Musculoskeletal Disorders & Fracture Complications

Following a traumatic event, which scenario poses the highest risk for avascular necrosis?

A child presents with a fracture involving the growth plate. Which of the following potential outcomes is of greatest concern regarding long-term musculoskeletal development?

A patient with a tibial shaft fracture develops increasing pain, swelling, and paresthesia in the affected leg, despite adequate pain medication. Dorsalis pedis pulse is present but diminished. Which mechanism is primarily responsible for these signs and symptoms?

A patient who sustained multiple long bone fractures in a motor vehicle accident develops acute respiratory distress, petechiae, and confusion 24 hours post-injury. Which of the following pathophysiological processes is the MOST likely cause of this patient's condition?

A 68-year-old male presents to the emergency department after a fall. He complains of hip pain and is unable to bear weight. Physical examination reveals that the affected limb is shortened and externally rotated. Which of the following fracture types is MOST likely responsible for his presentation?

What is the underlying mechanism that leads to acute respiratory distress syndrome (ARDS) in patients with fat embolism syndrome following a fracture?

A 22-year-old male is involved in a high-speed motorcycle accident and sustains a comminuted open left femur fracture. Thirty-six hours post-injury, he develops confusion, and a pulse oximeter indicates 88% saturation. Notably, he also has developed petechiae across the chest and in the axillae. Which of the following best explains the underlying cause of the skin lesions observed?

A 35-year-old man falls on his outstretched hand and presents to the clinic complaining of wrist pain. Physical examination reveals tenderness to palpation over the anatomic snuffbox. Initial X-rays are negative. Which of the following accurately describes the rationale for splinting the wrist despite negative initial radiographs?

Which of the following statements BEST explains the mechanism of injury resulting in a Colles fracture?

An elderly woman with osteoporosis falls on her outstretched hand, resulting in a "dinner fork" deformity of her wrist. Radiographic examination reveals a dorsally displaced and angulated fracture of the distal radius, with a small, non-displaced fracture of the ulnar styloid. Which mechanism contributes MOST significantly to the characteristic deformity observed in this type of fracture?

A 7-year-old boy presents to the emergency department after falling onto his outstretched arm. Examination reveals swelling, pallor, and increasing pain at the elbow despite multiple doses of analgesics. His radial pulse is intact. The radiograph shows a supracondylar fracture of the humerus. Which of the following complications should you be MOST concerned about in this patient given that the radial pulse is still intact?

Why is a supracondylar fracture such a high-risk fracture for the initiation of compartment syndrome?

A 48-year-old man falls down the steps in a darkened house, and grabs the handrail to avoid falling which resulted in a humerus fracture. X-rays reveal an oblique fracture in the middle to distal thirds of the humerus. What is the MOST probable neurological consequence associated with this patient’s injury given the fracture location?

Why can hip fractures involving the femoral neck lead to avascular necrosis?

A trauma patient presents with a femur fracture. Why would a physician assess the pelvis?

Following a motor vehicle accident, a patient is diagnosed with a tibial fracture. What is the most likely complication?

Following a motor vehicle accident, a patient is diagnosed with a pelvic fracture. What is the most life threatening complication?

A patient presents with pain and decreased mobility in their shoulder. Their arm is being adducted, and internally rotated. What should you consider?

In an elderly patient presenting with shoulder dislocation, which is the most likely concurrent injury to be concerned about?

How would you examine for most common deficits associated with a patient that has suffered an anterior shoulder dislocation?

In a patient presenting with a knee dislocation, what is the most likely injury?

A radiograph of a bone tumor demonstrates a periosteal "sunburst" pattern. What is the likely diagnosis?

Over 90% of Ewing's Sarcoma cases result from what?

A 7-year-old presents with a painful mass in left leg that comes and goes. Biopsy of the lesion shows numerous small round blue cells that stain positive for CD99 and negative for lymphoid markers and CD45. What is a characteristic of this disease?

What findings would indicate Slipped Capital Femoral Epiphysis (SCFE)?

What is the next step in management of Slipped Capital Femoral Epiphysis (SCFE)?

Legg-Calve-Perthes Disease is caused most directly by what?

At what age do the signs/symptoms of Legg-Calve-Perthes Disease tend to present?

A patient has Legg-Calve-Perthes Disease. Aside from osteochondritis of the capital femoral epiphysis, what tends to occur?

Which of the following fracture complications is specific to children due to the presence of a growth plate?

In the context of musculoskeletal injuries, what is the MOST critical distinction between a dislocation and a subluxation?

A 55-year-old woman, known to have osteoporosis, presents with a wrist injury following a fall. Radiographic examination reveals a distal radius fracture with dorsal displacement and angulation, creating a "dinner fork" deformity. Which of the following mechanisms BEST explains the dorsal angulation observed in this fracture type?

A college football player injures his left knee during a game. On physical examination, the clinician notes that the patient’s tibia can be easily displaced anteriorly relative to his femur with minimal resistance. Which of the following anatomical structures is MOST likely damaged given these findings?

Why does trauma, leading to bleeding and tissue swelling, contribute to the development of compartment syndrome?

Why is pain described as 'out of proportion to the expected injury' considered the most reliable symptom of compartment syndrome?

What leads to acute respiratory distress syndrome (ARDS) in patients with fat embolism following a long bone fracture?

After a motorcycle crash, a 22-year-old man with a comminuted open left femur fracture develops confusion and his pulse oximeter reads 88%. Petechiae are noted across the chest and in the axillae. How does a pulmonary contusion contribute to fat embolism syndrome?

What is the primary reason scaphoid fractures are prone to avascular necrosis when not treated appropriately?

