HPI - History of road traffic accident
How should this injury be definitively treated?
HPI - Sustained fracture after simple fall on the ground on her side
Best treatments possible ?
HPI - This is a 19 year old manual laborer whose nondominant left hand was pulled violently into a machine at work. He is neurovascularly intact. It is difficult to examine his carpus for a scapholunate injury given his pain, but on XR his films are suspicious for a widened scapholunate injury. He presented for treatment 2 days after injury.
How would you treat this patient operatively?
HPI - Fell down playing Padel 3 days ago. Non dominant hand, independet for daily life activities
How should this patient be treated?
HPI - septic arthritis ankle 2 years ago, since then bulking intermittent pain for 6 months.
Would you obtain any additional imaging studies prior to deciding treatment?
HPI - # Pain in the neck and right arm since 8 weeks. Pain significant in the first 2 weeks and gradually getting better and is under control on Pregabalin (75 mg BD). Initially treated with Diclofenac and oral steroid course. Pain still present but intermittent and mild discomfort. Noted especially while repeatedly abducting the shoulder.No interruption in daily routines.
# Weakness: Initial weakness using the right hand in the first 2 weeks. Gradually improving. Currently some subjective weakness.
No history of trauma
What should be the next step of management for pain (still requiring oral medications) and subjective weakness
HPI - 12 yr old female c/o limping gait and mild to moderate pain in left hip.no fever or weight loss
What is the most likely diagnosis
HPI - Painless knee crepitus
What is the MRI finding?
HPI - Lower extremity accident 48 hours prior to presentation
What additional imaging, if any would you obtain?
HPI - LEFT ANKLE INJURY ON MOTOR VEHICLE ACCIDENT. NO OTHER INJURIES.
How would you treat this fracture?
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 - accidental trauma, fell from ladder
how would you have treated this?
HPI - Patient sustained a proximal tibia fracture 4 months prior to presentation. The patient underwent ORIF without any apparent complications.
How would you treat this patient?
HPI - Patient developed pain left hip joint 2years back. After investigation he was diagnosed as having cystic lesion in the femoral head and neck with a pathologic fracture. He underwent ORIF as well as placement of a nonvascularized fibular allograft. The patient continues to have pain now.
Repeat MRI shows increase in the lytic lesion in head and neck with decrease in joint space and involvement of acetabulum.
What should be the treatment plan
HPI - Patient sustained a communited distal radius fracture 3 months prior to presentation. The patient underwent closed reduction and external fixation. After removal of external fixator at 6 weeks deformity progressively increased.At present patient has NO PAIN but pronation and supination are limited and there is decrease in dorsiflexion.
How would you treat this patient now?
HPI - 12 y/o male baseball player presents with his family concern of "limp" when running. No traumatic incident reported. 6 months of symptoms.
What would be your first line of treatment?
HPI - Right hand dominant patient who sustained an elbow injury after a fall from standing height 4 months ago ( August 2013 ) and was treated conservatively.
What is your preferred treatment?
HPI - 3 weeks after hemi for displaced femoral neck fracture, patient returns to clinic with click in hip. Has bilateral BKA's but previously ambulatory with prosthesis. Has been "crawling" around nursing home as current prostheses don't fit. Denies new injury. Wants to return home and walk again with prostheses. Has had stump wound problems recently but skin healing and prostheses being made.
How would you treat this injury?
HPI - Road side accident four days back.
HPI - A 32-year-old male, right hand dominant, is involved in a bar altercation when he punched the skull of another individual. The patient had immediate pain in his right hand and went to the emergency room. An initial reduction was performed and the patient was placed in a splint. Post reduction films are shown. He presents to your office 4 days after the injury.
How would you treat this fracture assuming there has been no change in the post reduction films?
HPI - 16 y/o male playing competitive baseball. While up at bat, he completes an aggressive swing and feels a pop above his right hip. He is unable to weight bear on the right leg due to pain.
What initial treatment option would you recommend?
HPI - The patient had an injury to his left elbow 3 years back. He underwent ORIF with k wires .Wires were removed after 6 months. Now he presents with stiffness at elbow joint with painless range of motion 70 to 90 degrees.
