ABOS Part I Comprehensive Review - Batch 51

Question 1

A 25-year-old otherwise healthy male presents to the emergency department with acute onset of severe pain and inability to bear weight in his left thigh following a ground-level fall. He reports a 6-month history of a vague, dull ache in the same are

Accepted Answer

Fibrous Dysplasia with pathological fracture

Question 2

Following initial radiographs, an MRI of the left femur was performed to further characterize the lesion and rule out secondary aneurysmal bone cyst (ABC) or malignant transformation. The MRI findings included heterogeneous low-to-intermediate signal

Accepted Answer

Prominent fluid-fluid levels

Question 3

A 25-year-old male presents with a displaced pathological fracture of the mid-diaphyseal femur through an expansile lytic lesion. The lesion involves more than two-thirds of the cortical diameter, and the patient reported moderate chronic pain prior

Accepted Answer

Score of 10, indicating urgent operative stabilization is required.

Question 4

During surgical intervention for the pathological femur fracture, an incisional biopsy was performed by meticulous curettage of the dysplastic tissue. The tissue samples were sent for histopathological examination. Which of the following histopatholo

Accepted Answer

Irregularly shaped trabeculae of immature woven bone without osteoblastic rimming, embedded in a loose fibrous stroma.

Question 5

Following thorough intralesional curettage of the dysplastic tissue and provisional fracture reduction, the surgeon proceeded to augment the large intramedullary defect and cortical windows. An intraoperative fluoroscopic image after augmentation and

Accepted Answer

Allograft bone chips and Polymethyl Methacrylate (PMMA) bone cement for immediate mechanical stability.

Question 6

Post-operatively, the patient was started on a structured, progressive rehabilitation program tailored to the underlying bone pathology and surgical fixation. Given the inherent weakness of the dysplastic bone and the healing fracture, careful consid

Accepted Answer

Touch-down weight-bearing (TDWB) of 10-15 kg.

Question 7

A 45-year-old female presents with a similar expansile lytic lesion in her proximal femur, but her CT scan (similar to the example provided) shows focal cortical breakthrough, significant endosteal erosion exceeding 2/3 of cortical thickness, and cha

Accepted Answer

Low-Grade Chondrosarcoma, characterized by chondroid matrix calcification and aggressive cortical involvement.

Question 8

A 25-year-old patient with monostotic fibrous dysplasia of the femur undergoes intralesional curettage and intramedullary nailing for a pathological fracture. Two years later, he presents with new onset pain and radiographic evidence of lesion expans

Accepted Answer

Inadequate initial curettage of the dysplastic tissue.

Question 9

Following successful surgical stabilization and rehabilitation, the patient is discharged with a confirmed diagnosis of monostotic fibrous dysplasia. Given the nature of this condition, what is the most appropriate long-term surveillance strategy for

Accepted Answer

Annual clinical and radiographic review for several years, with further imaging for new symptoms.

Question 10

The patient's initial systemic examination and laboratory investigations were unremarkable. Specifically, there was no café-au-lait pigmentation, and serum calcium, phosphate, and alkaline phosphatase levels were within normal ranges. The absence of

Accepted Answer

McCune-Albright syndrome

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Key Takeaway