dr Grace Bottoni (HIV and Hepatitis C GP Champion, Lewisham) for a series of podcasts about HIV. Together, they explore a range of top...

Baker’s cysts commonly present in primary care. In this episode, Dr Kate Chesterman discusses the pathophysiology, underlying aetiology and management options for this condition, describing possible differential diagnoses and indications for investigations. She also explains the self-care options for those with minimal symptoms and how to escalate treatment, as well as when to consider a referral....

A rotator cuff injury is an event that causes pain in the shoulder. This can be due to a tear, inflammation or narrowing of the space within the shoulder joint. The rotator cuff muscles interlock to work as a unit. They help to stabilise the shoulder joint and also help with shoulder joint movement. In this episode, Dr Roger Henderson takes a specific look at tears to the rotator cuff – a problem...

Ganglion cysts, also sometimes referred to as synovial cysts, are the most common benign soft-tissue masses of the hand and wrist. These cysts arise from the synovial lining of joints or tendon sheaths and are filled with a gelatinous, mucin-rich fluid. Despite their benign nature, ganglion cysts can cause discomfort, restrict motion and cause neurovascular compression (requiring medical intervent...

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy, primarily affecting the median nerve at the level of the wrist. The condition results from compression of the median nerve within the carpal tunnel, leading to sensory and motor impairments in the affected hand. There are a range of causes for the condition, and treatments range from simple conservative measures to surgery. In...

Temporal arteritis, also known as giant cell arteritis, is an inflammatory condition that affects the large- and medium-sized arteries, primarily those in the head. It most commonly occurs in adults over 50, particularly women. The exact cause is unknown, but it is believed to be an autoimmune response that leads to inflammation and narrowing of the arteries, reducing blood flow. Symptoms include...

Febrile seizures are common in the first 5 years of life, and many factors that increase the risk of such seizures occurring have been identified. Initial evaluation should determine whether features of a complex seizure are present, as well as identifying the source of fever. In this episode, Dr Roger Henderson provides an overview of febrile seizures in childhood and also looks at risk factors,...

In this episode, Dr Hannah Rosa continues looking at the new asthma guideline from the British Thoracic Society (BTS), NICE and SIGN, which was published in 2024. This guideline, based on the latest research, contains some big changes, which will hopefully help you to improve the lives of your patients living with asthma. In the first episode in the series (episode 146), Dr Rosa covered suspected...

What if one of the most misunderstood diagnoses of the past is now one of the most manageable chronic conditions? How can GPs play a pivotal role in tackling stigma, increasing testing and improving outcomes for people living with HIV? Dr James Waldron is joined by Dr Grace Bottoni (HIV and Hepatitis C GP Champion, Lewisham) for the first episode in an insightful series that dives into the evolvin...

Dupuytren’s disease is a chronic, progressive condition that primarily affects the palmar and digital fascia of the hand. Over time, fibrous cords form under the skin, thickening and contracting, which can cause the fingers (most often the ring and little fingers) to curl inward. This results in Dupuytren’s contracture, limiting hand function and impacting daily activities. It often starts with th...

Roseola infantum is a viral infection primarily affecting infants and young children, most commonly between the ages of 6 and 12 months. It accounts for 10–45% of febrile illnesses in infants, and cases tend to peak in the spring and autumn seasons. Diagnosing roseola is almost always clinical, and for patients with the classic presentation a clinical diagnosis can be made based on physical examin...

Raynaud's phenomenon is a relatively common condition seen in primary care (especially during the autumn and winter months) that is characterised by vasospasm. This causes digits to change colour to white due to a lack of blood flow, usually brought on by cold temperatures. Affected areas subsequently turn blue due to deoxygenation and red due to reperfusion. The most common type is primary (idiop...

Sickle cell anaemia is a disease of red blood cells, caused by an autosomal recessive single gene defect in the beta-chain of haemoglobin, which results in production of sickle cell haemoglobin. Sickle cells can obstruct blood flow and break down prematurely, and they are associated with varying degrees of anaemia. A common presentation of sickle cell disease (SCD) is a painful sickle crisis, caus...

Paronychia is a common condition affecting the proximal and lateral nail folds of the hands or feet. In this episode, Dr Kate Chesterman discusses the differences between acute and chronic paronychia and the thinking around the causes and treatment of each. She also gives some tips that we can pass on to our patients regarding self-management and prevention. Access episode show notes containing ke...

In this episode, Dr Hannah Rosa discusses the new asthma guideline from the British Thoracic Society (BTS), NICE and SIGN, which was published in 2024. This guideline, based on the latest research, contains some big changes, which will hopefully help you to improve the lives of your patients living with asthma. In this first part of a two-episode series, topics covered include when to suspect asth...

Around 0.5% of the adult population in England experience problems gambling, 3.8% are at elevated risk of gambling harms and an estimated 7% are negatively affected by someone else’s gambling. NICE has published NG248 – its first recommendations on gambling, covering the identification, assessment and treatment of people over the age of 18 who are experiencing gambling-related harms. The recommend...

The National Osteoporosis Guideline Group (NOGG) clinical guideline for osteoporosis was updated in December 2024. In this episode, Dr Hannah Rosa shares 10 things she learnt from the updated guideline about how to prevent and treat osteoporosis. Access episode show notes containing key references and take-home points at: https://gpnotebook.com/en-GB/podcasts/musculoskeletal-medicine/ep-144-osteop...

Irritable bowel syndrome (IBS) is a chronic condition characterised by abdominal pain associated with bowel dysfunction and is one of the most common gastroenterology presentations in primary care. The pain is often relieved by defecation and is sometimes accompanied by abdominal bloating, with no structural abnormalities to explain the pain. IBS occurs in up to 20% of the adult population, and it...

Colorectal cancer (CRC) is the fourth most common malignancy in the UK and a major cause of morbidity and mortality. It refers to malignancies that arise from the caecum to the rectum and can be detected on screening, on imaging or endoscopy, or following presentation with change in bowel habit, iron deficiency anaemia or bowel obstruction. Its management depends on the stage of the disease and pa...

Hidradenitis suppurativa (HS) is a chronic inflammatory dermatosis that typically affects areas of pilosebaceous gland-containing skin. In HS, patients often suffer recurrent attacks of discharging and painful lesions that can require multiple courses of antibiotics or surgical drainage. The condition causes significant morbidity, distress and sometimes long-term scarring. In this episode, Dr Roge...

Seasonal affective disorder (SAD) is a form of depression that occurs at specific times of the year, most commonly during the autumn and winter months when daylight hours are shorter. Characterised by symptoms such as persistent sadness, fatigue and changes in appetite or sleep patterns, SAD is more than just the "winter blues." It is a clinically recognised but often underdiagnosed condition that...