Spot the diagnosis 139-143

(139) An adult male has come for enlargement of lyjmph nodes which are firm , discrete and shotty . Spot the diagnosis ?
(140) A patient of fifty has come for the enlargement of lymph nodes which are stony hard and fixed to the surrounding muscles. Spot the diagnosis?
 ( 141) A patient has come with an ulcer whose discharge is greenish with typical smell . Spot the diagnosis?
(142) A patient has come with an ulcerating black mass of the big toe. Spot the diagnosis?
(143) A patient has come with an enlarged and hard liver . Whose one eye has been already  enucleated. Spot the diagnosis?
Answers
(139) Syphilitic nodes .
(140) Secondary carcinoma.
(141) Infected with B. pyocyaneus.
(142) Malignant melanoma .
(143) Malignant melanoma.

Spot the diagnosis 135-138

(135) A boy of sixteen has come in S.O.P.D for an ulcer in the axilla . The margin of the ulcer is thin ,undermined and bluish . Spot the diagnosis?
(136) A man of fifty has come in S.O.P.D for an ulcer on the penis. The margin of the ulcer is raised and everted . Spot the diagnosis?
(137) A man of forty has come in the S.O.P.D for an ulcer on the side his nose . The margin of the ulcer is raised and beaded . Spot the diagnosis ?
(138) A man of fifty has come with an ulcer on his tongue . The margin is punched out . Spot the diagnosis ?


Answers
(135) Tubercular ulcer .
(136) Carcinoma of penis .
(137) Rodent ulcer .
(138) Syphilitic ulcer .

Spot the diagnosis 131- 134

(131) A patient has come in the O.P.D for pain in the shoulder . On examination of the joint there is tenderness  just below the acromion . The arm is lying by the side of the chest . Spot the diagnosis?
(132)  A fatty lady of forty five has come for pain in the shoulder and itching of the back at upper side and sometime naucea and vomiting . On examination of her back there is hypersthecia on the back right side from nine to eleven ribs .
(133) A patient has come for pain in the shoulder and upper arm during the mid range of abduction from (45°to160°) and freedom from pain at the extremes of the range .
(a) Spot the diagnosis ?
(b) What are the causes ?
(134) A lady of sixty five has come for stiffness of the shoulder and pain which is worse at night often wakening her after she has fallen asleep . X-ray of her shoulder is normal . Spot the diagnosis ?

Answers
(131) Painful arc syndrome .
(132) Chronic cholecystitis .
(133)
(a) Painful arc syndrome .
(b1) incomplete rupture of the supraspinatus .
(2) supraspinatus tendnitis .
(3) Calcified  deposites supraspinatus tendons .
(4) subacromial bursitis.
(5) Crack fracture of the greater tuberosity .
(134) Frozen shoulder.

Spot the diagnosis 129-130

(129) An adult male of fifty from a well- to -do family has come  . He complains of pain in the front of medial epicondyle . Nothing abnormal was detected  . Spot the diagnosis ?
(130) A lady of forty has come . She feels pain near the tip of radial styloid process near the  anatomical snuff box. On examination there is tenderness and a firm nodule in the size of a orange pip is palpably enlarged . The Finkelstein 's test is positive.
(a) Spot the diagnosis ?
(b)  What is Finkelstein 's test?
(c) What are the tendons involve in it .
(d) What is the nature of the disease ?

Answers
(129) Golfer's elbow
(130)
(a) De Quervain's tenovaginitis .
(b) Passive adduction or ulnar deviation of the wrist and thumb causes the patient to wince with pain .
(c) Abductor pollicis longus and extensor pollics brevis .
(d) Chronic stenosing tenovagitis.

Spot the diagnosis 127-128

(127) A patient came with injury of the elbow joint . The doctor diagnosed it as posterior dislocation of  the elbow joint without x-ray. The doctor reduced the dislocation very easily but it recurred easily  . What was the cause of recurrence in your opinion ?

(128) A surgeon was consulted for pain in the front of lateral epicondyle . The doctor did two tests .
(a) The doctor flexed passively his hand at the full extent .
(b) The patient was told to dorsiflex  his hand and the doctor tried to flex the hand against resistance .
And in both the tests pain was aggravated . What is your diagnosis?

Answers
(127) Fracture of coronoid process .

(128) Tenis elbow .
(a) Mills's manoeuvre .
(b) Cozen's test

Spot the diagnosis 121-126

(121)An old man of seventy walks with his hands crossed on his back still doesn't stand fully straight .
(122) An old man of seventy five has come with enlarged prostate but he says that there is much pain on his back .
(123) One patient of hand injury has come there is swelling on the anatomical snuff box and tenderness on the same place when the hand moves medially .
(124) A patient has come there is tenderness when the tip of the thumb is pressed against the fore finger of the injured side .
(125) A patient of hand injury has come there is a bony protuberance  felt anteriorly behind the flexor retinaculum .
(126) A patient of hand injury has come . There is tenderness over the knuckle of the second metacarpal on percussion .


Answers
(123) Fracture of scaphoid .
(126) Fracture of scaphoid .
(125) Dislocation of lunate .
(121) Senile osteoporosis.
(122)  Carcinoma prostate .
(124) Fracture of scaphoid .

Spot the diagnosis 121

(1) A patient of severe injury has come in the emergency . He is a well-built adult and his thigh assumes the position of flexion ,adduction and internal rotation . Spot the diagnosis ?
Ans Posterior dislocation of the hip .