Injury of axillary nerve (axillary neuropathy) is a condition that can be associated with a surgical neck of the humerus fracture. It can also be associated with a dislocated shoulder or with traction injury to the nerve, which may be caused by over-aggressive stretching or blunt trauma that does not result in fracture or dislocation. One form of this injury is referred to as axillary nerve palsy. Injury most commonly occurs proximal to the quadrangular space.Injury in this nerve causes paralysis (as always) to the muscles innervated by it, most importantly deltoid muscle. This muscle is the main abductor of the shoulder joint from 18 to 90 degrees (from 0 to 18 by supraspinatus). Injury can result in a reduction in shoulder abduction. So a test can be applied to a patient with injury of axillary nerve by trying to abduct the injured shoulder against resistance.The pain from axillary neuropathy is usually dull and aching rather than sharp, and increases with increasing range of motion. Many people notice only mild pain but considerable weakness when they try to use the affected shoulder. References


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Superior limbic keratoconjunctivitis (SLK, Théodores syndrome) is a disease of the eye characterized by episodes of recurrent inflammation of the superior cornea and limbus, as well as of the superior tarsal and bulbar conjunctiva. It was first described by F. H. Théodore in 1963. Symptoms and signs
Patients present with red eye, burning, tearing, foreign body sensation and mild photophobia. Upon examination, the conjunctiva appears inflamed and thickened, especially at the limbus. Pathophysiology
The development and pathophysiology of SLK is not well understood, but appears to involve microtrauma of keratoconjunctival surfaces. This mechanical hypothesis is supported by the increased lid apposition of exophthalmic thyroid patients, who are known to have an increased incidence of superior limbic keratoconjunctivitis. Diagnosis
Treatment
First-line treatments include topical corticosteroids and artificial tears. For non-responsive cases, potential treatments include topical ciclosporin A, vitamin A, autologous serum and injections of triamcinolone. Surgical treatment options include thermocauterization of the bulbar conjunctiva and conjunctival resection, typically under rose bengal (RB) staining to visualize affected areas. Epidemiology
Superior limbic keratoconjunctivitis tends to occur more often with dry eye syndrome (keratoconjunctivitis sicca), hyperthyroidism and hyperparathyroidism. It is also a rare complication associated with rheumatoid arthritis. Rarely, it may occur as a consequence of upper eyelid blepharoplasty surgery. References


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