Ortho Dx: Severe pelvic pain after childbirth

Ortho Dx: Severe pelvic pain after childbirth

A 19-year-old woman complains of severe pain in her pelvis after vaginal delivery of her first child. One day after ...

Ortho Dx: What is the best treatment for this knee injury?

Ortho Dx: What is the best treatment for this knee injury?

A 22-year-old woman presents to the emergency department with left knee pain after a motor vehicle accident. Her left knee ...

Ortho Dx: Treatment for lower back and buttock pain

Ortho Dx: Treatment for lower back and buttock pain

A 27-year-old woman presents to the emergency department with increasing lower back and buttock pain for 3 weeks. She admits ...

Ortho Dx: A 67-year-old woman with activity-related thigh pain

Ortho Dx: A 67-year-old woman with activity-related thigh pain

A 67-year-old woman presents with activity-related right thigh pain. The pain increases as she gets farther into her walks, and ...

Ortho Dx: Foot pain that is worse in the morning

Ortho Dx: Foot pain that is worse in the morning

A 64-year-old man presents with right foot pain that he has had for several months. The pain is worse in ...

Ortho Dx: What is the best treatment for this shoulder pain?

Ortho Dx: What is the best treatment for this shoulder pain?

A 62-year-old woman presents with 3 months of left shoulder pain. X-rays show osteonecrosis of the humeral head with advanced ...

Ortho Dx: Neck pain after a motor vehicle accident

Ortho Dx: Neck pain after a motor vehicle accident

A 46-year-old man presents to the emergency department with severe neck pain after a motor vehicle accident. Imaging shows a ...

Ortho Dx: A woman with a hip that is popping out of place

Ortho Dx: A woman with a hip that is popping out of place

A 35-year-old woman presents with right hip pain, which she has had for several months. She stopped running recently due ...

Ortho Dx: What is the best treatment for this foot injury?

Ortho Dx: What is the best treatment for this foot injury?

A woman presents with left foot pain from a fall 2 days prior to her visit. She complains of pain ...

Ortho Dx: A shoulder injury after a mixed martial arts competition

Ortho Dx: A shoulder injury after a mixed martial arts competition

A 23-year-old woman presents to the emergency department with a left shoulder injury that occurred when she was competing in ...

Ortho Dx: Preventing postoperative infection after an open femur fracture

Ortho Dx: Preventing postoperative infection after an open femur fracture

A 48-year-old man presents to the emergency department by way of ambulance after a motorcycle accident. He was thrown off ...

Ortho Dx: Complications after total knee arthroplasty

Ortho Dx: Complications after total knee arthroplasty

An 80-year-old woman presents with 3 months of right shin pain. She had a revision total knee replacement 5 years ...

Ortho Dx: Elbow pain in the throwing athlete

Ortho Dx: Elbow pain in the throwing athlete

A 17-year-old male presents with right elbow pain for several months. He plays baseball 7 months of the year and ...

Ortho Dx: Treatment for a comminuted scaphoid fracture

Ortho Dx: Treatment for a comminuted scaphoid fracture

A 58-year-old woman presents with left wrist pain after slipping on ice and falling 3 months ago. X-rays show a ...

Ortho Dx: A case of compartment syndrome

Ortho Dx: A case of compartment syndrome

A 38-year-old man presents to the emergency department in an ambulance after sustaining a right leg injury. X-rays show a ...

Ortho Dx: Which grade of arthritis does this patient have?

Ortho Dx: Which grade of arthritis does this patient have?

A 63-year-old woman presents with left knee pain that she has had for several months. X-rays show mild joint space ...

Ortho Dx: Wrist pain after a motorcycle accident

Ortho Dx: Wrist pain after a motorcycle accident

A 24-year-old male presents with right wrist pain following a motorcycle accident 2 days ago. An X-ray taken on the ...

Ortho Dx: A chainsaw injury to the forearm

Ortho Dx: A chainsaw injury to the forearm

A 58-year-old male presents with a chainsaw injury to the left forearm. He was trimming some trees when he lost ...

Ortho Dx: Can you identify this structure?

Ortho Dx: Can you identify this structure?

Can you identify the structure in Figure 1 that the yellow arrow points to?

