Answer for BIR CoW 19 Jan 2025
Malunited fracture of left proximal shaft of femur with acute on chronic osteomyelitis with formation of involucrum , sequestrum and abscess formation.
Findings
Malunited fracture of left proximal shaft of femur . Evidence of diffuse irregular cortical thickening noted in the shaft of femur. Multiple tiny sclerotic foci noted in the medullary cavity. Focal cortical defect noted in the distal shaft of femur. Prominent soft tissue component noted in subcutaneous plane with skin surface irregularity.
Discussion
Difference between non union vs malunion
NON UNION:Fractured bone shows a persistent radiolucent line at the fracture. Radiographic Signs: Rounding of fracture margins. Lack of callus formation. Sclerosis of fracture margins. Pseudoarthrosis.
MALUNION: Fracture heals in non anatomical position . Radiographic signs: Malalignment. Deformity.
Radiologic signs of osteomyelitis:
EARLY SIGNS Soft tissues Elevation and displacement of fat planes. Obliteration of fat planes Increased density. Bones: Moth eaten or permeative medullary and cortical destruction Periosteal new bone( solid or laminated ).
LATE SIGNS: Soft Tissues: Draining sinus. Debris. Bone Destruction of adjacent cortex. Ivolucrum Cloaca. Sequestrum. Sclerosis and moth eaten sclerosis. Loss of joint space. Healing by bony ankylosis
Findings
Malunited fracture of left proximal shaft of femur . Evidence of diffuse irregular cortical thickening noted in the shaft of femur. Multiple tiny sclerotic foci noted in the medullary cavity. Focal cortical defect noted in the distal shaft of femur. Prominent soft tissue component noted in subcutaneous plane with skin surface irregularity.
Discussion
Difference between non union vs malunion
NON UNION:Fractured bone shows a persistent radiolucent line at the fracture. Radiographic Signs: Rounding of fracture margins. Lack of callus formation. Sclerosis of fracture margins. Pseudoarthrosis.
MALUNION: Fracture heals in non anatomical position . Radiographic signs: Malalignment. Deformity.
Radiologic signs of osteomyelitis:
EARLY SIGNS Soft tissues Elevation and displacement of fat planes. Obliteration of fat planes Increased density. Bones: Moth eaten or permeative medullary and cortical destruction Periosteal new bone( solid or laminated ).
LATE SIGNS: Soft Tissues: Draining sinus. Debris. Bone Destruction of adjacent cortex. Ivolucrum Cloaca. Sequestrum. Sclerosis and moth eaten sclerosis. Loss of joint space. Healing by bony ankylosis
Note:
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!
We do not discourage differential diagnosis. But all the differentials must satisfy the findings noted in the case.
If you feel you have answered rightly but cannot find your name in the above list, please call 09551942599.
Did you Know?
The order in which the names appear in this winner's list is based on the time of submission. The first person to send the correct answer gets his/her name on top of the list!