4.2 of 46 Ratings
Technique guides are not considered high yield topics for orthopaedic standardized exams including ABOS, EBOT and RC.
An 18-year-old female military recruit falls and sprains her wrist during basic training. One month later she reports to clinic with a dorsal wrist mass. A wrist MRI is reviewed (Figures A and B). The histopathology of the lesion would reveal what cellular pattern?
Uniform distribution of stromal cells and giant cells
Mixture of mature fat cells and spindle cells
Fibroblasts with mixed Schwann cells, mast cells, and lymphocytes
Lobular pattern of vascular proliferation with inflammation
Mucin-filled space with occasional spindled fibroblasts
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A 35-year-old jack-hammer operator presents with progressive hand weakness over the last year. He has been reluctant to see a physician. He notes some loss of coordination but otherwise denies any numbness. When asked to pinch a piece of paper, his thumb IPJ and index finger DIPJ flex. Electrodiagnostic studies demonstrate positive sharp waves in the adductor pollicis. An MRI is obtained and is seen in Figure A. What is the physical relationship of the affected neurovascular bundle?
The superficial branch of the radial nerve is dorsal and radial to the radial artery
The median nerve is ulnar to the radial artery
The ulnar nerve is dorsal and radial to the ulnar artery
The ulnar nerve is volar and radial to the ulnar artery
The ulnar nerve is ulnar and dorsal to the ulnar artery
A 25-year-old male presents to the clinic with a painful, enlarging mass at the volar radial wrist. He initially noticed the mass 6 months ago after he hurt his wrist golfing. Figure A shows a clinical photograph of the patient's wrist. Radiographs are unremarkable. An ultrasound of the mass is shown in Figure B. Surgical excision is planned. Which of the following is the most appropriate type of resection and histologic finding?
Intralesional excision; synovial cells with mucin accumulation
Incision & drainage; polymorphonuclear cells
Wide excision; histiocytes with frequent giant cells
Marginal excision; synovial cells with mucin accumulation
Intralesional excision; histiocytes with frequent giant cells
A 54-year-old male presents with a slowly enlarging mass on the dorsum of his left wrist which has been present for 3 years. He denies any significant symptoms. Physical exam shows a 1 cm palpable mass. An MRI is shown in Figure A. Based on these findings, which of the following is true regarding the most likely diagnosis?
Definitive aspiration yields low recurrence rate
Lacks a true epithelial lining
Lined by synovial cells with mucinous accumulation
Most commonly originate from the STT joint
Wide excision is necessary
Which of the following factors is inconsistent with a retinacular cyst of the flexor tendon sheath?
Small size (2-8mm)
Palpable under metacarpophalangeal flexion crease
May be excised with a small portion of the flexor sheath to prevent recurrence
Aspiration may be a successful treatment
Mass moves with the tendon
A 10-year-old boy presents with a painless mass on the dorsal aspect of his wrist that has been present for 3 weeks. A clinical image is shown in Figure A. T1 and T2 magnetic resonance images are shown in Figure B and C, respectively. On your exam, the mass transilluminates and Allen test reveals patent radial and ulnar arteries. What is the most appropriate next step in management?
Referral to a orthopaedic oncologist
Surgical excision with wide margins
Autologus bone marrow aspirate injection
Injection of N-Butyl-Cyanoacrylate