Feature Article

Avoiding commonly missed orthopaedic problems

Kim Slater, George N Zoys



Musculoskeletal injuries may result in chronic and disabling conditions if not diagnosed early and managed appropriately. Armed with an accurate history and a detailed examination, the family clinician can avoid the commonly missed diagnoses.

Key Points

  • Suspect a talar dome lesion in a sprain that fails to improve as expected.
  • Hand and wrist injuries are commonly overlooked because they are not totally disabling. The scaphoid is the most frequently fractured carpal bone.
  • A delay in diagnosis of an ulnar collateral ligament injury leads to less satisfactory results than early surgical repair. Persistent painful thumb instability can result and compromise grip.
  • Think of the hip in an adolescent presenting with knee pain. A missed slipped upper femoral epiphysis can have potentially disastrous consequences.