MSK/rheumatology reverse

Question 1

Rotator cuff injury (SITS muscle)

Answer 1

Shoulder pain after repetitive activity, point tenderness at anterior humerus or AC joint. + drop arm test or apprehension test

Question 2

Colle’s fx; tx = volar splint

Answer 2

FOOSH, radial fracture w/ dorsal displacement, dinner-fork deformity

Question 3

Carpal tunnel syndrome

Answer 3

Typing, secretary wrist pain and numb/tingling from wrist to hand. New mothers, pregnant may worsen

Question 4

deQuervain’s tenosynovitis

Answer 4

Pain at base of thumb, distal radial styloid. Pain reproduced with ulnar deviation of clenched fist.

Question 5

Boxer’s fracture. Ulnar gutter w/ intrinsic plus positioning. ORIF if angulation > 40 degrees

Answer 5

Hand injury after a punch

Question 6

Limb will be:
-shortened
-internally rotated
-adducted

Answer 6

posterior hip dislocation

Question 7

Scoliosis (>25 degree Cobb angle = surgery)

Answer 7

Female exam, asymmetric posterior chest wall or uneven scapula height with forward bending

Question 8

Limb will be:
-externally rotated
-shortened

Answer 8

Hip fracture

Question 9

ACL (look for description of lachman or drawer test)

Answer 9

Knee injury during a football game

Question 10

Legg-calve-perthes disease

Answer 10

8-10 yo male with limp, knee pain

Question 11

SCFE

Answer 11

12-15 yo overweight male knee pain, limp, hip pain (knee XR normal)

Question 12

Osgood-Schlatter disease

Answer 12

Adolescent male with knee pain, tenderness over tibial tuberosity

Question 13

Patellofemoral pain syndrome - increased Q angle, strengthen quadiceps

Answer 13

Retropatellar knee pain esp. in females

Question 14

Morton’s neuroma; Tx w/ NSAIDs, wide shoes, then steroid injections

Answer 14

Pain on plantar foot @ 2nd and 3rd metatarsal. Assoc. with tight shoes, relieved by removing shoes. Palpable painful mass

Question 15

Compartment syndrome

Answer 15

Pain after tx of fracture with cast

Question 16

Ankylosing spondylitis, Reiter’s syndrome

Answer 16

HLA-B27

Question 17

Septic arthritis (synovial fluid = leukocytosis, low glucose)

Answer 17

Acute joint pain. Swollen, warm, erythema.

Question 18

Osteoarthritis. Acetaminophen #1 choice

Answer 18

Large joint pain. Knees w/ medial joint space narrowing, osteophytes. No erythema or warmth.

Question 19

Osteoarthritis (herberden - DIP; bouchard - PIP)

Answer 19

Enlarged PIP, DIP

Question 20

Rheumatoid arthritis. Methotrexate (DMARDs) #1

Answer 20

Female morning joint pain and stiffness esp. hand/wrists. MCP joint swelling, ulnar deviation

Question 21

Polymyalgia rheumatica

Answer 21

Proximal symmetric muscle pain and stiffness esp. shoulder, neck, pelvic girdle

Question 22

Ankylosing spondylitis; Tx = NSAIDs (Indomethacin)

Answer 22

Male w/ low back pain, stiffness. Pain worse wakening, improve during the day. Decreased ROM at spine. Plain films show sacroiliac abnormality. HLA-B27 positive

Question 23

Reiter’s syndrome

Answer 23

Conjunctivitis, iritis, arthritis, cervicitis, urethritis

Question 24

SLE

Answer 24

Female with arthralgias, malar rash, +ANA, +anti-double stranded DNA antibodies, +anti-phospholipid antibodies

Question 25

Fibromyalgia (exercise program good management)

Answer 25

Female, fatigue, general aching, pain at neck, upper shoulders, sleeping problems, tender points

Question 26

Raynaud's phenomenon

Answer 26

Cold induced pain at extremities with change as they warm up

Question 27

Pseudomonas aeruginosa (foam padding in shoes)

Answer 27

Osteomyelitis after stepping on nail wearing sandals or tennis shoes

Question 28

Ewing sarcoma periosteal "onion skin" reaction

Answer 28

teenage female with long bone pain without trauma or injury. XR w/ lytic mass, multi-laminated periosteal reaction

Question 29

Multiple myeloma

Answer 29

Lytic lesions in the back or skull

Question 30

SITS (supraspinatus, infraspinatus, teres minor, subscapularis)

Answer 30

Parts of the rotator cuff

Question 31

Posterior - foosh anterior posterior - MVA

Answer 31

Common dislocation directions elbow shoulder Hip

Question 32

Annular ligament - subluxation of radial head

Answer 32

Nursemaid's elbow

Question 33

Mallet finger

Answer 33

Unable to extend at DIP

Question 34

Dupuytren's contracture

Answer 34

Progressive fibroproliferative dz of palmar fascia. Most commonly ring finger

Question 35

Salter Harris "SAL" I = S - separation of growth plate (GP) II = A - Above GP III = L - Below GP IV = through both V - crush

Answer 35

Pediatric growth plate classification system

Question 36

Thumb spica splint

Answer 36

Splint for non-displaced scaphoid fx

Question 37

Meniscal tear

Answer 37

McMurray test

Question 38

Achilles tendon integrity

Answer 38

Thompson test

Question 39

Deep peroneal nerve

Answer 39

Footdrop

Question 40

Pain, pallor, pulselessness, paralysis, paresthesia

Answer 40

5 Ps of compartment syndrome