image Q.6 - Accessory part2

Q. Identify the accessory bone as marked by an arrow in the foot radiograph?


a. Os tibiale externum
b. Accessory navicular
c. Os subtibiale
d. Os trigonum

Answer-
a,b

There are two correct answers as the accessory bone adjacent to navicular is usually accessory navicular which also is called os tibiale externum.

Os trigonum is accessory bone related to Talus bone.

Common associations seen with accessory navicular are
- Flatfeet ( pes planus)
- posterior tibial tendon (PTT) disorders
  

image Q.5 - Accessory part1

Q. Identify the accessory bone as marked by an arrow in the foot radiograph?


a. Os peroneum
b. Os cuboid
c. Os calcis
d. Os calcaneum secondum

Answer -
a

Os peroneum is accessory bone found at keel of cuboid or calcaneocuboid joint.

image Q. 4 - About bump

Q. The common well defined soft tissue swelling at dorsum of wrist is ganglion in most cases, which if these is closest d/d of similar swelling in hand?


a. Enchondroma
b. Exostosis
c. Lipoma
d. Giant cell tumor

Answer -
d

Enchondroma is mist common bone tumor involving hand. But tgt would commonly involves digits or metacarpals and not present as such swelling.

Exostosis is bony outgrowth but very rare in hand and will be hard on palpation.

Lipoma is well defined freely mobile soft tissue mass that may occur anywhere in the soft tissues but will be kept lower on differentials.

Giant cell lesion especially Giant cell tumor of tendon sheath (GCT TS) is common entity and second most common tumor of hand after enchondroma.

image Q.3 - Heel the world

Q. A ten year old child complaints of periodic heel pain for few weeks, there is no history of significant trauma. Which if these can be d/d in this case with given radiographs?


a. Kohler's disease
b. Sever's disease
c. March fracture
d. Calcaneum fracture

Answer -
b

The given radiograph is showing with arrow pointing at calcaneal apophysis ( which can be confused with fracture) and this is normal picture till the apophysis fuses with native calcaneum bone.

The pain may be osteochondritis of calcaneum also called Sever's disease.

Osteochondritis of navicular is called Kohler's disease.

March fracture is stress fractures if metatarsal and usually found in adults with repeated foot walking and usually involve second or third metatarsal.

image Q. 2 - Pelvic injury

Q. What is the disorder/ injury in the given radiograph called ?


a. Arthrodiastasis
b. Pubic Diastasis
c. Pubic subluxation
d. Pubic distraction
e. Central fracture dislocation

Answer-
b

Pubic diastasis is separation of pubic symphysis.

Central fracture dislocation invilves acetabulun fracture with significant displacement of femur head inside pelvis region.

Arthrodiastasis is surgical procedure where joint is distracted with the help of fixators for various indications.

image Q. 1- Tarsal exostosis

Q. Osteochondroma, one of the most common benign bone tumor commonly involves which of these tarsal bones?


a. Cuboid
b. Talus
c. Navicular
d. Calcaneum

Answer-
d

Osteochondroma is rare in carpal and tarsal bones as these bones arise from ossification centre that is centrifugally expanding as in epiphysis.
Calcaneum is an exception as this bone has a secondary centre of ossification.