HPI - Felt a pop when landing after a layup in basketball. Had some immediate pain and inability to push off his left ankle. Was seen in urgent care and given an ankle brace for a "sprain." Little pain at rest, but difficulty walking. After a week of not getting better, PCP orders and MRI and referred patient.
What treatment options would you recommend for this patient?
HPI - 45-year-old male with severe ankle pain following nonoperative treatment of ankle fracture when he was 23 years old. Patient has received cortisone injections, stem cell treatments, and has used a brace on/off for the last 2 years
Would you try additional nonoperative treatment modalities in this patient?
HPI - Active patient, denies trauma, bilateral painless hallux valgus deformity since adolescence, no associated neuromuscular conditions, shoe modifications have failed to provide relief
Which foot would you operate on?
HPI - Patient complains of chronic pain at the lateral side of the foot. The pain is somewhat relieved by NSAIDs then reoccurs.
What is the diagnosis?
HPI - A 17 year old male presented to sports clinic for assessment after twisting his ankle while playing soccer two days earlier. Prior to this recent episode, his ankle was completely asymptomatic.
XRays were taken, which revealed an OCD lesion of the medial talar dome. He was referred for an MRI. Images are shown.
How would you manage this patient's OCD lesion?
HPI - 20 year old college football player with "mild" right midfoot pain after being tackled 3 days ago. The other player landed on the back of his foot. MRI was read by the University radiologist as a "partial Lisfranc ligament tear." He states that he feels better and wants to resume play immediately.
With a negative stress image obtained in the office, how would you treat this patient?
HPI - 60 yo male patient had heel pain last fall and had a cortisone injection done in October and then with vigorous activity ruptured plantar fascia in December 2015. He is wearing arch supports which allow walking but still start up pain felt laterally and in the arch every day and after sitting for 10 minutes. Walking 20 feet loosens it up. He has had MRI which shows ruptured plantar fascia at the calcaneus and x-rays show mild loss of arch.
Do you think the steroid injection was the primary cause of the rupture
HPI - No history of ankle or foot trauma.
Started complaining of pain in the ankle and midfoot in 2009, which slowly progressed.
MRI shows a 8mm x 8mm lesion in the talar dome.
How would you treat the osteochondral lesion of the talus?
HPI - Pain full right feet for one week following hard exercise
no history of major trauma
What is the most likely diagnosis based on the information provided?
HPI - at the first time pev and then post op pes cavus
The patient is a 4.5 years old male who presents with a postoperative cavus deformity.
Four years ago by report he presented with a pes deformity that was treated with ponseti casting 5 times. This was followed by a posteromedial release when he was in sixth month old.
Now he presents a very rigid foot with pes cavus .
we talk about right foot.
What do you think was the reason the patient presented with Pes Planovalgus that was treated with surgery 4 years ago?
HPI - Fall from 4meters, reception on the left foot
How would you treat the patient?
HPI - Right ankle sprain 9 months ago. 1 month of rest with cast
What is the most likely cause of the cysts in the talus?
HPI - Lives independently with no walking aids. Plays tennis 3 days per week. Trip and fall 5 days ago with isolated injury. No previous foot pain.
How would you treat this patient?
HPI - gradual onset progressive course now interfering with activities
What is the most likely diagnosis of the right foot condition?
HPI - Pilon fracture operated 4 years ago. Bone scan and CT scan rule out osteomyelitis.
Assuming on has evaluated for, and eliminated any infection, how would you treat this patient?
HPI - An otherwise healthy male complains of right foot pain that has gradually progressed over the last year. He denis any history of trauma. Now the pain is severe and limiting his function.
The patient has a history of a similar condition in left foot 11 years ago (patient reports "death" of navicular) that was treated by bone grafting years ago. He reports relief of his symptoms and now he has tolerable left foot pain.
What is the most likely diagnosis of the RIGHT foot pain?
HPI - Patient 29 years old from Honduras, male, sustained a Type C Weber ankle fracture in Nov last year. Soon after waking up from surgery medial aspect of the heel and sole of the foot was without sensation with concomitant pain on the dorsal aspect of the distal third of the leg, where fracture site was. Allodynia, pain and progressive contracture of the toes developed.
EMG: Sensitive-motor neuropathy with axonal lesion of right peroneal nerve and severe posterior tibial nerve.
Motor Nerve conduction study: right tibial nerve at ankle = Lat: 4.3ms; Dur:1.0ms; Amp:50.0uV; Area:0.0mVms; Segment: Ankle; Distance: 120mm; Interval: 4.3ms
What is the best treatment?
