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Ortho Free Review | Dr Hutaif General Orthopedics Revie -...

Updated: Feb 2026 51 Views
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Orthopedics Online MCQs

QUESTION 1
**ORTHO MCQS BANK 011 FREE 04**
Q 1 1a 1b 1c 1d 1e A 43-year-old female factory worker has had a 6-month history of right plantar and lateral foot pain. She has pain with weight bearing and has difficulty standing at work. Management consisting of physical therapy, time off of work, and fracture boot immobilization has failed to provide relief. She is overweight and, as a result of the pain, cannot exercise to lose weight; thus she is getting worse instead of better. Examination reveals that the foot is not grossly swollen but is diffusely tender over the lateral, plantar, and medial hindfoot. The alignment is normal and the posterior calf muscles are mildly tight. A lateral radiograph is shown in Figure 1a and MRI scans are shown in Figures 1b through 1e. These findings are most consistent with which of the following?



















































































































1
**Painful os trigonum**
2
**Complex regional pain syndrome**
3
**Stress fracture of the anterior aspect of the calcaneus**
4
**4- Hematogenous osteomyelitis** **5- Plantar fasciitis** DISCUSSION: The studies are most consistent with a stress fracture or insufficiency fracture of the anterior portion of the calcaneus. The radiograph shows normal findings. There is increased signal involving the inferior anterior aspect of the calcaneus on the T2-weighted images (Figures 1c through 1e), which is consistent with edema. There is also an abnormal trabecular pattern within this region with changes on the T1 and T2 images consistent with a stress or insufficiency fracture of the calcaneus. Whereas there is some increased signal from the os trigonum and the origin of the plantar fascia, these diagnoses are inconsistent with her symptoms. The MRI findings of osteomyelitis (decreased T1 signal and increased T2 signal) with secondary soft-tissue findings of adjacent soft-tissue ulcers, cellulitis, phlegmon, abscess, sinus tracts, or cortical bone destruction are not present. Complex regional pain syndrome has a wide spectrum of findings on MRI and is usually much more diffuse. The Preferred Response to Question # 1 is
5
**Question2** 2a 2b 2c A 36-year-old man reports pain and fullness in the medial arm just proximal to the epicondyle. He denies trauma to the arm but noted some soreness following an arm wrestling match a few months ago. Figures 2a through 2c show the radiographs and a CT scan. What is the most likely diagnosis?![img](/media/upload/KZsygusI024XTv7GHRkJBc7Ewdvt9vCPvyiVmiDIztw00l3Xh1Rwiw8eEOxercdPHQuRLUw-tFWSLgO17_Lvx4kAu6GRIy_9KlKKo4A4Szx7wGdgMaF-BdlS2GAkQf-KyZTSgZFc1Bapiy5-rmwWXbw_pM6Ie7x5R7G_ZcNRNEBEsCTZcKIn8a8KYOOn-p9HHVlcQglIxA)
Dr. Mohammed Hutaif
Written & Medically Reviewed by
Consultant Orthopedic & Spine Surgeon