Lower Quarter - Screening

Question 1

What past medical history factors are important for lower quadrant screening?

Answer 1

Cancer (e.g., prostate, breast), joint replacement, history of alcoholism (osteonecrosis).

Question 2

What are common risk factors for lower quadrant pain?

Answer 2

Varies by system; includes infection, atherosclerosis, and improper implant size.

Question 3

What are typical pain patterns for neuromusculoskeletal hip pain?

Answer 3

Hip pain can refer to low back, buttock, groin, SI joint, anterior thigh, or even knee or ankle.

Question 4

What is the typical presentation of hip pain from the upper lumbar vertebrae?

Answer 4

Pain radiates into the anterior aspect of the thigh.

Question 5

What is the typical presentation of hip pain from the lower lumbar vertebrae?

Answer 5

Pain felt in the gluteal region with radiation down the back or outer aspect of the thigh.

Question 6

What test is highly specific for intraarticular hip pain?

Answer 6

Log rolling test (high specificity).

Question 7

What is a common cause of unilateral or bilateral groin pain after activity?

Answer 7

Adductor strain.

Question 8

What are the signs of a sports hernia (athletic pubalgia)?

Answer 8

Deep groin pain aggravated by activity, often involving tear of adductors, lower abdomen, and fascia.

Question 9

What are the characteristics of a labral tear?

Answer 9

Night pain, positive FADIR test (high specificity), and common in asymptomatic populations.

Question 10

What are signs of femoroacetabular impingement (FAI)?

Answer 10

Younger adults, gradual onset, pain with walking, sitting, or sports, rule in/out with log roll test or FABER.

Question 11

What are systemic causes of groin pain?

Answer 11

Cancer, gynecological conditions, prostate/testicular pathologies, infection.

Question 12

What signs suggest a systemic cause of anterior thigh pain?

Answer 12

Look for urologic problems, lower thoracic disc herniation, tumor, or abscess.

Question 13

What does posterior or posterolateral thigh pain indicate?

Answer 13

Lower lumbar vertebrae or sacrum involvement.

Question 14

What does lateral thigh pain suggest?

Answer 14

Inflammation of TFL and ITB syndrome, or T-L junction dysfunction.

Question 15

What is a common cause of anterior thigh pain in older patients?

Answer 15

L3-L4 disc herniation, especially in those with a history of lumbar spine surgery.

Question 16

What are typical signs of mechanical knee pain?

Answer 16

Local pain and tenderness, locking, giving way, or poor localization with weight-bearing.

Question 17

What are systemic causes of generalized knee pain?

Answer 17

Fractures, Baker’s cyst, tumors, arthritis, infection, DVT.

Question 18

What differentiates vascular claudication from neurogenic claudication?

Answer 18

Vascular: bilateral, no burning; Neurogenic: burning in back, buttocks, or legs.

Question 19

What are common signs of peripheral neuropathy?

Answer 19

Pain, aching, numbness, motor, sensory, autonomic changes, stocking-glove pattern.

Question 20

What are typical symptoms of restless leg syndrome?

Answer 20

Crawling sensation in legs, involuntary calf contractions at night, sleep disturbance.

Question 21

What are the two types of stress fractures?

Answer 21

Insufficiency fracture (normal forces on abnormal bone), fatigue fracture (abnormal forces on normal bone).

Question 22

What test is highly sensitive for stress fractures?

Answer 22

Fulcrum test (Sn = 1.0).

Question 23

What are risk factors for systemic causes of sciatica?

Answer 23

General: age, comorbidities, cancer; Arterial: smoking, atherosclerosis; Infectious: surgery.

Question 24

What are red flags for oncologic causes of lower quadrant pain?

Answer 24

Painless lymph node enlargement, fever, weight loss, bleeding, skin lesions.

Question 25

What are signs of an osteoid osteoma?

Answer 25

Hip, thigh, or knee pain worse at night, antalgic gait, relieved by aspirin.

Question 26

What are signs of urologic causes of groin pain?

Answer 26

Pain in upper thigh or groin with ureteral pain, positive Murphy’s percussion test.

Question 27

What are signs of prostate or testicular pathologies?

Answer 27

Groin pain with LBP/buttock/pelvic pain; may be caused by prostate or testicular cancer, BPH, prostatitis.

Question 28

What are signs of a psoas abscess?

Answer 28

Constitutional symptoms, hip pain in medial thigh or femoral triangle, hip flexion and IR, positive iliopsoas test.

Question 29

What signs suggest gastrointestinal causes of lower quadrant pain?

Answer 29

Alternating abdominal and back or hip pain, symptoms not relieved by PT, psoas abscess.

Question 30

What signs suggest vascular causes of lower quadrant pain?

Answer 30

Throbbing pain with activity, trophic changes, abnormal vital signs, risk factors like tobacco use, heart disease.

Question 31

What sign indicates appendicitis related to thigh pain?

Answer 31

Positive reverse straight leg raise (SLR) test.

Question 32

What systemic signs are associated with osteonecrosis?

Answer 32

Diabetes, long-term corticosteroid use, Cushing’s syndrome, alcohol abuse.

Question 33

What red flag is associated with Hodgkin’s disease?

Answer 33

Painless enlargement of inguinal or popliteal lymph nodes.

Question 34

What is a common presentation of Crohn’s disease?

Answer 34

Back or joint pain occurs in 25% of patients, skin rash may precede joint pain.

Question 35

What are red flags for avascular necrosis?

Answer 35

Hip pain, difficulty weight-bearing, antalgic gait, limited ROM (especially flexion, abduction, IR).

Question 36

What test is positive for a psoas abscess?

Answer 36

Positive iliopsoas test or obturator sign.

Question 37

What signs suggest a systemic cause of back pain?

Answer 37

Constitutional symptoms, failure to improve with PT, associated signs like fever or weight loss.

Question 38

What symptom is common in older adults related to vascular issues?

Answer 38

Burning or pain in the legs and feet at night.

Question 39

What clinical presentation is typical for gastrointestinal causes of hip pain?

Answer 39

Hip pain with associated bowel symptoms like Crohn’s disease or irritable bowel syndrome.

Question 40

What does a positive Murphy’s percussion test indicate?

Answer 40

Urologic cause, often related to kidney involvement.