Musculoskeletal Injuries 325307.A 29-year-old woman presents to the ED complaining of worsening
left wrist pain for 1 month. She states that approximately 3 months ago she
fell from a ladder and landed on her outstretched hand. She never went to
the hospital and just dealt with the pain for a while. On examination, there
is no deformity of the wrist. Neurovascular status is normal, but there is
tenderness when you palpate the snuffbox. What is the most likely reason
for this patient’s wrist pain?
a. Fracture of the distal ulna
b. Acute fracture of the scaphoid
c. Avascular necrosis of the scaphoid
d. Hematoma of the radial artery
e. Fracture of the lunate
308.A 43-year-old warehouse worker is helping to stock large refrigerator
boxes onto the forklift. One of the boxes starts to fall off the shelf and he
tries to catch it before it falls. In doing so, his hand is hyperextended at the
wrist and causes immediate pain. In the ED, you note limitation of the nor-
mal motion of the wrist with palpable fullness on the volar aspect. The
patient also complains of tingling in the distribution of the median nerve.
Which of the following injuries is most frequently associated with the
development of acute carpal tunnel syndrome?
a. Lunate dislocation
b. Perilunate dislocation
c. Scapholunate dislocation
d. Capitate dislocation
e. Scaphoid fracture
309.A 22-year-old college football player presents to the ED with knee
pain. He states that during the football game today, he received a direct
blow to the lateral aspect of his knee. Radiograph of the knee is negative
for fracture, but shows an effusion. On examination, you confirm the
hemarthrosis. As you examine his knee ligaments, you note joint instability
with valgus stress in 30 degrees of flexion. The rest of your examination is
unremarkable. This patient’s injury is most consistent with?
a. Rupture of the LCL
b. Rupture of the MCL
c. Rupture of the ACL
d. Rupture of the PCL
e. Tear of the medial meniscus