Something is Afoot
For each case, choose the correct answer
For answers, see next issue; for discussion, go to www.mdedge.com/clinicianreviews/picture
Case 1 was originally published in the American Journal of Orthopedics (2013;42[3]:121-124).
Case 2 adapted courtesy of Cutis (2000;66[3]:211-212). Copyright 2017 Frontline Medical Communications Inc.
Case 3 adapted from the Journal of Family Practice (2008;57[5]:321-323).
Case 4 credit: ScienceSource. IMAGE NUMBER: SN0826 LICENSE: RIGHTS MANAGED
Answers to last month’s “Picture This” (Clinician Reviews. 2017;27[6]:43): 1c, 2a, 3d, 4b
3. A 39-year-old man was playing a game of pick-up basketball when he felt a pop, immediately followed by a sharp pain in the back of his ankle and lower leg. He now walks with a limp. The cause is
a) Achilles tendon rupture
b) Medial gastrocnemius tear
c) Calf muscle strain
d) Posterior tibial stress syndrome
Diagnosis: Often diagnosed as an ankle sprain, an Achilles tendon rupture most commonly occurs in middle-aged men from overexertion in sports—usually tennis, racquetball, basketball, or badminton, which involve bursts of jumping, pivoting, and running. Rupture may also occur from a sudden stumble, fall from a significant height, or abrupt step into a hole or off a curb, which causes the tendon to overstretch forcefully.