HPI - Fracture of the proximal end of femur 1.5 yrs ago. The patient underwent an ORIF with a DHS.
What option would be next in your treatment plan?
HPI - h/o fall 5 days ago treated in another hospital for medial elbow dislocation and radial head fracture. The elbow was not able to be completely reduced secondary to an intra articular fragment. The patient was reffered for further management
HPI - patient had closed fracture humerus 2 yrs back. Was treated with C/R AND I/F with ILN.
What should be further course of treatment
HPI - Fell 3 months ago. No dislocation.
What is the best treatment
HPI - fall from height.injury rt hip.pain.inabilty to stand
How would you treat this comminuted peri-trochanteric hip fracture
HPI - Asian male has insiduous onset pain swelling left wrist for 6 months. No h/o morning stiffness , trauma or any surgery
H/o night pain preaent
Mri showa inflammatory process. Esr is 40. Biopsy shows lymphocytes infiltration. No caseation . AFB biopsy negative
AFB culture is negative
HPI - pain at left hip ,increases on moving the left lower limb,5 cms of shortening,
what is treatment of choice now?
HPI - Motorcycle accident 9 days ago
What is the recommended treatment?
HPI - Rt. Hip pain post MVA.
what is the best treatment option for this kind of acetabular fracture.
HPI - She has been treated conservatively during 6 months
What is the best treatment?
HPI - Fall onto outstretched hand
No dislocation by report
HPI - Post MVA 5 days, initially presented with hip dislocation, after reduction hip joint stable
What is the best treatment option?
HPI - Fell from the stairs.
HPI - fall from height
How would you definitely treat this fracture
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 - pain bilateral knee joint ,right knee joint pain more severe than left.Had arthoscopic partial medial menisectomy and lavage about 3years back which gave temporary releif for about 6 months. also had intra articular hylaurinic acid injection, pain in right knee joint has increased severely
How would you treat this patient's right knee?
HPI - 33 y/o male s/p fall and distal radius fracture. Treated ~3 weeks ago at outside hospital with volar plate/screws. Has been using hand for work as a mechanic; c/o continued wrist pain.
How would you treat this pathology?
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.
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 - Trauma 2 months ago. No treatment
What would be your treatment choice?
HPI - Child hood septic arthritis right knee joint leads to ankylosis right knee
Now right knee joint is ankylosed, and osteoporosis
previously patient was fully mobile with stiff knee joint
What will be the best treatment for her
HPI - h/o RTA 5 mths ago treated by rt radius fixation nad left tibia nailing.radius healed uneventful.pain in leg since full weight bearing after 6 weeks.its 5 months since surgery. no intervention since then
What would be your treatment of choice
HPI - 38 y/o male smoker, thin build with permanent Rt femoral nerve neurotmesis deep in pelvis s/p GSW >12 months ago with early pelvic infection and Rt acetabular fx now healed and no infection for > 6 months off abx. Patient motivated to achieve more strength and mobility despite achieving independent gait with minimal pain. Knee extension only from IT band and tensor fascia. Functional and stable yet weak gait with intact hamstrings and gastrocnemius. Unable to perform leg raise in supine or sitting position. Neurosurgeon does not plan femoral nerve grafting.
What is your treatment recommendation for this previously active recreational athlete, community leader and businessman?
HPI - two years back patient had an accident and sustained Gustillo open III fracture Rt femur for which external fixator was applied.later on that was converted to Illizarov fixator but still not united.
now presented to us with gap union
How can this be treated??
HPI - Road side accident two days back.
What should be the treatment plan.
HPI - 2003 ankle fracture
yesterday accidental trauma
How would you treat it?
HPI - 21 year old female with history of recurrent dislocation patella was operated 2yrs back .lateral release ,proximal and distal alignment were performed .intraoperatively there was no dislocation. patient was asymptomatic for one year when after fall she again developed symptoms of recurrent dislocation of patella dwhich takes place in flexion beyond 100 degree
what should be the further treatment plan
HPI - h/o inabilty to weight bear on left leg after a twisting injury
operative or casting