FOOT AND ANKLE
2025
,1*Figures N1 Nand N2 Nare Nthe NT2-weighted NMR Nimage Nand NAP Nradiograph Nof Na N55-year-old Nlaborer
Nwho Nsustains Nan Nankle Nsprain Nafter Na Nfall Nfrom Nscaffolding. NInitial Nfilms Nare Nread Nby Nradiology Nas
Nnormal. NDespite Nan Nexhaustive N6-month Ncourse Nof Nimmobilization; Nshoe Nmodifications; Nand
Ntherapy, Nthe Npatient Ncontinues Nto Nhave Nactivity-related Nlateral Nhindfoot Npain, Nwhich Nhas
Nprevented Nhim Nfrom Nreturning Nto Nwork. NOn Nexamination, Nthe Npatient Nhas Nfull Neversion Nstrength
Nthat Nis Npainless. NAnkle Nrange Nof Nmotion Nis Nfull Nand Npainless. NNo Nanterior Ndrawer Nis Nobserved.
NThere Nis Ntenderness Nand Nmild Nswelling Ndistal Nto Nthe Nsinus Ntarsi. NSensation Nand Nmotor Nare Nintact
Nand Nthe Nskin Nis Notherwise Nunremarkable Nin Nappearance. NAn NMRI Nis Nobtained. NWhat Nis Nthe Nnext
Nbest Nstep?
,1- Referral Nfor Ncomplex Nregional Npain Nsyndrome N(CRPS) Nworkup
2- Lace-up Nankle Nbrace
3- Excision Nof Nthe Nsuperior Nanterior Nprocess Nof Nthe
calcaneus N4-Arthroscopic NBrostrom
N
Correct Nanswer N: N3
The Npatient Nhas Na Nnonunion Nof Nanterior Nprocess Nof Nthe Ncalcaneus. NHis Nsymptoms Nare Nconsistent
Nwith Nthe Nexamination Nand Nimaging Nfindings, Nand Nhe Nhas Nfailed Nnonsurgical Ntreatment. NTherefore,
Nsurgical Nexcision Nof Nthe Nnonunion Nfragment Nis Nindicated. NNo Nfindings Nconsistent Nwith NCRPS Nare
Nseen Nin Nthis Npatient. NHe Nhas Nactivity-related Npain Nat Na Nfocal Narea Nand Nis Nwithout Nskin Nchanges.
NA Nlace-up Nankle Nbrace Nis Nunlikely Nto Nprovide Nsubstantial Nimmobilization Nand Npain Ncontrol Nat Nthe
Nhindfoot. NIn Naddition, Nthe Npatient Nhas Ntried Nnonsurgical Ntherapies Nwithout Nlasting Nimprovement.
NThe Npatient Nhas Ncomplaints, Nexamination, Nand Nimaging Nfindings Nconsistent Nwith Na Nsingle
Ndiagnosis. NA Nlateral Nankle Nstabilization Nprocedure Nsuch Nas Na NBrostrom Nis Nnot Nindicated Nbecause
the Npatient Nhas Nno Ninstability Non Nexamination.
N
, 2*Figure N1 Nis Nthe NT1-weighted Nlateral NMR Nimage Nand NFigure N2 Nis Nthe NT2-weighted Nlateral NMR
Nimage Nof Na N25-year-old Nwoman Nwith Nankle Npain Nfor Nthe Nlast Nyear Nthat Nis Nassociated Nwith
Nwalking Ndown Nstairs Nand Nplaying Nsports. NNo Nknown Ninjury Nhas Nbeen Nidentified. NThe Nankle Npain
Nhas Nbeen Nmanaged Nwith Nrest, Ntherapy Nfor Nrange Nof Nmotion, Nand Na Nperiod Nof Nimmobilization.
NIntra-articular Nsteroid Ninjection Nprovided Nlimited Nrelief Nof Nsymptoms. NWhat Nis Nthe Nbest Nnext
Nstep?
