MSK

Question 1

Patellofemoral pain syndrome vs. Osgood Schlatter

Answer 1

Both can cause anterior knee pain that is exacerbated by things like squatting/climbing stairs/prolonged sitting but onset of latter is in preadolescent and adolescent patients, whereas PFPS is seen mostly in adult women.

In PFPS, pain is reproducible with isometric quadriceps contraction.

Dx is clinical and treatment involves avoiding triggers, strengthening quads and hip abductors. NSAIDs can only provide temporary relief–not effective for chronic management.

Question 2

MCTD characterized by:

Answer 2

Sequential manifestation of SLE, SS, and polymyositis.

anti-U1 ribonucleoprotein

Question 3

Cervical spondylotic myelopathy

Answer 3

Canal narrowing (can cause Lhermitte sign!) causing mechanical SC compression and interruption of blood supply to cord, resulting in progressing neuro deficits and upper and lower extremities.

1) Damage to cervical spinal roots (PNS) –> neck pain radiating to shoulders/ arms, LMN findings in myotome/dermatome pattern in UE
2) Damage to SC descending tracts (CNS) –> unsteady gait (spastic, scissoring), sensation of leg weakness/stiffness, UMN signs in LE

Question 4

Ankylosing spondylitis

Answer 4

Sacroilitis, reduced chest expansion and spinal mobility, enthesitis (esp. with achilles tendon), dactylitis, uveitis

Can be complicated by soteoporosis/vertebral fx, aortic regurgitation, cauda euinqa

Get XR of sacroiliac spine