Final

Question 1

Dx cluster for lumbar radiculopathy

Answer 1

Dermatomal pattern
Pain on cough, sneezing, straining
More pain sitting
Subjective muscle weakness
Subjective sensory loss
Paresis/motor loss
\+SLR
Unilateral ankle reflex absent

Question 2

Dx cluster for cauda equina

Answer 2

Rapid sxs within 24 hrs
Hx of back pain
Urinary retention
Loss of sphincter tone
Sacral sensation loss
Lower extremity weakness or gait loss

Question 3

Dx cluster for stenosis

Answer 3

Bilateral sxs
Leg pain more than back pain 
Pain during walking/standing
Pain relief upon sitting
Age > 48 yrs

Question 4

Dx cluster for ankylosing spondylitis

Answer 4

Age onset less than 40yrs
At least 3 mos
Morning back stiffness
Pain not relieved by supine
4/5 of above and improved by exercise

Question 5

Dx cluster for lumbar compression fracture

Answer 5

Age > 50 (sensitive)
Age > 70 (specific)
Trauma
Corticosteroid use

Question 6

Dx cluster for spine CA

Answer 6

Age > 50
Previous hx of CA
Failure to I,prove in 1 month of therapy
No relief with bed rest
Duration of pain > 1 month
Insidious onset
Constitutional sxs

Question 7

Am college of Rheumatology Dx of hip OA

Answer 7

Cluster 1:
pain in hip (not SIJ)
Less than 115 deg of hip flexion
Less than 15 deg hip IR

Cluster 2:
Pain w hip IR
greater than 60 min am stiffness
Greater than 50 yrs

Question 8

Ottawa Knee Xray Rules

Answer 8

Age 55+
Isolated tenderness of patella
Tenderness at head of fibula
Inability to flex to 90
Inability to bear weight (immediately after and in ED)

Question 9

Ottawa Ankle Rules

Answer 9

Bone tenderness along distal 6cm of pos edge of tibia or medial malleolus
Bone tenderness along distal 6cm of pos edge of fibula or lateral malleolus
Inability to bear weight for 4 steps

Question 10

Ottawa Foot Rules

Answer 10

Pain in midfoot AND
Bone tenderness at base of 5th metatarsal (or)
Bone tenderness at navicular (or)
Inability to bear weight for 4 steps