Ortho Dx: Pain over the lateral midfoot

Ortho Dx: Pain over the lateral midfoot

The pain is located over the lateral midfoot, and the patient has tenderness to palpation over an apparent ossicle adjacent ...

Ortho Dx: Ankle stabilization

Ortho Dx: Ankle stabilization

On examination, the patient has an increased anterior drawer test and slight talar tilt of the left ankle. Radiographs of ...

Ortho Dx: A nondisplaced fracture through a radiolucent lesion

Ortho Dx: A nondisplaced fracture through a radiolucent lesion

Examination of a patient presenting with finger pain finds tenderness to the distal phalanx without deformity. Radiographs show a nondisplaced ...

Ortho Dx: Thigh pain 2 years after hip replacement surgery

Ortho Dx: Thigh pain 2 years after hip replacement surgery

A 65-year-old postal worker who had total hip replacement surgery 2 years ago notices pain in his thigh over the ...

Ortho Dx: A humerus fracture after a bike accident

Ortho Dx: A humerus fracture after a bike accident

A 19-year-old woman is thrown over the handlebars of her bicycle during an accident and lands on her elbow. Radiographs ...

Ortho Dx: Would you remove this fingernail?

Ortho Dx: Would you remove this fingernail?

After getting her finger caught between a board and a cement block, a 50-year-old woman presents with a subungual hematoma ...

Ortho Dx: Increased forefoot pain when metatarsal heads squeezed

Ortho Dx: Increased forefoot pain when metatarsal heads squeezed

A 56-year-old woman presents with a several-month history of forefoot pain. Examination finds that the pain increases when squeezing the ...

Ortho Dx: A calcified mass in the back of the knee

Ortho Dx: A calcified mass in the back of the knee

Lateral radiograph of an 82-year-old man with knee pain reveals a calcified mass in the back of the knee. Magnetic ...

Ortho Dx: Pediatric plastic deformation

Ortho Dx: Pediatric plastic deformation

A child riding on a scooter falls forward and lands on his outstretched hand. Radiographs show a distal one-third radius ...

Ortho Dx: A fibula fracture with ankle swelling

Ortho Dx: A fibula fracture with ankle swelling

A 29-year-old man has ankle and leg pain after slipping on ice. Radiographs of the tibia and fibula show an ...

Ortho Dx: Which graft would you choose to reconstruct this ACL?

Ortho Dx: Which graft would you choose to reconstruct this ACL?

A 17-year-old male injures his knee during a lacrosse game. Magnetic resonance imaging shows a complete anterior cruciate ligament (ACL) ...

Ortho Dx: Does this patient's pain originate at the neck?

Ortho Dx: Does this patient's pain originate at the neck?

A 48-year-old woman with severe shoulder and neck pain demonstrates mildly positive shoulder impingement signs and a negative Spurling test ...

Ortho Dx: Choose the best surgical option for these two patients

Ortho Dx: Choose the best surgical option for these two patients

A 70-year-old man and a 74-year-old man with shoulder pain have failed conservative treatment with intra-articular steroid injections, rest, and ...

Ortho Dx: Which finding indicates cervical myelopathy?

Ortho Dx: Which finding indicates cervical myelopathy?

Anteroposterior and lateral cervical spine radiographs of an 85-year-old man with severe upper extremity pain show multilevel degenerative changes.

Ortho Dx: The treatment dilemma with partial rotator cuff tears

Ortho Dx: The treatment dilemma with partial rotator cuff tears

Shoulder arthroscopy of a 49-year-old woman with a 4-month history of shoulder pain reveals a partial tear through 60% of ...

Ortho Dx: A girl with knee pain when she jumps and runs

Ortho Dx: A girl with knee pain when she jumps and runs

A 12-year-old girl recently started playing basketball and presents with knee pain that seems to increase with jumping and running. ...

Ortho Dx: A young cheerleader falls on her arm

Ortho Dx: A young cheerleader falls on her arm

After falling on her outstretched arm from 4 feet in the air, an 11-year-old cheerleader is experiencing pain and difficulty ...

Ortho Dx: Progressive flexion deformity of the finger

Ortho Dx: Progressive flexion deformity of the finger

A 52-year-old man diagnosed with Dupuytren contracture a year ago presents with increasing contracture to his ring finger.

