MSK / Sports

Question 1

which hand condition affecting the MCP joint area is more common in patients with diabetes, RA, or amyloidosis?

Answer 1

trigger finger

Question 2

ultrasound of a patient with finger pain shows flexor tendon thickening and fascial thickening over the tendon sheath. what is the diagnosis?

Answer 2

trigger finger

Question 3

how long should conservative therapy with splint, nsaids, and therapy be attempted prior to considering injection for mild to moderate trigger finger?

Answer 3

4-6 weeks

Question 4

a patient experiences pain at the base of the thumb, exacerbated by pinching and gripping activities. what is the most likely diagnosis?

Answer 4

CMC joint arthritis

Question 5

how long after the start of conservative management with bracing and therapy for 1st CMC joint arthritis should injection be considered?

Answer 5

4-6 weeks

Question 6

what type of splint is helpful for 1st CMC joint arthritis?

Answer 6

thumb spica

Question 7

in what palpable anatomic landmark should an injection for 1st CMC joint arthritis be given?

Answer 7

anatomic snuffbox

Question 8

what condition is marked by nodules and fibrous cords of the palmar aponeurosis?

Answer 8

Dupytren’s contracture / palmar fibromatosis

Question 9

what mg of triamcinolone should be used for palmar fibromatosis?

Answer 9

60 - 120mg

Question 10

for patients with palmar fibromatosis that is refractory to conservative management and corticosteroid injection, what other injection option could they try?

Answer 10

collagenase

Question 11

t/f corticosteroid injection of ganglion cyst produces additional benefit when compared to aspiration alone

Answer 11

false

Question 12

when performing the injection for carpal tunnel syndrome, from what direction should the needle be guided?

Answer 12

ulnar

Question 13

once you have placed the needle for carpal tunnel injection, what is the sequence of how you should inject around the nerve?

Answer 13

inject the anterior portion to separate from the flexor retinaculum first, then redirect to the posterior aspect of the nerve

Question 14

what is the cause of proximal intersection syndrome?

Answer 14

dorsal compartment 1 is intersecting over dorsal compartment 2

Question 15

what wrist motion is the most problematic for patients with proximal intersection syndrome of the wrist?

Answer 15

wrist extension

Question 16

what is the most common MOI for TFCC injury?

Answer 16

FOOSH in pronation

Question 17

what is the most common physical exam finding of TFCC injury?

Answer 17

tenderness over the ECU

Question 18

what is the screwdriver test for TFCC injury?

Answer 18

apply ulnocarpal axial load and then perform full forearm supination to pronation

Question 19

describe how to perform an injecton of the TFCC

Answer 19

horizontal transducer over the dorsal wrist. approach from ulnar side, needle guided toward radial side. inject deep to the ECU

Question 20

when compared to PT, arthroscopic surgery for degenerative meniscal tears does not result in better pain control, function, quality of life. However arthroscopic surgery may result in worsening of what two things when compared to PT?

Answer 20

cartilage surface area and range of motion may worsen with surgery

Question 21

relative rest including limiting screen time and limiting activity is recommended for how many days after acute concussion?

Answer 21

2 days

Question 22

how long after concussion should you wait before returning to light physical activity if symptoms are not exacerbated by activity?

Answer 22

24-48 hours

Question 23

by how many points on a 10 point pain scale is an acceptable amount to tolerate when returning to activity after concussion?

Answer 23

no more than 2 points

Question 24

referral to a sports related concussion specialist should be considered for patients who experience symptoms lasting longer than how many weeks?

Answer 24

4 weeks

Question 25

a patient recovering from concussion has symptom exacerbation with activity that lasts beyond 1 hour. How long should a pause in activity occur?

Answer 25

1 day at least

Question 26

a patient has dorsal wrist pain and squeaking in the wrist with wrist extension. what is the most likely diagnosis?

Answer 26

proximal intersection syndrome

Question 27

what is the most significant exam finding in bone stress injury?

Answer 27

palpatory bony tenderness

Question 28

what is the immediate step in management for a tension sided femoral neck BSI?

Answer 28

urgent surgical consultation

Question 29

t/f populations with low vitamin D intake are at higher risk for bone stress injury

Answer 29

true

Question 30

what is the definitive radiology study for BSI?

Answer 30

MRI

Question 31

t/f femoral neck and tarsal navicular are considered high risk BSI sites

Answer 31

true

Question 32

localized pain and loss of function in the setting of changes in training volume and frequency are hallmarks of what condition?

Answer 32

BSI

Question 33

long term use of what pain medication class is associated with increased risk of stress fracture

Answer 33

nsaid

Question 34

bone stress injury grading has how many levels?

Answer 34

4

Question 35

what are the three most clinically concerning locations for BSI?

Answer 35

anterior tibial shaft, tarsal navicular and femoral neck

Question 36

what are the two modalities used for acute pain control with bone stress injury?

Answer 36

acetaminophen and ice

Question 37

what drug class is associated with increased risk of non union with stress fracture?

Answer 37

nsaid

Question 38

t/f lighter shoes with smaller heel to toe drop and wider toe box reduce the rate of BSI

Answer 38

true

Question 39

what modality, when added to exercise therapy can speed recovery from MTSS?

Answer 39

ECSWT

Question 40

t/f vitamin D supplementation has a protective effect against stress fracture

Answer 40

true

Question 41

t/f nsaids consistently reduce pain from hip OA

Answer 41

true

Question 42

t/f intraarticular hyaluronic acid injections have benefit for hip OA

Answer 42

false

Question 43

according to the AAOS, what is the general expected timeline/duration of treatment effect for intraarticular steroids when used for hip OA?

Answer 43

4 months treatment effect

Question 44

what medication is recommended perioperatively for total hip arthroplasty to reduce the risk of anemia?

Answer 44

TXA

Question 45

what is the major risk of using intrarticular steroid for hip OA, according to the AAOS guidelines?

Answer 45

rapidly progressing arthritis

Question 46

t/f intraarticular steroids improve pain and function in adhesive capsulitis in the short and medium term

Answer 46

true

Question 47

t/f intraarticular steroid can improve both pain and function of hip OA at 4 months

Answer 47

true

Question 48

t/f US guided carpal tunnel injections have better symptom and functional improvement with reduced rate of complications compared to landmark guided injection

Answer 48

true