Upper Limb and Spine Pathologies

Question 1

Mechanical back pain should be treated with bed rest? True/False

Answer 1

False

This increases potential stiffening. Should be treated with physio and analgesia.

Question 2

List some causes of mechanical back pain

Answer 2

Poor lifting technique
Bad posture
Obesity
Degenerative Disc prolapse
Depression

Question 3

What significant finding makes you think Acute Disc Tear

Answer 3

Pain worse on coughing

Question 4

What serious syndrome occurs in a central disc prolapse?

Answer 4

Cauda-equina syndrome

Question 5

What must be done in when suspicious of Cauda Equina Syndrome

Answer 5

A PR exam

Question 6

What symptoms suggest cauda-equina?

Answer 6

Saddle anesthesia
Bilateral Leg pain
Problems with urinating and defecating i.e. incontinence, retention or constipation

Question 7

What urgent investigation is required in potential Cauda-Equina Syndrome?

Answer 7

MRI scan before discectomy

Question 8

What are osteoporotic crush fractures?

Answer 8

Spontaneous Fractures which occur in patients with osteoporosis, causing pain and kyphosis

Question 9

Where is the commonest place for a disc prolapse to occur?

Answer 9

L4/5

Question 10

What are the red flags for spinal pain?

Answer 10

Systemic upset
Back pain <20y/o
New onset of back pain in >60y/o
Constant severe pain, which worsens at night

Question 11

Where can neck pain radiate to?

Answer 11

Shoulders

Question 12

What groups are at risk of cervical spine instability?

Answer 12

Down’s syndrome

Rheumatoid Arthritis Patients

Question 13

What is effected in impingement syndrome? (painful arc)

Answer 13

Internal rotation

Question 14

What is the test for diagnosing painful arc syndrome?

Answer 14

Hawkins’s Kennedy Test

Question 15

What causes painful arc syndrome?

Answer 15

Tendons of rotator cuff get trapped in sub acromial space

Question 16

Another term for adhesive capsulitis?

Answer 16

Frozen Shoulder