Despite negative initial radiographs, a 35-year-old man with wrist pain and tenderness over the anatomic snuffbox is splinted. What is the rationale for this course of action?

What best describes the mechanism of injury that results in a Colles fracture with dorsal displacement?

How does osteoporosis increase the likelihood of a Colles fracture?

What biomechanical factor is responsible for the characteristic 'dinner fork' deformity observed in a Colles fracture?

Why is compartment syndrome a major concern with a supracondylar fracture in a child, even with an intact radial pulse?

In a midshaft humerus fracture, how can the radial nerve become entrapped contributing to functional deficits in wrist extension?

Why are femoral neck fractures more likely to result in avascular necrosis compared to intertrochanteric hip fractures?

Why is it important to assess the pelvis radiologically in patients with femoral shaft fractures resulting from high-energy trauma?

Why are fractures of the tibia particularly susceptible to compartment syndrome?

Massive blood loss is the most life-threatening complication of pelvic fractures. What is the most significant reason for this?

A patient with an anterior shoulder dislocation will hold the arm in which position?

How does the risk of rotator cuff injury relate to shoulder dislocations in elderly patients?

When evaluating a patient for an anterior shoulder dislocation, why is sensory function on the lateral aspect of the shoulder assessed?

What is the most critical concern regarding neurovascular structures in a knee dislocation?

What radiographic finding suggests osteosarcoma?

What genetic abnormality is associated with >90% of Ewing's sarcoma cases?

A 7-year-old boy presents with a painful mass in the left leg that comes and goes. Biopsy shows small, round blue cells staining positive for CD99 but negative for lymphoid markers/CD45. Which of the following is a characteristic of this disease?

A 12-year-old tall, obese boy complains of activity-related left knee pain and has painful decreased hip internal rotation. What radiographic finding would confirm a diagnosis of slipped capital femoral epiphysis (SCFE)?

You see a 12 year old obese boy complaining of hip and thigh pain. You are highly suspicious of slipped capital femoral epiphysis (SCFE). What would be the immediate next course of action?

In Legg-Calve-Perthes disease, what is the underlying pathophysiology that leads to avascular necrosis of the femoral head?

A 5-year-old boy is brought to the physician because of a 5-week history of pain in his left thigh. On examination, abduction and internal rotation are limited by pain. An x-ray of the pelvis shows a left femoral epiphysis that is smaller than the right with widening of the medial joint space on the left. What is the diagnosis?

A 5-year-old boy is brought to the physician because of a 5-week history of pain in his left thigh that occurred after a fall. His left groin is tender to palpation; abduction and internal rotation is limited by pain. What are other signs/symptoms that tend to be present with a patient with Legg-Calve-Perthes?

Which factor, if untreated, is MOST likely to lead to avascular necrosis following a posterior hip dislocation?

Following a motor vehicle accident, a 65-year-old woman complains of severe right hip pain. Examination reveals adduction, flexion, and internal rotation of the right thigh. Given her acute presentation, what is the primary structure at risk due to her condition that could lead to long-term morbidity if not addressed quickly?

A 55 year old presents with arm adducted and internally rotated. Which diagnosis should you consider?

What is the most critical risk to address in a patient presenting with a knee dislocation?

A radiograph shows a tumor with mineralized bone matrix and a periosteal reaction exhibiting a 'sunburst' pattern. In which age group is this tumor most commonly observed?

In a 14-year-old boy with knee pain, a radiograph reveals a periosteal 'sunburst' pattern indicative of osteosarcoma. Which secondary complication should be given the highest priority?

What is the most important difference between a dislocation and subluxation?

What key historical detail differentiates a posterior shoulder dislocation from an anterior dislocation?

What clinical finding would indicate a posterior hip dislocation?

Clinically, how would you expect an anterior shoulder dislocation to present?

What is the typical time window to reduce a hip after dislocation to prevent avascular necrosis?

What are common risk factors involved with Slipped Capital Femoral Epiphysis (SCFE)?

Beyond direct trauma, which factor MOST significantly elevates the risk of avascular necrosis in femoral neck fractures?

What is the distinguishing factor between a Type I and Type II Salter-Harris fracture?

Which is the MOST reliable symptom of compartment syndrome?

Which factor is MOST responsible for acute respiratory distress syndrome (ARDS) in a patient with fat embolism syndrome?

Hip fractures are most commonly characterized by which presentation?

What explains petechiae in the axillae and chest in fat embolism syndrome?

What biomechanical principle explains dorsal angulation in a Colles fracture?

Why does pain described as 'out of proportion to the expected injury' often accompany compartment syndrome?

What is the rationale behind splinting a wrist with suspected scaphoid fracture despite normal initial radiographs?

What feature in a pediatric supracondylar fracture poses a significant risk of compartment syndrome, even with a palpable radial pulse?

In humerus fractures, what is the mechanism of radial nerve injury leading to wrist drop?

Why must you assess the pelvis with a radiograph when a patient has a femur fracture?

Why do fractures of the tibia have a high risk of compartment syndrome?

What aspect of pelvic fractures leads to risk of rapid, life-threatening hemorrhage?

When presented with a patient with an anterior shoulder dislocation, what assessment would be MOST important?

In anterior shoulder dislocations the axillary nerve is often injured. What resulting region of the body is affected?

What is the potential time window in which it would be acceptable to reduce a hip dislocation?

Which finding is MOST indicative of osteosarcoma?

Which genetic abnormality occurs most commonly in Ewing's Sarcoma?

Which is the MOST appropriate initial management step for a patient diagnosed with Slipped Capital Femoral Epiphysis (SCFE)?