image based Q.23 - Knee sports injury

Q. The below skiagram is of an adolescent kid who twisted and injured his knee during soccer match and presents with pain and swelling. The arrow in the picture depicts an avulsion of lateral capsular attachment site. Which of these is best term for the injury ?


1. Segond fractue
2. Bosworth frcture
3. Pallegrini- Steida lesion
4. Corner fracture

Answer - 1


Lateral capsular avusion is also termed Segond fracture. This injury has high correlation with associated ACL tear.


Bosworth fracture is fracture of distal fibula with fibula stuck behind the tibia.


Pallegrini -Steida lesion is calcification over MCL (medial collateral ligament) attachment following strain or injury to it.


Corner fractures are characteristic of Child abuse/ Battered baby syndrome. These are presented as abnormal bones at metaphyseal region of children eg. in distal femur corner etc.

image based Q.22 - elbow injury child

Q. The below radiograph of an injured child with elbow region swelling has pain and restricted motion. The black shadow in front of distal humerus depicts which of these signs to call it an occult fracture with subsequent effusion ?



1. Crescent sign
2. Fish tail sign
3. Fat pad sign
4. Arc sign

Answer - 3

The normal fat pads over distal humerus get elevated due to any effusion in the joint or occult underlying fracture and a black shadow/ lucency  is seen in the radiograph either anterior (as seen here - anterior fat pad= coronoid fat pad ) or posterior (posterior fat pad= olecranon fat pad).


Posterior fat pad are more specific for occult  fractures (>70%)


Crescent sign is seen in supracondylar humerus  fracture as the normal capitellum is seen overshadowed by proximal ulna thus formation of a crescent.


Fish tail deformity results from osteonecrosis of trochlea due to various injuries.

Image based Q. 21 - post- trauma deformity

Q. The fracture described below requires constant monitoring of patient to check for development of which of these deformity ?

1. Genu Varum
2. Genu valgum
3. Genu recurvatum
4. Growth arrest

Answer -

Valgus deformity is common complication following proximal tibia metaphyseal fracture. This late deformity is named after Cozen and also referred as Cozen's fracture/ phenomena.

Image based Q. 20 - bone excision

Q. ‘Astragalectomy’ is excision of which bone given below?

1. Navicular

2. Cuneiform

3. Cuboid

4. Talus

Answer -4

The 'astragalus' is old name for talus bone.

The fracture neck talus was also known as 'Aviator's Astragalus' after old name of talus as astragalus. It is also called 'aviator's fracture' now.

Thus Astragalectomy is synonymous with Talectomy.

image based Q.19 - Hip disorder in a child

Q. Which of these is a treatment modality for hip disorder in below radiograph?

1. Arthrodiastasis

2. Arthroreisis

3. Arthrokatadysis

4. Ligamentotaxis

Answer – 1.


The disorder here is Legg-Calve -Perthes Disease (LCPD) of left hip.

Arthrodiastasis is joint distraction while the pathology heals . It is done with the help of external fixators/ Rail fixators in certain disorders where joint healing is encouraged by keeping joint surfaces distracted.

Arthroreisis is surgical procedure to correct flat foot, and

Arhrokatadysis is synonymous with 'protrusio actabuli' or Otto pelvis.

Ligamentotaxis is used in various fracture treatment.

image based Q.18 - Injured index finger

Q. Which of these is not the structure that surround and constrict metacarpal head in the following injury ?


1. Natatory ligament
2. Lumbricals
3.  Flexor tendon and pretendinous band 
4. Deep transverse ligament

Answer - 4

The Superficial Transverse ligament is among the other four structures ( rest three options included) that constrict the metacarpal dislocated head and make reduction difficult and more difficult to achieve on attempt of reduction.

image based Q.17- recurrent heel pain

Q. entrapment of which nerve may be in the differentil diagnosis of recurrent plantar fasciitis ?



1. Lateral plantar nerve
2. Medial plantar nerve
3. nerve to sinus tarsi
4. deep plantar nerve

Answer - 1


First branch of lateral plantar nerve (FBLPN)  when entrapped may give rise to pain similar to plantar fasciitis.
It should be ruled out in refractory heel pain.

It is also called Baxter's nerve.

image based Q.16- a fractured arm

Q. What is the possible nerve injury with below fracture ?

1. Median nerve

2. Radial nerve

3. Anterior interosseous nerve

4. Musculocutaneous nerve

Answer – 2

The typical fracture of distal third of humerus with lateral spike may injure radial nerve as the nerve passes anterior from posterior side through intermuscular septa at lateral aspect of distal humerus.

This typical fracture pattern with propensity of associated radial nerve injury is called  Holstein Lewis fracture pattern.

Radial nerve injury with fracture shaft humerus is mostly seen in middle third fractures. 

The reported incidence of humerus fracture with associated radial nerve injury is 18%.