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Ortho Dx: Alcoholism-Induced Avascular Necrosis of the Hip

Nontraumatic avascular necrosis of the hip is a result of the disruption of the arterial supply to the femoral head. Several conditions have been associated with AVN, including chronic alcohol use, hypercoagulable states, steroid use, sickle cell disease, and trauma. Alcoholism and steroid use contribute to >65% of nontraumatic cases of AVN. The most widely…

Derm Dx: Circular, Ecchymotic Lesions on the Back

Cupping therapy is an ancient modality used to treat various medical conditions.1 Cupping involves creating suction with a ceramic, bamboo, plastic, or glass cup pressed against the skin. The application of a flame to the cup removes oxygen to create negative pressure; this can also be achieved with a suction device.2 The 2 most common…

Ortho Dx: Subtrochanteric Fracture Following a Fall

Atypical fractures of the femur associated with long-term bisphosphonate use can be distinguished by their distinct fracture pattern. These types of fractures generally are low-impact injuries that may occur when walking or turning while standing. The fracture is transverse and usually starts at the lateral cortex. As the fracture extends to the medial cortex, the…

Derm Dx: Furrows and Thickened Skin on the Posterior Neck

Cutis rhomboidalis nuchae, also known as farmer’s or sailor’s neck, is a dermatologic condition that results from chronic sun exposure to the posterolateral aspect of the neck.1 The disorder most commonly manifests in individuals who have spent considerable time outdoors such as farmers, sailors, athletes, or mountain guides.2 The condition is rare in women as…

Ortho Dx: Pain and Weakness in the Shoulder Following a Skiing Accident

Acromioclavicular (AC) joint separation is a common injury that occurs following direct impact to the shoulder. Anterior-posterior stability of the AC joint is provided by the AC ligaments, and superior-inferior stability is provided by the coracoclavicular (CC) ligaments. Injury to the 2 CC ligaments (the medial conoid and the lateral trapezoid) can cause superior migration…

Ortho Dx: Can You Diagnose the Weber Fracture?

Isolated fractures of the lateral malleolus are the most common type of ankle fractures. The Weber classification system is commonly used to describe these fractures and is based on the level of the fracture in relation to the ankle syndesmosis. Type A Weber fractures occur below the level of the syndesmosis of the ankle. The…

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