Case 34

68 year old F with R leg pain.  Walking down wooden steps, slid down 2 steps, landed on R knee.  Mechanical fall.  R lateral distal thigh pain at rest, worse with ambulation and flexion.  Unable to bear weight on R leg.  No paresthesias.  No head trauma, no LOC, no fevers.  No dizziness, CP, SOB, palpitations or HA.  No PMHx.  No PSHx. No medications.  No allergies.  

Constitutional: No fever or chills.
Musc: (+) R knee pain
Neuro: No head trauma or LOC. No numbness or tingling.
Skin: No skin rash. No erythema, ecchymoses, abrasions or lacerations.
(+) R knee swelling

SKIN: No erythema, ecchymoses, abrasions or laceration to R LE. (+) R
knee swelling lateral > medial
EXT:  Lateral bony tenderness to right knee present. Swelling present
but no obvious boney deformity. Decreased active ROM of R knee in
flexion. Full active ROM in extension. (-) Anteior and Posterior
Drawer tests.
NEURO: Motor 5/5 and sensation intact throughout lower extremites. 2+
dorsalis pedis and tibialis posterior b/l. Unable to ambulate
secondary to R knee pain.


1. A. What view are we looking at?  B. What anatomy is the arrow pointing to?

2. What abnormality is shown here?


3. What abnormality is shown in this picture of the lateral femur epicondyle?