MSK

Question 1

What are the features of adhesive capsulitis?

Answer 1

symptoms develop over a few days. frozen shoulder. external rotation worse, both active and passive movement, painful phase, freezing phase, recovery phase, usually lasts between 6 months and 2 years

Question 2

What are the features of trochanteric bursitis?

Answer 2

Pain over the lateral side of the hip
Tenderness on palpation on the greater trochanter

Question 3

When should you reassess fracture risk in patients on alendronate?

Answer 3

After 5 years of treatment

Question 4

If someone has a high FRAX score, what is the next step?

Answer 4

DEXA scan

Question 5

What is the definition of reactive arthritis?

Answer 5

Arthritis that develops following an infection where no organism can be recovered from the joint

Question 6

What is the management of reactive athritis?

Answer 6

symptomatic: NSAIDS, intra-articular steroids
sulfasalazine and methotrexate if persistant
usually lasts less than 12 months

Question 7

What is the classical triad of reactive athritis?

Answer 7

Cant see, cant pee, cant climb a tree

Question 8

What is found in the synovial fluid of someone with reactive athritis?

Answer 8

sterile synovial fluid with a high white cell count

Question 9

Which type of arthritis has bouchards and heberdens nodes?

Answer 9

Osteoarthritis

Question 10

Are bouchards and heberdens nodes painful?

Answer 10

No

Question 11

What are the features of spinal stenosis?

Answer 11

gradual onset, unilateral/bilateral leg and back pain, numbness and weakness, worse on walking, resolves on sitting/crouching

Question 12

What are the features of ankylosing spondylitis?

Answer 12

lower back pain and stiffness, worse in the morning and improved by exercise, peripheral arthritis

Question 13

What are the features of facet joint pain?

Answer 13

pain worse in the morning and on standing, pain over facets. usually worse on extension of the back.

Question 14

What is a positive straight leg raise?

Answer 14

Pain on raising leg from lying - sciatic nerve pain

Question 15

What are the features of venous ulcers?

Answer 15

brown pigmentation, lipodermatosclerosis (champagne bottle legs), eczema, painless, usually above the ankle

Question 16

What are the features of arterial ulcers?

Answer 16

occur on toes and heel, deep, punched-out appearance, painful, cold, low pulses

Question 17

What are the features of neuropathic ulcers?

Answer 17

over plantar surface of metatarsal head and plantar surface of hallux, due to pressure, usually in diabetics

Question 18

What is the management of an extracapsular hip fracture?

Answer 18

Intertrochanteric - dynamic hip screw
other extracapsular - intramedullary device

Question 19

What is the management of an undisplaced intracapsular hip fracture?

Answer 19

internal fixation or hemiarthroplasty if unfit

Question 20

What is the management of a displaced intracapsular hip fracture?

Answer 20

arthroplasty (hemiarthroplasty if unfit)

Question 21

After how many years of bisphosphonates should you re-assess FRAX and DEXA?

Answer 21

Five years for oral bisphosphonates
three years for IV

Question 22

What can cause avascular necrosis of the hip?

Answer 22

long-term steroids, chemo, alcohol, trauma

Question 23

What are the features of trochanteric bursitis?

Answer 23

Lateral hip/thigh pain over greater trochanter, usually worse when lying on side, older women

Question 24

What are the features of compartment syndrome?

Answer 24

Pain on movement even passive, parasthesia, pallor, arterial pulsation
commonly supracondylar and tibial shaft fractures

Question 25

What is the most commonly affected joint in septic arthritis?

Answer 25

knee

Question 26

What organism most commonly causes septic arthritis?

Answer 26

staphylococcus aureus (or gonorrhoeae in young adults)

Question 27

What is the management of septic arthritis?

Answer 27

flucloxacillin or clindamycin if pen allergic (IV 2 weeks then oral 2 weeks)
needle aspiration to decompress joint

Question 28

What is chondrocalcinosis and when is this seen?

Answer 28

linear calcifications of the meniscus and articular cartilage - seen in pseudogout

Question 29

What are the features of De Quervain’s tenosynovitis?

Answer 29

inflammation of sheath of extensor pollicis brevis and abductor pollicis longus tendon
- causes radial wrist pain, usually middle-aged women
Finkelstein’s test (adduct and flex thumb, radial wrist hurts)

Question 30

How do you manage an open fracture?

Answer 30

• debridement
• external fixation after soft tissue healing
• IV broad spectrum Abx

Question 31

What are the features of osteomalacia?

Answer 31

bone pain, tenderness and proximal myopathy (waddling gait)

Question 32

Which muscles do which parts of arm abduction?

Answer 32

Supraspinatus (0-15)
Deltoid (15-90)
Trapezius (the rest)

Question 33

What is the painful arc?

Answer 33

60-120 degrees - due to supraspinatus impingement

Question 34

What must you do when starting allopurinol?

Answer 34

Give colchicine cover for up to 6 months