FMGE 2026 - Orthopaedics PYQs Practice Questions

Q: Which ligament injury is shown?

Anterior cruciate ligament. ***Anterior cruciate ligament*** - The **Anterior Cruciate Ligament (ACL)** is the most commonly injured ligament in the knee, often occurring in sports involving sudden **deceleration**, **pivoting**, or **cutting maneuvers**. - Physical examination typically reveals a positive **Anterior Drawer Test** or **Lachman test**, indicating increased anterior translation of the tibia relative to the femur. *Posterior cruciate ligament* - The **Posterior Cruciate Ligament (PCL)** is injured by a high-energy **posteriorly directed force** against the proximal tibia while the knee is flexed, commonly known as a **'dashboard injury'**. - Physical examination reveals a positive **Posterior Drawer Test**, which tests for posterior tibial sag or displacement. *Medial cruciate ligament* - The **Medial Collateral Ligament (MCL)** injury typically results from a **valgus stress** on the knee, affecting the stability of the medial compartment. - Clinical assessment involves a positive **valgus stress test**, where the knee is stressed into abduction, demonstrating laxity on the medial side. *Lateral cruciate ligament* - The **Lateral Collateral Ligament (LCL)**, also known as the fibular collateral ligament, is injured by a **varus stress** force applied to the knee. - Injury is less common than MCL or ACL tears and is assessed via a **varus stress test**, revealing laxity when the knee is stressed into adduction. [Practice more Orthopaedics PYQs on OnCourse]

Q: Fracture to the medial epicondyle of the humerus can lead to which of the following nerve injury?

Ulnar. ***Ulnar nerve*** - The **ulnar nerve** runs in the **cubital tunnel** posterior to the **medial epicondyle**, making it highly susceptible to injury during fractures of this region. - Clinical signs of injury include **claw hand deformity**, sensory loss in the **medial 1.5 digits**, and weakness of intrinsic muscles in the hand. *Axillary nerve* - This nerve is most commonly injured with **surgical neck fractures** of the humerus or **shoulder dislocations**. - Injury typically results in **deltoid muscle atrophy** and sensory loss over the lateral aspect of the shoulder, often referred to as the **regimental badge area**. *Radial nerve* - The **radial nerve** is closely related to the humerus in the **spiral groove** (radial groove), making it vulnerable during **mid-shaft humeral fractures**. - A characteristic manifestation of radial nerve injury is **wrist drop**, due to paralysis of the **extensor muscles** of the forearm. *Median nerve* - The **median nerve** is typically at risk during **supracondylar fractures** of the humerus, where it lies anteriorly. - Injury at this level often leads to the **hand of benediction** sign, particularly when attempting to flex the digits. [Practice more Orthopaedics PYQs on OnCourse]

Q: A patient sustained an elbow dislocation that was treated locally. Due to improper healing, the patient later developed a tingling sensation in the palm. Which nerve is most likely involved?

Ulnar nerve. ***Ulnar nerve*** - The **ulnar nerve** runs posterior to the **medial epicondyle** of the humerus, a site highly susceptible to injury during an **elbow dislocation** or subsequent **valgus deformity** (tardy ulnar nerve palsy). - Compression or entrapment of this nerve leads to sensory loss and a **tingling sensation** in the medial aspect of the palm, the little finger, and the medial half of the ring finger. *Median nerve* - The **median nerve** is located on the anterior aspect of the elbow, making it more prone to injury during **supracondylar fractures** of the humerus rather than posterior dislocations. - Injury here typically presents with a 'hand of benediction' sign and sensory deficits in the lateral aspect of the palm. *Radial nerve* - The **radial nerve** is primarily associated with **mid-shaft fractures** of the humerus, where it travels in the **spiral groove**. - A lesion here classically results in **wrist drop** and sensory loss on the dorsum of the hand, not the palm. *Axillary nerve* - The **axillary nerve** is commonly injured in **shoulder dislocations** or fractures of the **surgical neck of the humerus**. - Clinical presentation involves weakness of the **deltoid muscle** and loss of sensation over the 'regimental badge' area on the lateral shoulder. [Practice more Orthopaedics PYQs on OnCourse]

Q: A 28-year-old male is brought to the emergency department following a high -speed motor vehicle collision in which his knee struck the dashboard. On physical examination, the right lower limb is shortened, adducted, and internally rotated. An anteroposte rior X- ray of the pelvis is shown below. Based on the clinical presentation and radiographic findings, what is the most likely diagnosis?

