Case Of The Week From 4/24/22

History: Failure to thrive.
Describe the findings: Cupping of the metaphysis of the distal ulna and radius with fraying.
What is the most likely diagnosis? Rickets
How is it treated? Vitamin D.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Case Of The Week From 4/17/22

History: Wrist pain after injury.
Describe the findings. Increased volar tilt to the lunate. (>30 percent capitolunate angle)
What is the diagnosis? VISI (Volar intercalated segment instability)
What are the associations? Disruption of radiocarpal ligaments on the ulnar side of the wrist. Needs to be surgically treated with reduction, casting, or fixation.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Case Of The Week From 4/10/22

History: Runner. Hip pain.
Describe the findings. Gluteus medius muscular edema and adjacent marrow edema at the right iliac wing. No definite linear fracture at the iliac wing.
What is the most likely diagnosis? Muscle strain of the gluteus medius and stress reaction at the right iliac wing.
What is the next test? Correlate with CT or plain film of the pelvis. Some iliac fractures can be subtle and not seen well on MRI!

 

Case Of The Week From 4/3/22

History: Listless.
Describe the findings. Multiple hyperechoic foci with some dirty shadowing.
What is the differential diagnosis? Free air, calcifications/granulomas, metastatic disesase (osteosarcoma), hypercalcemia
What is the next test? Upright abdomen or CT scan of the abdomen depending on acuity.