Ortho Dx: Avascular necrosis of the hip

Ortho Dx: Avascular necrosis of the hip

After physical therapy and trigger-point injections, a 27-year-old woman continues to have lower back and left hip pain. Left hip ...

Ortho Dx: A rare foot injury

Ortho Dx: A rare foot injury

After tripping while running, a 32-year-old man presents with severe foot pain and deformity; 3-dimensional computed tomography shows incongruence of ...

Ortho Dx: Is this a patella alta or a patella baja?

Ortho Dx: Is this a patella alta or a patella baja?

A 31-year-old woman trips on the stairs, and her knee strikes a railing. She has been unable to bear weight ...

Ortho Dx: A teenager falls off his friend's shoulders

Ortho Dx: A teenager falls off his friend's shoulders

A 16-year-old male injures his shoulder falling off the shoulders of a friend. He has had shoulder pain since the ...

Ortho Dx: Chronic lower back pain after traumatic fall

Ortho Dx: Chronic lower back pain after traumatic fall

After recovering well from a T12 compression fracture that resulted from a fall 5 years ago, a 42-year-old man’s back ...

Ortho Dx: Can you see the radiographic finding that indicates the diagnosis?

Ortho Dx: Can you see the radiographic finding that indicates the diagnosis?

After a rollover car accident, a 29-year-old man cannot move his shoulder. Imaging scans show a posterior shoulder dislocation.

Ortho Dx: Snapping hip

Ortho Dx: Snapping hip

A 23-year-old man is diagnosed with snapping hip. Radiographs are negative for abnormalities.

Ortho Dx: Growth disturbances following growth plate fracture

Ortho Dx: Growth disturbances following growth plate fracture

Computed tomography of a 13-year-old boy who injured his knee jumping off of a wall shows a minimally displaced Salter-Harris ...

Ortho Dx: A pediatric distal radius fracture

Ortho Dx: A pediatric distal radius fracture

An 8-year-old boy presents with wrist pain following a soccer injury. Radiographs show a distal radius fracture.

Ortho Dx: A double posterior cruciate ligament sign

Ortho Dx: A double posterior cruciate ligament sign

After a soccer injury, a 31-year-old man presents with knee pain and cannot fully extend his knee. Magnetic resonance imaging ...

Ortho Dx: A man with years of ankle pain

Ortho Dx: A man with years of ankle pain

After intermittent pain in the ankle for 3 to 4 years, a 42-year-old man presents with a 6-week history of ...

Ortho Dx: How would you treat this clavicle fracture?

Ortho Dx: How would you treat this clavicle fracture?

A 19-year-old man sustains a clavicle fracture after falling off his dirt bike. The skin over the clavicle is intact ...

Ortho Dx: What are the grade and type of this spondylolisthesis?

Ortho Dx: What are the grade and type of this spondylolisthesis?

Imaging of this 55-year-old woman with lower back pain finds facet arthropathy, disk space narrowing, and both foraminal and central ...

Ortho Dx: A bump on the back of the heel

Ortho Dx: A bump on the back of the heel

A 67-year-old woman presents with a tender bump that has been on her heel for 1 year. Oral anti-inflammatory drugs, ...

Ortho Dx: How would you treat this ankle fracture dislocation?

Ortho Dx: How would you treat this ankle fracture dislocation?

A 51-year-old man presents to the emergency department with left ankle pain and deformity after tripping while hiking. Radiographs show ...

Ortho Dx: A rare source of shoulder pain

Ortho Dx: A rare source of shoulder pain

An incidental finding on radiographs taken of this 40-year-old man shows a rare source for his shoulder pain.

Ortho Dx: Femur fracture before walking age

Ortho Dx: Femur fracture before walking age

Skeletal survey of a 4-month-old girl identifies a spiral fracture of the left femur. The father reports that he lost ...

Ortho Dx: Thumb pain with repeated lifting

Ortho Dx: Thumb pain with repeated lifting

A 57-year-old woman who recently began caring for her 1-year-old granddaughter presents with thumb pain.

Ortho Dx: A child is injured after a fall from a tree

Ortho Dx: A child is injured after a fall from a tree

Trauma radiographs of the elbow of a 3-year-old boy who fell from a tree show supracondylar distal humerus fracture with ...

