NR Medical Academy

NR Medical Academy Coming soon Radiation Protection Officer (RPO) course.

Academic activities Medical: CME for x-ray license renewal (4 CPD points), 40 hour course for new license holders (20 CPD points), PoCUS Ultrasound Workshops & Radiographic Technique Workshop.

OSGOOD-SCHLATTER DISEASE (OSD) 12M, sport injury 1 month ago, still painLateral view knee showing fragmentation of anter...
22/01/2026

OSGOOD-SCHLATTER DISEASE (OSD)
12M, sport injury 1 month ago, still pain
Lateral view knee showing fragmentation of anterior tibia tubercle. This is consistent with Osgood-Schlatter Disease (OSD) or Tibial Tubercle Apophysitis.

Osgood-Schlatter Disease (OSD) is an overuse injury in growing kids especially boys. It is similar to Sinding-Larsen-Johansson Syndrome (SLJS). The key difference is location: OSD affects the tibial tubercle where the patella tendon attaches to the tibia, while SLJS affects the inferior pole of patella where the tendon originates. Both cause anterior knee pain, swelling, and tenderness, often in athletes, and are self-limiting, resolving as growth stops.
In OSD, x-rays show irregularity and fragmentation of the tibial tubercle.
In SLJS, x-rays may be normal or may show spur at inferior pole of patella.
You can make this diagnosis clinically with the help of plain x-rays.
Do you need MRI? No, not really.
KIARA MEDICAL CENTRE, DESA SRI HARTAMAS, KUALA LUMPUR, MALAYSIA

LISFRANCE INJURIES 37F, fall down the stairs hurting left foot, swollen and tenderness along the metatarsal region & the...
21/01/2026

LISFRANCE INJURIES
37F, fall down the stairs hurting left foot, swollen and tenderness along the metatarsal region & the dorsum of the foot, unable to bear weight.
Foot x-rays showing increased in inter-metatarsal distance and, malalignment of cuboid-4th metatarsal. No associated fractures. These are consistent with Lisfrance injuries.

Lisfranc injuries, also called Lisfranc fracture-dislocations are dislocation of the articulation of the tarsus with the metatarsal bases. On foot views, a number of findings can be seen:
increased distance between the medial cuneiform and the 2nd metatarsal
increased distance between the medial and intermediate cuneiforms
malalignment between the medial border of the base of the 4th metatarsal and the cuboid
Next step is to do CT to rule out fractures.
Internal fixation is the most common treatment.
The most common complication is post-traumatic arthritis.
KLINIK NG DAN SINGH (KG SG TERENTANG), RAWANG, SELANGOR, MALAYSIA

SHOULDER FRACTURE DISLOCATION86F, p/w swelling over the left shoulder region discoloration over the skin.X-rays left sho...
20/01/2026

SHOULDER FRACTURE DISLOCATION
86F, p/w swelling over the left shoulder region discoloration over the skin.
X-rays left shoulder showing fracture dislocation of left shoulder. The humerus is fractured at surgical neck with fracture line extending to the lesser tuberosity. This is a 3 part fracture. Humeral head is displaced inferiorly, medially and anteriorly. This is anterior shoulder dislocation.

Its quite rare to have both fracture and dislocation together. It is now a challenge to the orthopaedic managing this case. Patient is 86 years old and the bones are osteoporotic. Treatment would most likely be non-surgical but healing may be delayed.
CARECLINICS KLINIK RAMABAI DAN SURGERI, KEPONG, KUALA LUMPUR, MALAYSIA.

SCHATZKER VI TIBIAL PLATEAU FRACTURE29M, alleged fall from stepsKnee views showing comminuted fracture at proximal tibia...
19/01/2026

SCHATZKER VI TIBIAL PLATEAU FRACTURE
29M, alleged fall from steps
Knee views showing comminuted fracture at proximal tibia involving lateral and medial tibial plateaus, and tibial metadiaphysis with mild depression of the tibial plateau. This is Schatzker VI tibial plateau fracture.

Schatzker classification system divides tibial plateau fractures into six types and type VI is the worst. It involves both condyles and fracture upper tibia.
It is usually a result of high-speed trauma like car accidents. Hx says he fell from steps - must be very high steps!).
It’s a complex fracture with significant injuries to ligaments and meniscus.
Treatment is also complex and many be done in many stages.
Prognosis is poor.
Complications are non-union and post-traumatic osteoarthritis.
KLINIK ANTAH, BANDAR MAHKOTA CHERAS, CHERAS, SELANGOR, MALAYSIA.

FRACTURE ENTHESOPHYTE OF THE ACHILLES TENDON43M, h/o injury over left ankle. TRO #. Ankle views showing a fractured ent...
18/01/2026

FRACTURE ENTHESOPHYTE OF THE ACHILLES TENDON
43M, h/o injury over left ankle. TRO #. Ankle views showing a fractured enthesophyte of the Achilles tendon.

