100 Cases in Orthopaedics and Rheumatology by Parminder J Singh, Catherine Swales

By Parminder J Singh, Catherine Swales

A 24-year-old girl attends rheumatology outpatients with an eight-week historical past of painful palms. On exam she is tearful and skinny. you're the medic on duty...

100 circumstances in Orthopaedics and Rheumatology provides a hundred situations usually visible via clinical scholars and junior medical professionals in orthopaedic and rheumatology clinics, or within the emergency division. A succinct precis of the patient's historical past, exam and preliminary investigations, with scientific and/or imaging images, is via questions about the analysis and administration of every case. the reply contains a precise dialogue on every one subject, with extra representation the place acceptable, offering a vital revision relief in addition to a realistic consultant for college students and junior medical professionals.

Making scientific judgements and selecting the simplest plan of action is likely one of the so much hard and hard components of educating to turn into a physician. those situations will train scholars and junior medical professionals to acknowledge vital signs and symptoms and, the place acceptable, their dating to different health conditions, and to enhance their diagnostic and administration abilities.

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A radiograph is shown in Fig. 1. 1 Questions • What is the diagnosis? • If you could not see the injury clearly on plain X-rays in a patient with pain, what investigation would you request next? • How would you classify this injury? • Describe the blood supply to the femoral head • How would you manage this patient’s injury? • How would you manage a patient with an extracapsular fracture of their proximal femur? 41 100 Cases in Orthopaedics and Rheumatology ANSWER 15 The diagnosis is a fractured neck of femur.

The third is the arteries of the ligamentum teres. A large branch of the medial femoral circumflex artery forms the extracapsular arterial ring posteriorly and anteriorly by a branch from the lateral femoral circumflex artery. The ascending cervical branches ascend on the surface of the femoral neck anteriorly along the intertrochanteric line. Posteriorly, the cervical branches run under the synovial reflection towards the rim of the articular cartilage, which demarcates the femoral neck from its head.

21 100 Cases in Orthopaedics and Rheumatology ANSWER 7 This is a fracture of the proximal humerus. The X-rays show displacement of the greater tuberosity and the surgical neck of humerus. The humeral head is not dislocated. This is a typical fracture pattern in an elderly woman with osteoporosis. Swelling and tenderness to palpation are typically present. Bruising extending along the arm distally and along the chest wall is often present a few days following injury. The proximal humerus consists of four bony parts: humeral head (articular surface), greater tuberosity, lesser tuberosity and the humeral diaphysis.

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