Cases & Science

Adult patient presenting with persistent knee pain and functional limitation following prior conservative management. MRI findings suggest degenerative changes; clinical examination indicates possible mechanical instability.

Should surgical intervention be considered, or should conservative management be extended given conflicting indicators?

Imaging findings alone suggested age-related degeneration; however, clinical instability and patient-reported functional limitation indicated mechanical involvement beyond imaging severity. Differential considerations included meniscal pathology versus ligament laxity not fully captured on MRI.

• Continued conservative management with physiotherapy
• Diagnostic arthroscopy
• Surgical intervention with alignment correction

Extended conservative management was deprioritized due to declining functional status and mechanical symptoms inconsistent with imaging-only pathology.

Surgical evaluation recommended following second-opinion review.

Long-term functional outcome given mixed degenerative and mechanical findings.

Adult patient with prior nasal trauma presenting with chronic obstruction and cosmetic asymmetry.

Can functional correction be achieved without compromising structural stability?

Airway obstruction correlated with septal deviation and internal valve collapse. Cosmetic correction required careful balancing to avoid worsening airflow.

• Functional septoplasty alone
• Combined functional and structural reconstruction

Isolated cosmetic correction rejected due to risk of persistent obstruction.

Combined functional-structural approach supported.

Postoperative airflow adaptation variability.