Enthesophyte is a bony outgrowth or spur that forms at the insertion point (enthesis) where the Achilles tendon meets the calcaneum.
How can it fracture? As a result of chronic inflammation and stress on the tendon, potentially from overuse, tight calf muscles, or obesity.
How does it present? Sudden, severe pain at the back of the heel.
How do you treat it? RICE, NSAIDs and physio
KLINIK MEDIVIRON (BUKIT INDAH), JOHOR BAHRU, JOHOR, MALAYSIA.

GRADE 1 SPONDYLOLISTHESIS AND SPONDYLOLYSIS 28F, alleged slip and fell in sitting position. Lateral view lumbar spine sh...
16/01/2026

GRADE 1 SPONDYLOLISTHESIS AND SPONDYLOLYSIS
28F, alleged slip and fell in sitting position.
Lateral view lumbar spine showing forward shift L5 over S1 and break in L5 pars interarticularis. This is grade 1 spondylolisthesis and spondylolysis.

The patient is a young 28 year old female. Spondylolysis is a form of stress fracture. Further probe into possible cause ought to be done. Usually this is linked to repetitive stress from sports like gymnastics, diving or dance. It could also be congenital defect.
KLINIK NUVAMED OLD KLANG ROAD, KUALA LUMPUR, MALAYSIA.

POSTERIOR ELBOW DISLOCATION WITH FRACTURE RADIAL HEADAlleged fall. Elbow views showing posteriorly dislocated right elbo...
15/01/2026

POSTERIOR ELBOW DISLOCATION WITH FRACTURE RADIAL HEAD
Alleged fall. Elbow views showing posteriorly dislocated right elbow. There are loose bodies within the olecranon fossa. Anterior part of radial head is fractured. Olecranon process is intact.
Typically, as a result of fall on out-stretched hand. Most are closed dislocation and most are posterior. Isolated dislocation without fracture is simple and dislocation with fracture is complex. Most common associated fracture is radial head followed by coronoid process.
Simple may be treated with closed reduction but complex fracture-dislocation would require surgical intervention.
Acute complications are injuries to ulnar nerve and median nerve.
Long term complications are secondary OA, limited ROM, instability and recurrent dislocation.
POLIKLINIK TIRAM, ULU TIRAM, JOHOR, MALAYSIA

AVULSION FRACTURE OF THE 5TH METATARSAL TUBEROSITY31F, alleged fall at workplace, climbing stairs, mosaic broke, rt ankl...
14/01/2026

AVULSION FRACTURE OF THE 5TH METATARSAL TUBEROSITY
31F, alleged fall at workplace, climbing stairs, mosaic broke, rt ankle inverted
X-ray foot showing fracture base of 5th metatarsal.
There are 3 types of fractures that can occur here:
-Avulsion fracture
-Jones fracture
-Stress fracture
Avulsion fracture occurs at the tuberosity. Tuberosity is the site of attachment for plantar aponeurosis and peroneus brevis tendon.
Jones fracture occurs at the level of 4th – 5th inter-metatarsal articulation.
Stress fracture occurs in the proximal diaphysis, distal to the level of 4th – 5th inter-metatarsal articulation.
Why is it important to differentiate between them? Treatment and prognosis between the 3 are different.
-Avulsion fracture heals well without surgery.
-Jones fracture may require surgery and can have delayed healing.
-Stress fracture has increased risk of impaired healing due to poor blood supply and have the poorest prognosis.
KLINIK SAFIYA & SURGERI, KULIM, KEDAH, MALAYSIA

FRACTURE PATELLA 42M, fell down while working on boat - right knee pain and swelling +++right knee x-rays showing displa...
14/01/2026

FRACTURE PATELLA
42M, fell down while working on boat - right knee pain and swelling +++
right knee x-rays showing displaced fracture of patella with significant haematoma and joint effusion.

How do you get patella fracture?
- Direct trauma to the patella
- Sudden forceful contraction of the quadricep muscles (usually related to sport injury)
How do you treat patella fracture?
- Minimally displaced fracture with intact extensor mechanism – knee splint
- Displaced fractures or disrupted extensor mechanism – K wire
MEDUS CLINIC, HUTAN MELINTANG, PERAK , MALAYSIA

13/01/2026

POLYOSTOTIC FIBROUS DYSPLASIA
42M, c/o right sided lateral chest pain on and off since 1-2 years, pain recently increasing intensity since past 3 days, no h/o fall / trauma, never been investigated before.
CXR AP & PA views were done showing multiple and bilateral expansile rib lesions. They involve the following ribs:
-4th anterior right rib
-6th anterior right rib
-8th posterior right rib
-7th posterior left rib
-9th anterior left rib
Differential diagnosis are fibrous dysplasia, enchondroma and metastases. Given the history, this is most likely fibrous dysplasia.

Fibrous dysplasia is a rare, benign bone disorder where normal bone is replaced by fibrous, scar-like tissue, making bones weak and prone to fractures. If it affects single bone, we call it monostotic. If it involves multiple bones, we call it polyostotic.
Most often detected during routine examination or present with bone pain due to fractures.
KLINIK SOFEA PLUS SEREMBAN, NEGERI SEMBILAN, MALAYSIA
Klinik Sofea Seremban

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