Ortho Dx: Pelvic bone fracture after a fall

Ortho Dx: Pelvic bone fracture after a fall

A 79-year-old woman presents with hip pain after a fall. Anteroposterior radiograph of the pelvis reveals left-sided superior and inferior ...

Ortho Dx: Incapacitating back pain after a car accident

Ortho Dx: Incapacitating back pain after a car accident

A 49-year-old woman returns to the emergency department for a second time with incapacitating mid-back pain 1 week after sustaining ...

Ortho Dx: Leg pain after a soccer kick

Ortho Dx: Leg pain after a soccer kick

A 20-year-old woman presents with 2 weeks of leg pain and swelling after a soccer injury. She has a mass ...

Ortho Dx: Painful calcium deposits on the forearm

Ortho Dx: Painful calcium deposits on the forearm

A 66-year-old woman with a history of scleroderma presents with cutaneous calcium deposits on the forearm with ulceration and sinus ...

Ortho Dx: MCL tear in a teen lacrosse player

Ortho Dx: MCL tear in a teen lacrosse player

A 16-year-old lacrosse player is diagnosed with a medial collateral ligament (MCL) tear 1 week after he was struck on ...

Ortho Dx: Knee pain and joint effusion years after TKA

Ortho Dx: Knee pain and joint effusion years after TKA

A 57-year-old man presents with knee pain and joint effusion 6 years after a total knee replacement. He denies injury ...

Ortho Dx: Stiffness after total knee replacement

Ortho Dx: Stiffness after total knee replacement

A 50-year-old man presents with complaints of stiffness and pain 6 weeks after having a left total knee replacement.

Ortho Dx: The kind of fracture you can't miss

Ortho Dx: The kind of fracture you can't miss

An 18-year-old male presents with left foot pain after twisting his ankle during a basketball game 2 days previously.

Ortho Dx: Leg length discrepancy after total hip replacement

Ortho Dx: Leg length discrepancy after total hip replacement

A 67-year-old woman presents with pain in her lower back and right lateral hip.

Ortho Dx: Shoulder pain and stiffness

Ortho Dx: Shoulder pain and stiffness

A 51-year-old woman presents with a 3- to 4-week history of left shoulder pain

Ortho Dx: Heel pain that worsened after a walking tour

Ortho Dx: Heel pain that worsened after a walking tour

A 72-year-old woman presents with left heel pain that has been present off and on for months but has become ...

Ortho Dx: Which nerve root is being compressed in this patient?

Ortho Dx: Which nerve root is being compressed in this patient?

A 66-year-old woman presents with a 4-week history of neck pain and radiating right arm pain.

Ortho Dx: Distal biceps rupture

Ortho Dx: Distal biceps rupture

A 50-year-old man presents with right arm pain, weakness, and bruising after an injury 3 days earlier.

Ortho Dx: Radiolucent lesion on the small finger

Ortho Dx: Radiolucent lesion on the small finger

A 38-year-old woman presents with a bump on her right small finger that she noticed a few months ago.

Ortho Dx: Degenerative spondylolisthesis

Ortho Dx: Degenerative spondylolisthesis

A 58-year-old woman presents with lower back pain for more than a year.

Ortho Dx: Valgus-impacted femoral neck fracture

Ortho Dx: Valgus-impacted femoral neck fracture

A 76-year-old woman presents with severe left hip pain after a fall at home.

Ortho Dx: Flexor tendon injury

Ortho Dx: Flexor tendon injury

A 19-year-old patient presents with a 1-week history of a left thumb laceration.

Ortho Dx: How does partial and total knee replacement compare?

Ortho Dx: How does partial and total knee replacement compare?

A 53-year-old woman presents with a several-month history of right knee pain.

Ortho Dx: Which surgery is best for MTP joint arthritis?

Ortho Dx: Which surgery is best for MTP joint arthritis?

A 46-year-old woman presents with a several-month history of pain in the left great toe.

Ortho Dx: Unresolved ankle pain after a sports injury

Ortho Dx: Unresolved ankle pain after a sports injury

A 10-year-old boy presents with a 4-month history of right ankle pain.

Ortho Dx: A mass on the wrist

Ortho Dx: A mass on the wrist

A 51-year-old woman presents with a 2-month history of a mass on her right wrist.