Posterior hip dislocation. ***Posterior hip dislocation*** - The mechanism of injury, known as the **dashboard injury**, where the knee strikes the dashboard, pushes the femoral head posteriorly out of the acetabulum. - The characteristic clinical presentation is a limb that is **shortened, adducted, and internally rotated**. *Anterior hip dislocation* - This presentation is typically associated with **abduction and external rotation** of the affected limb. - It is usually caused by excessive abduction and external rotation forces, rather than the forward force typical of a dashboard injury. *Intertrochanteric fracture* - In hip fractures, the leg is typically **shortened and externally rotated**, distinguishing it from the internal rotation seen here. - There is often history of a fall in an elderly patient, though it can occur in high-energy trauma, it does not classically present with internal rotation. *Fracture of acetabulum* - While this can occur in high-speed crashes and involve injury to the hip joint, it is a broad diagnosis that describes a bony injury rather than the **dislocation** itself. - This diagnosis would require definitive confirmation via imaging for the presence of a fracture line, whereas the specific posture of adduction/internal rotation is pathognomonic for a posterior dislocation. [Practice more Orthopaedics PYQs on OnCourse]

Q: A 9-year-old child presents with pain and swelling over the mid -shaft of the tibia, associated with low -grade fever and an elevated erythrocyte sedimentation rate (ESR). An X-ray of the affected limb is shown below. Based on the clinical features and radiographic findings, what is the most likely diagnosis?

Ewing sarcoma. ***Ewing sarcoma*** - Classically presents in the **diaphysis** (mid-shaft) of long bones in children and adolescents, causing localized pain, swelling, and systemic symptoms like fever and elevated **ESR** that mimic infection. - Radiographic findings typically show an ** [Practice more Orthopaedics PYQs on OnCourse]

Question 1

Which ligament injury is shown?

Accepted Answer

Anterior cruciate ligament

Answer

Posterior cruciate ligament

Answer

Medial cruciate ligament

Answer

Lateral cruciate ligament

Question 2

Fracture to the medial epicondyle of the humerus can lead to which of the following nerve injury?

Accepted Answer

Ulnar

Answer

Axillary

Answer

Radial

Answer

Median

Question 3

A patient sustained an elbow dislocation that was treated locally. Due to improper healing, the patient later developed a tingling sensation in the palm. Which nerve is most likely involved?

Accepted Answer

Ulnar nerve

Answer

Median nerve

Answer

Radial nerve

Answer

Axillary nerve

Question 4

A 28-year-old male is brought to the emergency department following a high -speed motor vehicle collision in which his knee struck the dashboard. On physical examination, the right lower limb is shortened, adducted, and internally rotated. An anteroposte rior X- ray of the pelvis is shown below. Based on the clinical presentation and radiographic findings, what is the most likely diagnosis?

Accepted Answer

Posterior hip dislocation

Answer

Anterior hip dislocation

Answer

Intertrochanteric fracture

Answer

Fracture of acetabulum

Question 5

A 9-year-old child presents with pain and swelling over the mid -shaft of the tibia, associated with low -grade fever and an elevated erythrocyte sedimentation rate (ESR). An X-ray of the affected limb is shown below. Based on the clinical features and radiographic findings, what is the most likely diagnosis?

Accepted Answer

Ewing sarcoma

Answer

Osteosarcoma

Answer

Acute osteomyelitis

Answer

Osteoid osteoma

Question 6

A 28-year-old female presents to the clinic with a complaint of dull, aching pain in her left hand after accidentally striking her finger against a door frame. On physical examination, there is mild tenderness over the affected area, but the range of m otion is preserved. An X -ray of the hand is shown below. Based on the clinical presentation and radiographic findings, what is the most likely diagnosis?

Accepted Answer

Enchondroma

Answer

Giant cell tumor

Answer

Brown tumor

Answer

Aneurysmal bone cyst

Question 7

Based on the image provided below, what is the most likely diagnosis?

Accepted Answer

Synovial chondromatosis

Answer

Pseudogout

Answer

Osteochondritis dissecans

Answer

Tumoral calcinosis

FMGE 2026 — Orthopaedics