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A 55 year-old woman comes to you with 2 months of right foot pain. She is active in ballet and her pain is exacerbated with push-off and en pointe maneuvers. A radiograph, bone scan, and MRI are found in Figures A-C, respectively. Your next step in management should consist of:
Percutaneous biopsy and referral to an orthopaedic oncologist
Walker boot application and evaluation for metabolic bone disease
Referral to an orthopaedic oncologist for limb salvage procedure
Internal fixation of the fracture and evaluation for metabolic bone disease
Metatarsal-cuneiform fusion of the Lisfranc joint
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A 19-year-old cross country runner complains of 3 months of foot pain with running. Based on the radiographs shown in Figure A, what is the most appropriate next step in treatment?
open reduction, internal fixation
continue running with a molded orthotic
protected weightbearing with crutches, with slow return to running
percutaneous Kirschner wire fixation
A 26-year-old professional ballet dancer presents with insidious onset of right midfoot pain which began 6 months ago. She has no history of ankle or foot trauma, and medical history is significant only for delayed menarche. Radiographs are shown in Figure A. What is the most likely diagnosis?
Lisfranc joint injury
Cuneiform stress fracture
Second metatarsal base stress fracture
Plantar fascia strain
First metatarsal base stress fracture
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?