2025
,1*Figures N1 Nand N2 Nare Nthe NT2-weighted NMR Nimage Nand NAP Nradiograph Nof Na N55-year-old Nlaborer
Nwho Nsustains Nan Nankle Nsprain Nafter Na Nfall Nfrom Nscaffolding. NInitial Nfilms Nare Nread Nby Nradiology Nas
Nnormal. NDespite Nan Nexhaustive N6-month Ncourse Nof Nimmobilization; Nshoe Nmodifications; Nand
Ntherapy, Nthe Npatient Ncontinues Nto Nhave Nactivity-related Nlateral Nhindfoot Npain, Nwhich Nhas
Nprevented Nhim Nfrom Nreturning Nto Nwork. NOn Nexamination, Nthe Npatient Nhas Nfull Neversion Nstrength
Nthat Nis Npainless. NAnkle Nrange Nof Nmotion Nis Nfull Nand Npainless. NNo Nanterior Ndrawer Nis Nobserved.
NThere Nis Ntenderness Nand Nmild Nswelling Ndistal Nto Nthe Nsinus Ntarsi. NSensation Nand Nmotor Nare Nintact
Nand Nthe Nskin Nis Notherwise Nunremarkable Nin Nappearance. NAn NMRI Nis Nobtained. NWhat Nis Nthe Nnext
Nbest Nstep?
,1- Referral Nfor Ncomplex Nregional Npain Nsyndrome N(CRPS) Nworkup
2- Lace-up Nankle Nbrace
3- Excision Nof Nthe Nsuperior Nanterior Nprocess Nof Nthe
calcaneus N4-Arthroscopic NBrostrom
N
Correct Nanswer N: N3
The Npatient Nhas Na Nnonunion Nof Nanterior Nprocess Nof Nthe Ncalcaneus. NHis Nsymptoms Nare Nconsistent
Nwith Nthe Nexamination Nand Nimaging Nfindings, Nand Nhe Nhas Nfailed Nnonsurgical Ntreatment. NTherefore,
Nsurgical Nexcision Nof Nthe Nnonunion Nfragment Nis Nindicated. NNo Nfindings Nconsistent Nwith NCRPS Nare
Nseen Nin Nthis Npatient. NHe Nhas Nactivity-related Npain Nat Na Nfocal Narea Nand Nis Nwithout Nskin Nchanges.
NA Nlace-up Nankle Nbrace Nis Nunlikely Nto Nprovide Nsubstantial Nimmobilization Nand Npain Ncontrol Nat Nthe
Nhindfoot. NIn Naddition, Nthe Npatient Nhas Ntried Nnonsurgical Ntherapies Nwithout Nlasting Nimprovement.
NThe Npatient Nhas Ncomplaints, Nexamination, Nand Nimaging Nfindings Nconsistent Nwith Na Nsingle
Ndiagnosis. NA Nlateral Nankle Nstabilization Nprocedure Nsuch Nas Na NBrostrom Nis Nnot Nindicated Nbecause
the Npatient Nhas Nno Ninstability Non Nexamination.
N
, 2*Figure N1 Nis Nthe NT1-weighted Nlateral NMR Nimage Nand NFigure N2 Nis Nthe NT2-weighted Nlateral NMR
Nimage Nof Na N25-year-old Nwoman Nwith Nankle Npain Nfor Nthe Nlast Nyear Nthat Nis Nassociated Nwith
Nwalking Ndown Nstairs Nand Nplaying Nsports. NNo Nknown Ninjury Nhas Nbeen Nidentified. NThe Nankle Npain
Nhas Nbeen Nmanaged Nwith Nrest, Ntherapy Nfor Nrange Nof Nmotion, Nand Na Nperiod Nof Nimmobilization.
NIntra-articular Nsteroid Ninjection Nprovided Nlimited Nrelief Nof Nsymptoms. NWhat Nis Nthe Nbest Nnext
Nstep?
