SKM/ORTHO

Question 1

Runner with medial ankle pain on activity. Tender/causes parathesias when palpated there. Dx?

Answer 1

Tarsal Tunnel Syndrome = entrapment of the posterior tibial nerve

Tibial nerve becomes entrapped secondary to varicose veins, tenosynovitis of the flexor tendon, trauma

Question 2

Common runner injuries

Answer 2

IT (Iliotibial) syndrome band syndrome: Stinging pain over the lateral femoral epicondyle

Stress fracture of femoral neck: persistent groin pain, and limited hip flexion and internal rotation.

Osteitis pubis: pain in the anterior pelvic area and tenderness over the symphysis pubis.

Question 3

What degree of angulation is tolerated on a boxer’s fracture?

Answer 3

40 degrees of volar angulation of the 5th metacarpal

(Fewer degree are acceptable for 4th, 3rd metacarpals)

–> ulner gutter

Question 4

Young, physically active patient with groin pain of insidious onset that is worse with sitting, rising from a seat/getting in and out of car, and leaning forward. Dx? PE?

Answer 4

Femoroacetabular impingment (congenital malformation/bone spur later leads to impingement)

+ FABER and FADIR test (96,88% sens)

–> Start with AP/lateral (and Dunn view)

–> PT may help, then consider surgery