investigations

Question 1

45 year old man with a history of severe low back pain radiating to right ankle and foot. Diminished right
ankle jerk found on examination. Limited straight leg raising.

Answer 1

MRI lumbar spine

Question 2

18 year old junior athlete presents with a 4week history of pain in left tibia. X-ray reported as normal.

Answer 2

MRI knee

Question 3

82 year old female on steroids for chronic asthma presents with acute mid thoracic pain. No neurological signs.

Answer 3

X-ray dorsal spine

Question 4

26 year old footballer with knee swelling and intermittent locking after a game two weeks previously.

Answer 4

X-ray knee

Question 5

75 year old man with known prostate carcinoma for 5 years develops pains in his back and chest. PSA level 143mg/l.

Answer 5

isotope bone scan

Question 6

An 18 year old man falls off his motorbike at high speed. He is brought to A&E complaining of a painful left knee.

Answer 6

cervical spine, chest and pelvic x-ray (trauma series)

Question 7

A 23 year old man playing football twists his left knee in a collision and is subsequently unable to fully flex or extend his leg.

Answer 7

MRI scan left knee (gammy knee)

Question 8

A 45 year old man who is a heavy smoker develops sudden pain in his right hip. An X-ray shows a subtrochanteric fracture of the right femur.

Answer 8

CXR (look for 1˚ tumour)

Question 9

A 55 year old lady trips and sustains a Colles’ fracture of the right wrist.

Answer 9

DEXA bone density scan (osteoporosis)

Question 10

A 70 year old man has a witnessed collapse in a supermarket and is seen to strike his head. He is now fully
conscious and has normal pupillary reflexes.

Answer 10

12 lead ECG (no neurological signs/pupillary abnormality –> ix other causes)