A 36-year-old female was working on her deck 2 hours ago when her thumb got caught between two planks of wood. She is reporting severe persistent pain in the left thumb nail and states it seems to be getting worse. On exam the patient’s thumb nail has black/purplish discoloration underneath the intact nail. She maintains normal AROM, and is neurovascularly intact. There is a XR negative for fracture. Based on her exam, what is your diagnosis and what would you recommend? 

What are differentials that need to be on your list? 

A 7 year old boy is brought into the clinic due to acute new onset of limping. The onset was insidious without injury to the affected let. There is pain and limitation of motion to the right hip. The patient is afebrile and generally well appearing besides this limp. Labs are unremarkable for any abnormality. This may be indicative of which of the following condition?

A 7 year old boy is brought into the clinic due to acute new onset of limping. The onset was insidious without injury to the affected let. There is pain and limitation of motion to the right hip. The patient is afebrile and generally well appearing besides this limp. Labs are unremarkable for any abnormality. This may be indicative of which of the following condition?

Match the following common back pain terms with the correct definition: 

A 36-year-old female was working on her deck 2 hours ago when her thumb got caught between two planks of wood. She is reporting severe persistent pain in the left thumb nail and states it seems to be getting worse. On exam the patient’s thumb nail has black/purplish discoloration underneath the intact nail. She maintains normal AROM, and is neurovascularly intact. There is a XR negative for fracture. Based on her exam, what is your diagnosis and what would you recommend? 

A 21 year old male reports pain to the right knee after quickly stopping running and twisting while playing soccer. The affected knee had immediate instability and the patient was unable to continue playing soccer after the injury. On physical exam you note acute swelling and effusion to the right knee with a positive Lachman and Anterior Drawer Tests. Which of the following conditions is most likely?

A 60 year old patient presents with complaints of knee pain with no trauma/injury precipitating the pain. They report pain with passive flexion of the affected knee as well as a sense of instability of the affected knee which is described as locking or giving away. Which of the following is the most likely diagnosis and what is the next best action for this patient?

What diagnostic tests would you consider for your top differential? 

Based on this patient’s symptoms and physical exam findings, lumbosacral nerve root is likely affected by this condition?