A 28-year-old basketball player sustained an inversion injur...

Sorry, only PEAK Subscribers can view this question

A 54-year-old man with a history of a bimalleolar ankle fracture eight years ago presents with chronic, worsening right ankle pain and progressive difficulty ambulating. On examination, he has a markedly antalgic gait and limited ankle dorsiflexion and plantarflexion. Radiographs reveal severe joint space narrowing and varus deformity at the tibiotalar joint, with mild degenerative changes at the subtalar joint. His medical history is notable for well-controlled type 2 diabetes without neuropathy. He elects to undergo an arthrodesis procedure. Which of the following is the most appropriate next step?

A 24-year-old female presents with lateral ankle swelling, p...

Sorry, only PEAK Subscribers can view this question

A 48-year-old woman presents with a closed, unstable bimalleolar ankle fracture-dislocation and develops fracture blisters diffusely over the ankle. Relevant past medical history is significant for well-controlled type 2 diabetes mellitus without peripheral neuropathy. Which initial management strategy is LEAST likely to lead to secondary loss of reduction and skin necrosis in this scenario?

A 22-year-old male collegiate football player sustains a lef...

Sorry, only PEAK Subscribers can view this question

You are a junior resident on call at a level-one trauma cent...

Sorry, only PEAK Subscribers can view this question

A 34-year-old banker is transferred to the hospital after he sustained a twisting injury to his right ankle while playing tackle football. Initial radiographs of the ankle are displayed in Image A, and you suspect that the patient may have a Maisonneuve fracture. Which of the following additional radiographs would suggest the presence of this injury?

You are consulted on a 64-year-old male who has sustained an...

Sorry, only PEAK Subscribers can view this question

A 66-year-old patient with diabetes underwent a left total a...

Sorry, only PEAK Subscribers can view this question

A collegiate volleyball player is referred to you from her t...

Sorry, only PEAK Subscribers can view this question

A 21-year-old ballet dancer presents to clinic with posterio...

Sorry, only PEAK Subscribers can view this question

A 23-year-old recreational soccer player presents with compl...

Sorry, only PEAK Subscribers can view this question

A 23-year-old female soccer player presents with chronic lat...

Sorry, only PEAK Subscribers can view this question

A 32-year-old male presents with acute pain and swelling of the right ankle following a high-energy motor vehicle accident. Radiographs confirm a displaced intra-articular ankle fracture. Synovial fluid aspirated from the ankle reveals a markedly increased neutrophil count. Histopathology of the synovium shows prominent neutrophil and macrophage infiltration with acute synovitis. Which cytokine is most likely responsible for recruiting these neutrophils and driving neutrophil-mediated cartilage degradation?

A 12-year-old boy who plays multiple sports has had insidiou...

Sorry, only PEAK Subscribers can view this question

A 17-year-old basketball player...

Sorry, only PEAK Subscribers can view this question

A 17-year-old basketball player...

Sorry, only PEAK Subscribers can view this question

Which of the following mechanisms of injury to the ankle is most likely to result in disruption of the superior peroneal retinaculum with subsequent peroneal tendon instability?

A 19-year-old military recruit presents to your office with complaints of lateral ankle pain approximately seven centimeters proximal to the ankle joint for the past three weeks. You are concerned that the patient has a fibular stress fracture. Which of the following describes the most likely radiographic findings for this injury at the time of presentation?

An ankle fracture is illustrated in Figure A. What is the La...

Sorry, only PEAK Subscribers can view this question

A 34-year-old patient is noted to have a lack of ankle dorsiflexion by 5 degrees with knee extension as seen in Figure A. However, the ankle dorsiflexion improves to 20 degrees with knee flexion as seen in Figure B. Which of the following diagnoses would benefit MOST from a gastrocnemius recession (Strayer procedure)?

A 21-year-old college student twisted her ankle while descending the stairs at the campus football stadium three days ago. She notes pain and swelling over the lateral ankle that is worse after walking across campus to her classes. Radiographs of the affected ankle are shown in Figures A-C. Clinical exam demonstrates no pain at the distal tibiofibular joint with compression of the calf above the joint, no excessive anterior displacement of the talus on the tibia in plantarflexion, and the additional findings reflected in Figure D. Which of the following reflects the next best step in her management?

An 11-year-old boy sustained an ankle injury while playing football. Figure 20 shows an AP radiograph obtained the day of injury. Treatment should consist of

Figure A is the radiograph of a 32-year-old male who present...

Sorry, only PEAK Subscribers can view this question

A well-educated nurse is seeking a third opinion regarding her 4-year-old daughter with right ankle pain. She states her daughter has sprained her ankle 15 to 20 times over the past year. She insists her daughter has a diagnosis of tarsal coalition that requires immediate surgery. She is also due to see a neurologist for a second opinion regarding unwitnessed seizure activity, despite reassurance from the last subspecialist that the child is healthy. The examination of the right ankle was normal. Radiographs of the foot and ankle are seen in Figures A and B. What would be the next best step in treatment?

A 49-year-old woman underwent a successful right ankle fusio...

Sorry, only PEAK Subscribers can view this question

An 18-year-old presents with complaints of ankle pain after a fall 10 days ago. He has kept his ankle wrapped and elevated as recommended by his primary care doctor. He is neurovascularly intact on physical exam. The provocative maneuver shown in Figure A is positive. What neuromuscular pathway needs to be rehabilitated to reduce recurrence of the injury?

Vitamin C has been shown to decrease the likelihood of which...

Sorry, only PEAK Subscribers can view this question

Figures A and B show a 50-year-old diabetic male who present...

Sorry, only PEAK Subscribers can view this question

Figures A&B are the radiographs of a 21-year-old female soccer player who sustained an ankle injury during a game seven days ago. She was placed in a splint and has been using crutches since the injury. She reports that she has been unable to put any weight on the ankle. On examination, she has mild tenderness both anterior and distal to the tip of the fibula. She is also found to have increased translation with the test shown in Figure C, but no pain with the test shown in Figure D. What would be the next best step in this patient's management?

The anterior drawer test with the ankle in 20 degrees of plantarflexion most effectively tests for injury or laxity or which of the following ligaments shown in Figure A?

A 23-year-old active duty soldier is referred to your clinic...

Sorry, only PEAK Subscribers can view this question

A 32-year-old male was skiing in the Swiss Alps two months a...

Sorry, only PEAK Subscribers can view this question

A juvenile Tillaux ankle fracture is caused by an avulsion injury involving which of the following structures?

A 30-year-old professional ballet dancer presents with persistant ankle pain after an ankle sprain 6 months ago. Physical therapy and NSAID's have not alleviated the symptoms. Physical exam reveals some joint swelling but no ligamentous instability. Radiographs are unremarkable. What is the next appropriate step in the management of this patient?