image Q. 90 - Battle of bulge

Q.   What is denoted by the arrow in the below imaging?

a. Modic change
b. High intensity zone
c. Scmorl node
d. End plate cyst
e. Intradiscal cleft

Answer -
c

The bulge or prolapse of the disc usually takes place posteriorly or posterolaterally toward spinal canal. The bulge or prolapse of disc toward vertebral body above or downward may also be found at times. This is termed as Scmorl's node.

Modic changes are MRI based changes in end plate of vertebra.

High intensity zone (HIZ) is found in MRI in early disc prolapse when annular tear has just started and that is seen as focus of high signal intensity area adjacent to affected annular tear site.

Other two options are not correct.

image based Q. 89 - Enchondroma Inc.

Q.  Enchondroma is component of all of these disorders except?

a. Ollier syndrome
b. Maffucci syndrome
c. Metachondromatosis
d. Dyschondrosteosis

Answer -
d

Enchondroma is associated with first three disorders -

Ollier syndrome - Multiple enchondroma, the condition is also called dyschondroplasia

Maffucci syndrome - Enchondroma with sift tissue hemangioma

Metachondromatosis - Enchondroma with osteochondroma

Dyschondrosteosis  is genetic disorder of mesomelic shortening and forearm disorder like madelung disease. Leri- Weill syndrome is part of disorder.

image Q. 88 - Homolog

Q.  meniscal homolog is found in ?

a. Wrist
b. Spine
c. Shoulder
d. Knee
e. Ankle

Answer -
a

Ulnar aspect of wrist ( below ulnar styloid as depicted in image below by area marked with asterisk*) contains sift tissue part known as TFCC ( Triangular Fibro- Cartilaginous Complex).

 It is composed of many structures and provides stability to ulnar Wrist and distal radioulnar joint.

The parts of TFCC are -

Articular disc
Ulnar collateral ligament
Meniscal homolog
Extensor carpi ulnaris
radioulnar ligaments

image Q. 87 - Throw it all

Q.    Thrower's fracture is related to which of these?


a. Acromion
b. Humerus
c. Coronoid
d. Carpal bones

Answer -
b

Fracture of humerus are sometimes reported in sportspersons engaged in throwing activities.

Mostly these fractures are spiral and result of torque and muscle forces during the activity.

image Q. 86 - Typecast

Q.  How would you classify below fracture with 2 cm. wound over it by Gustilo Anderson classification ?

a. Grade 1
b. Grade 2
c. Grade 3 a
d. Grade 3 b

Answer -
c
The fracture here is segmental fracture femur. The segmental fracture is classifies as Grade 3 a irrespective of wound size.

Below is snapshot of Gustilo-Anderson classification -

image Q. 85 - Going Sleeve less

Q.   'Sleeve fracture' is related to which bone in children ?

a. Iliac apophysis
b. Calcaneum apophysis
c. Tibial tuberosity
d. Distal radius metaphysis
e. Patella
f. Ribs

Answer -
e

The sleeve fracture results when outer rim of the bone is separated from main body of bone and results in dusplacement and deformity like proper fracture ( below image)

This type of injury is found in Patella in children and is termed Patella sleeve fractures.