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NBME 24 Answers

nbme24/Block 3/Question#39 (40.2 difficulty score)
A 34-year-old woman is brought to the ...
tags: MSK 

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submitted by neonem(578),
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Filnlga no oesdrthectut :dhan asicdoph is otms moocmn neo ot be treudc,raf anetlu is smto nmmooc to be do.siatcdle eLunat itsnicldaoo nca ceusa tceua capral lnentu e.yrdosnm

hiTnk of het nocnmiem St"higtar ineL To nP,iky Hree eoCms hTe uhTm"b fro the eosnb of eth p,lma wandrig a lfotlbao shaep girtasnt olewb eth umtbh CMP ontji njacdaet ot teh sdru,ai neth gnomvi ot royu alimed rtws,i nda thne abck to eth htum.b

piocd,Sah t,nleau iumqtue,rtr io,srfpmi athm,ae caa,tetip ptreido,za a.uzirpetm hTe naeult koslo keli t'is rlyeripoots eidotldsac r.hee

sympathetikey  Yep. I didn't even look at the X-ray. +11  
dr.xx  loonies love lunate +2  
wes79  she landed on her "right hand", but the X-ray is showing a left hand?? +1  
wes79  i legit have no idea whats going on in that xray lol +9  
nbme4unme  X-ray confused the hell out of me, I was going to put lunate based on Q stem but ended up putting Pisiform because it looks like that's what's messed up in the photo? Should have ignored the picture haha. +1  
nwinkelmann  for @dr.xx, love your mnemonic. I added to it, or at least found an explanation on why it works. "loonies love lunate" and "loonies" are "dislocated" from reality. +3  
niboonsh  Some Lovers Try Positions That They Cant Handle +10  
vsn001  ngl if scaphoid was an option - would've sprung at that real quick -> thanks for teaching me the importance of knowing to look for dislocation vs fracture :D +  
regularstudent  Ahh, the classic "left hand" x-ray but actual fracture of "right hand" NBME tactic +  
sars  I think the x-ray is showing the lunate protruding out of the palmar side. Imagine the situation where you are falling and using your hand to stop the fall. Your lunate will dislocate forward as the rest of the carpal bones recoil back, hence why it protrudes through the palmar side. Thats why it causes an acute carpal tunnel syndrome. +  
makingstrides  Another mnemonic, Some Lovers Tried Positions, That They Can't Handle +  
ineedhelpwitmed  so long to pinky, here comes the thumb +  

submitted by jucapami(11),
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td-ar:/eral.cosantgcbeara/spiilporh/p/oitsedawoth r inkgta a kool

submitted by pingra(4),

Check out UWORLD question 16595 - The X-ray is showing the "spilled T cup" sign

pingra  which is specific for a lunate dislocation* +