Lower Limb

Question 1

when does the apophysis of 5th MT appear

Answer 1

10 years - female
12 years - male

Question 2

35% of all foot injuries are ___

Answer 2

MT injuries

Question 3

70% of all MT # are ___

Answer 3

5th MT #

Question 4

tuberosity avulsion # is due to ___

Answer 4

• Forced inversion of foot & ankle while they are in plantar flexion
• combo of forced contraction peroneus brevis during hindfoot hindfoot inversion & contracture of plantar fascia lateral band

Question 5

stress # mainly affect

Answer 5

2nd & 3rd MTs

Question 6

what are the accessory ossicles of the foot

Answer 6

trigonum, pernieum, naviculare, intermetatarseum, vesalianum, supranaviculare, supratalare, talotibiale, calcaneus secundarium

Question 7

transverse # of base of 5th MT is due to

Answer 7

twisted ankle with forced inversion injury

Question 8

what is bohler’s angle

Answer 8

between a line drawn from the highest point of the anterior process of the calcaneus to the highest point of the posterior facet and a line drawn tangential to the superior edge of the tuberosity and the posterior facet

Question 9

bohler’s angle is normally __

Answer 9

20 - 40 degrees

Question 10

bohler’s angle of < 20 degrees is suggestive of

Answer 10

calcaneal #

Question 11

AP mortise joint space is normally __

Answer 11

4mm width

Question 12

clear separation of tibia & fibula in AP mortise suggest

Answer 12

torn interosseous membrane

Question 13

lateral view of the ankle is good for __

Answer 13

assessing full extent of talar # & displacement, posterior tibial lip, talus & calcaneum

Question 14

what are the signs which suggest tibial plateau

Answer 14

• # plateau has irregular surface / layered & # lines extend inferiorly
• Area of focal density increase below plateau suggestive of bone compression
• Lateral tibial condyle margin displacement of > 5mm suggestive of lateral plateau #
• Fat fluid level seen on lateral radiographs suggestive of lipohaemoarthrosis which is marrow fat leaking into the joint via #

Question 15

what signs suggest PCL avulsion #

Answer 15

tiny fragment close to tibial articular surface posterior

Question 16

what signs suggest ACL avulsion #

Answer 16

Tiny fragment seen close to tibial spine

Question 17

what is a common site for tibial stress #

Answer 17

proximal tibia as a sclerotic band

Question 18

what signs are suggestive of ruptured patellar tendon

Answer 18

Distance from tibial tubercle to lower pole of patella exceeds patellar length of > 20%

Question 19

what signs are suggestive of bipartite patella

Answer 19

patella parts do not fit together like a puzzle

Question 20

what signs are suggestive of fabella

Answer 20

tiny bone found in tendon of lateral head of gastrocnemius muscle

Question 21

when is joint effusion present

Answer 21

if suprapatellar strip > 5mm

Question 22

what happens when the suprapatellar strip > 5mm

Answer 22

displaces quadricep tendon & patella anteriorly

Question 23

what are the signs consistent with lipohemarthrosis

Answer 23

comminuted intra-articular plateau # & fat fluid level in suprapatellar pouch

Question 24

what are the signs consistent with ruptured infrapatellar ligament

Answer 24

if patella is abnormally higher than knee joint such as increased distance between inferior pole of patella & tibial tuberosity

Question 25

white lines in bones suggest

Answer 25

impaction

Question 26

black lines in bones suggest

Answer 26

displacement

Question 27

dislocations are common from ____ & occurs ___

Answer 27

high energy trauma; anteriorly, centrally, posteriorly

Question 28

intracapsular # have increased risk of ___

Answer 28

avascular necrosis

Question 29

extracapsular # have no increased risk of __

Answer 29

avascular necrosis

Question 30

where is os acetabuli

Answer 30

small bony fragment at superior margin of acetabular rim

Question 31

pediatric patient presents with hip pain but no recent trauma. what could be the disease?

Answer 31

Perthe's Disease

Question 32

patient of puberty age presents with hip pain but no recent trauma. what could be the disease?

Answer 32

slipped capital femoral epiphysis

Question 33

patient of 13 - 25 years old presents with hip pain but no recent trauma. what could be the disease?

Answer 33

soft tissue calcification / apophyseal irregularities

Question 34

what view confirms the suspicion of slipped capital femoral epiphysis

Answer 34

frog leg lateral view

Question 35

if the lateral edge of epiphysis is within lateral 3rd of metaphysis, what is the condition of SCFE

Answer 35

mild

Question 36

if the lateral edge of epiphysis is between lateral 1/3 & midpoint of metaphysis, what is the condition of SCFE

Answer 36

moderate

Question 37

if the lateral edge of epiphysis is medial 3rd / over the midpoint of metaphysis, what is the condition of SCFE

Answer 37

severe