Mimetic
Musculoskeletal System
0
{"ops":[{"insert":{"image":"\/storage\/case-images\/cs\/P5_F2.jpg"}},{"insert":"\n\nYou\u0027ve had a fairly straightforward day in the orthopedic clinic so far. Fractures, osteoarthritis, post-operative follow-ups \u2013 nothing too challenging.\n\nThe door opens once more. You spy a familiar face: Mrs. Morris, who you treated for a Colles fracture around a year ago. She is accompanied by a teenager, whom she introduces as her 14-year-old son, Devon.\n\n\u0022Doctor, Devon\u0027s been having pain in his leg today \u2013 thought of showing him to you,\u0022 Mrs. Morris says.\n"}]}
1
{"ops":[{"insert":"You introduce yourself and start taking a history.\n\nDevon has experienced a throbbing pain in his right leg for the last 4 days. The pain was mild at first, but then became worse over time. He ignored the pain initially \u2013 but decided to tell his mother today, after the pain kept him up at night. No other symptoms are present. \n\nDevon plays basketball in school, but categorically states that he hasn\u0027t experienced any trauma at all recently. He has been in excellent health so far, and is not on any medications. His family history is unremarkable.\n\nYou proceed to the examination. Devon\u0027s vital signs are within normal parameters for his age. During the musculoskeletal examination, you elicit point tenderness over the medial aspect of the right tibia, around 4 cm below the right knee joint. The overlying skin appears normal. The right knee joint is clinically normal. The remainder of the musculoskeletal examination is unremarkable. Cardio-respiratory and abdominal examination is also unremarkable. Neurological examination shows no sensory or motor abnormalities.\n"}]}
2
{"ops":[{"insert":"Examination completely, you sit back and ponder what to do.\n\nWhich of the following will you do now?\n"}]}
1. Prescribe analgesics, ask Devon to rest, and review in a week
2. Order x-rays of the right hip joint, knee joint, and lower leg
3. Order magnetic resonance imaging (MRI) of the right lower limb
4
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7
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6
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3
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5
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