HPI - Since a year ago and without any traumatic event patient had an insidious onset of discomfort over his right 2nd MTP joint.
Which is the best treatment plan?
HPI - 4 days ago fell of the bike
HPI - Falling from height (4M) two days ago
No other Musculoskeletal abnormal data
NV is okay, no signs of compartment syndrome
How to manage?
HPI - pain on right foot. can not stand. sudden swelling after bike accident. no other issues. can bend leg, toes. He is on cast NWB.
What zone is this fracture in?
HPI - Chronic left forefoot pain, incidentally discovered foreign body.
How would you classify this injury?
HPI - First pain complaints at the age of 10
What is the best surgical treatment at this stage
HPI - Bilateral club feet treated by multi-surgeries in the early childhood.
HPI - Inability to walk, severe unstable hind foot with type 3 Charcot Foot underwent TTC fusion 6/12 back, failed with exposed tip of one calcaneal screw.
HPI - deformity noticed at left ankle six months back , no h\o of trauma ,deformity gradually increasing,with instability of ankle &inability to attend his daily routine, pain at leg after walk for few meters.(5m)
what is treatment of choice?(pt demand is stable ankle)
HPI - Polio since childhood,treated in braces previously
HPI - trauma at work in April 2010, initially only treated for scaphoid fracture with plaster removed one month later , request tac 3d. August 2010 triple arthrodesis.
HPI - 39 y/o female presents to ER with red, hot, swollen foot. No history of trauma or open lesions/ulcers. Patient diagnosed with diabetes and admitted to hospital for cellulitic foot. Patient was re-admitted to the hospital twice over a one month period for treatment of unresolved cellulitis. During that one month period the patient's diabetes was managed by PCP. No imaging studies were ordered during this one month period by any specialists. Patient was referred to infectious disease to uncover the source of cellulitis. Infectious disease ordered radiograph which revealed charcot foot.
What would be your first line of treatment in this case?
HPI - a car hit her foot -20 days ago - and caused this fracture and a wound at the dorsum of the foot and between the fingers ( not in continuity with the fracture )
What would be your treatment for this injury ?
HPI - history of fall 5months back leading to bimalleolar fracture.patient was managed conservatively ,gradually patient started developing symptoms with increasing pain .now patient is not able to walk even 500 meters with out experiencing pain.
How would you treat this injury?
HPI - history of twisting injury left ankle 2years back,treated by rest analgesics and crepe bandage.pain has gradually worsened and also sometimes radiates up the leg
What should be mode of treatment plan
HPI - pain& deformity of right ankle since 3 months,varus deformity increses on weight bearing,h/o underwent conservative treatment for 5 weeks by below knee cast,after removal of cast,instability&deformity persists,pt under went orif with reconplate & screw fixation to right ankle, after 6 weeks post operative,pt c/o rt ankle deformity,
what is the choice of treatment?
HPI - Severe pain resistant to medical treatment for 6 months.
HPI - patient is a 12 years old boy came for right foot pain and tearing of his right shoe just beneath 1st metatarsal head
which treatment do you prefer
HPI - passenger TA
overriding injury, Lt foot lateral lay
What is your choice of treatment this patient?
HPI - The patient fell down stairs 4 days ago and she injured her left leg.
HPI - Jumped out of second story house. Was found by police screaming and intoxicated.
What would you do for initial treatment
HPI - 20 year mai operated for club foot as child having
Residual foot deformity pain and shoe wearing difficulty
HPI - Patient with hallux valgus with first surgery consisted Chevron technique
What procedure do you perform ?
HPI - denies trauma, pain for several months
How would you treat this?
HPI - 41 yo Male twisted his left foot stepping off stair and could not bear weight
1)what should we management ,cast VS. operation ?
2) which choices of surgical technique incase you prefer operation??
HPI - patient is having pain in his left foot for 7 month aggravated by last 3 month.cant mobilise because on stepping he feels pain.on biopsy we found avn of bones.but ct angio and dopler studies found arterial system intact.
what can be the differential diagnosis and line of treatment
HPI - s/p glass vs. leg, with multiple tendon lacerations and 15cm laceration
How would you rehab this?
HPI - Rt Ankle Injury March 2011, presents now with Rt ankle pain.
HPI - s/p injury playing soccer. denies previous pain/trauma. was treated in non-weightbearing short-leg cast for the last 8 weeks.
What implant do you use?
HPI - s/p multiple podiatric surgeries on ankle, now with chronic pain, freely draining purulence. We were then consulted for evaluation by the podiatry team.
What would you do with this scenario?
HPI - 29 yo F twisted foot stepping off bleachers at a youth baseball game.
Would you fix this Jones fx?