2. ◼ A 35 year old male with c/o pain at right hip and limp since 2 year
◼C/O pain at bilateral knee and since 2 year
◼ His walking distance reduced to <50m and he is unable to squat, sit cross legged and has
difficulty in climbing stairs and not able to do his work.
◼He had no h/o smoking and alcohol consumption
◼ On examination of right hip -
◼FFD of 40 degrees present at hip
◼ Anterior joint line tenderness present.
◼Right limb shortened by 3cm
◼Restricted and painful ROM in all planes
Case -1
3. On examination of right hip -
◼FFD of 40 degrees present at hip
◼ Anterior joint line tenderness present.
◼Right limb shortened by 3cm
◼Restricted and painful ROM in all planes
GPE:
Multiple nodules present over forearm, arm, legs ?Lipomas
Swelling and Valgus deformities at B/L MCPs, PIP, DIP
Hyperextension at MCPs ,Felxion deformities at DIP
Hammer toe present B/L
Valgus deformity at B/L 1st MTP
4. On examination of right knee -
◼FFD of 25 degrees present at knee
◼ Joint line tenderness present.
◼Right limb shortened by 3cm
◼No DNVD
◼Restricted and painful ROM
On examination of left knee -
◼FFD of 20 degrees present at knee
◼ Joint line tenderness present.
◼Right limb shortened by 3cm
◼No DNVD
◼Restricted and painful ROM
12. ◼A 55yr old male patient with A/H/O RTA , sustained injury to B/L lower limb, left hip. He
complains of pain and swelling in B/Llower limb and left hip
◼Patient was operated for ankle spanning Ex Fix in private hospital
On examination of Right lower limb
sutured wound of around 10cm present at distal leg and ankle
Swelling present at leg and foot
Tenderness and crepitus present over right distal leg
Ex Fix apparatus intact
NO DNVD
ROM couldn’t be assessed due to Exfix
Case -2
13. On examination of left lower limb
Swelling present at thigh, leg and ankle
No external injuries
Tenderness present over left Iliac crest ,hip and proximal tibia
Painful and restricted ROM of left hip, knee, ankle
No DNVD
Pelvic compression test positive
Patient is chronic alcholic for which psychiatry opinion was
taken and was started on Inj Lorazepam and Haloperidol but
still patient developed withdrawl symptoms and had broken
the exfix appartus
18. Diagnosis: Right type 3b open both bone leg fracture(43A3, 4F3A)
Left closed proximal tibia fracture (Schtazker 1)
Left inferior pubic rami fracture with acetabular wall (Anterior wall and anterior
column)
Left iliac wing fracture
Diagnosis
24. CASE 3
A 27 yr/M with A/H/O self fall 5 month ago and sustained injury to right Lower limb
C/o pain in right ankle
C/o inability to bear weight on left lower limb
On examination –Right Lowerlimb
-Swelling present over distal 1/3rd leg and ankle.
-Tenderness present over medial malleolus .
-ROM painful and restricted at left ankle
-Active toe movements present
-Distal pulses palpable
-No DNVD’s
29. CASE 4
A 53 yr/M with A/H/O self fall and sustained injury to right upper limb
C/o pain in right arm
C/o inability to move right shoulder and elbow
On examination –Right upper limb
-Swelling present over Right arm
Tenderness present over Right arm
ROM painful and restricted at Right shoulder and elbow
-Active finger movements present
-Distal pulses palpable
-No DNVD’s
36. CASE 5
A 58 yr/M with A/H/O Slip and fell and sustained injury to right upper limb
C/o pain in right elbow
C/o swelling in right elbow and forearm
C/O Inability to move right elbow
On examination –Right Upper Limb
-Swelling present over Right elbow and forearm and wrist.
-Tenderness present over right elbow and proximal 1/3rd forearm
-Active finger movements present
-Distal pulses palpable
-ROM: painful and restricted at elbow
-No DNVD’s
