You are evaluating a cross-country runner who has sustained…
You are evaluating a cross-country runner who has sustained a knee injury. He relates that as he turned a corner while running on a cross country course, he stepped in a shallow hole; his knee was slightly externally rotated. He noted quick swelling in his knee and that the knee seemed to “lock.” With the patient supine and his hip and knee flexed, external rotation of the lower leg on the affected side reveals a palpable “click” as the knee is flexed and extended. Further examination reveals a negative Drawer sign. Based on this information, which of the following conditions is the most likely source of this patient’s complaint?
Read DetailsA 38-year-old male presents with a three-month history of lo…
A 38-year-old male presents with a three-month history of low back pain and right leg pain that has failed to improve with non-operative modalities, including selective nerve root corticosteroid injections. Leg pain and paresthesias are localized to his buttock, lateral and posterior calf, and the dorsal aspect of his foot. On strength testing, he is graded a 4/5 for plantar-flexion and 4+/5 to ankle dorsiflexion. On flexion and extension radiographs there is no evidence of spondylolisthesis. Sagittal and axial T2-weighted MRI images reveal a large L5/S1 disc herniation. Which of the following treatment modalities will allow the greatest improvement of physical functioning?
Read DetailsA 10-year-old boy presents with left shoulder pain and defor…
A 10-year-old boy presents with left shoulder pain and deformity after a fall from his skateboard while attempting a half-pipe maneuver an hour ago. He heard a “cracking” sound and was unable to continue skateboarding. He has pain with movement of the arm in any direction. On exam, you note tenderness over the superior central shoulder with a palpable deformity and “tenting” of the skin. What is his most likely diagnosis?
Read DetailsA 16-year-old female presents to the Emergency Department af…
A 16-year-old female presents to the Emergency Department after injuring her knee in a soccer match earlier today. The injury occurred while suddenly decelerating and cutting to run in another direction. She heard a pop in the knee and complains the knee now gives out with any twisting motion. Which of the following tests is the most useful in eliciting the most likely diagnosis?
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