Ortho Dx: Hip pain after a fall

Ortho Dx: Hip pain after a fall

A 90-year-old woman is brought to the emergency department by emergency medical services after sustaining a fall at home.

Ortho Dx: Valgus deformity of the knee

Ortho Dx: Valgus deformity of the knee

A 57-year-old man presents with knee pain and valgus deformity of his right knee.

Ortho Dx: Lumbar compression fracture

Ortho Dx: Lumbar compression fracture

A 66-year-old man presents with severe lower back pain after falling from an 8-foot ladder one week previously.

Ortho Dx: Dislocation following hip replacement

Ortho Dx: Dislocation following hip replacement

A 90-year-old man presents to the emergency department with left hip pain and inability to bear weight on his left ...

Ortho Dx: A girl who has had more than 30 fractures

Ortho Dx: A girl who has had more than 30 fractures

An 8-year-old girl presents with left ankle pain after “stepping wrong” 2 days previously.

Ortho Dx: A corrections officer with a dislocated shoulder

Ortho Dx: A corrections officer with a dislocated shoulder

A 37-year-old man presents 2 weeks after a right shoulder dislocation.

Ortho Dx: Ankle pain following soccer injury

Ortho Dx: Ankle pain following soccer injury

A 16-year-old female presents with pain that developed in the right ankle following a soccer injury.

Ortho Dx: Fracture following snowmobiling accident

Ortho Dx: Fracture following snowmobiling accident

A 67-year-old man presents to the emergency room after injuring his right wrist during a snowmobiling accident.

Ortho Dx: A Popeye deformity

Ortho Dx: A Popeye deformity

A 56-year-old man presents with a left arm deformity after a fall 2 days previously.

Ortho Dx: Shoulder injury after snowboarding off 20-foot jump

Ortho Dx: Shoulder injury after snowboarding off 20-foot jump

A 14-year-old boy presents to the emergency department after a snowboarding injury earlier in the day.

Ortho Dx: "Popping" and pain in an adolescent's knee

Ortho Dx: "Popping" and pain in an adolescent's knee

A 13-year-old girl presents with a 4-month history of anterior lateral left knee pain.

Ortho Dx: Femur pain in a woman with lung cancer

Ortho Dx: Femur pain in a woman with lung cancer

A 63-year-old woman with a history of stage-4 non-small-cell lung cancer presents to the emergency department with increasing pain in ...

Ortho Dx: A Salter-Harris type II fracture

Ortho Dx: A Salter-Harris type II fracture

A 15-year-old boy presents to the emergency department with severe right leg pain after a skateboarding injury.

Ortho Dx: Knee pain following a "pop" during gymnastics

Ortho Dx: Knee pain following a "pop" during gymnastics

A 16-year-old girl presents with a 2-day history of right knee pain after a gymnastics injury.

Ortho Dx: Bone lesion of the proximal phalanx of the toe

Ortho Dx: Bone lesion of the proximal phalanx of the toe

A 45-year-old woman presents with a bone lesion found on x-ray by her primary care physician.

Ortho Dx: Elbow pain and a displaced radial neck fracture

Ortho Dx: Elbow pain and a displaced radial neck fracture

A 60-year-old woman presents with elbow pain after a fall 2 days earlier.

Ortho Dx: A deformity resulting from rigid footwear

Ortho Dx: A deformity resulting from rigid footwear

A 61-year-old man presents with chronic pain of the right heel.

Ortho Dx: Heel pain in a child who plays soccer every day

Ortho Dx: Heel pain in a child who plays soccer every day

A 9-year-old boy presents with a 2-month history of right heel pain that has worsened over the previous 2 weeks.

Ortho Dx: A dancer with persistent sesamoiditis

Ortho Dx: A dancer with persistent sesamoiditis

A competitive dancer, aged 18 years, presents with several months of pain in her left foot.

Ortho Dx: Atrophy to the first dorsal web space of the hand

Ortho Dx: Atrophy to the first dorsal web space of the hand

A 56-year-old man presents with several months of progressive weakness of the right hand.

Ortho Dx: Deformity of an adolescent's arm after a fall

Ortho Dx: Deformity of an adolescent's arm after a fall

A 13-year-old male presents to the emergency department with an obvious deformity to the right forearm after falling off his ...

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