Musculoskeletal

Question 1

A 65yo sedentary woman presents with back pain and mild kyphosis. A week later she fractures her femur with minimal trauma

Answer 1

Osteoporosis

Question 2

35yo female presents with chronic widespread body pain and fatigue. On examination, tenderness is diffuse

Answer 2

Fibromylagia

Question 3

A patient presents with symmetrical, proximal muscle weakness associated with a low-grade fever. The patient eventually develops muscle atrophy and hyporeflexia. There are no other neurological or sensory changes

Answer 3

Myopathy

Question 4

6yo male presents with increasing muscle weakness particularly affecting the shoulder and hip girdles. On examination, he has hypertrophied calves and Gower’s sign

Answer 4

DMD

Question 5

40yo patient presents with chronic onset muscle weakness and atrophy associated with difficulty in motor tasks such as standing from chairs. Associated fever, weight loss and fatigue. The patient goes on to develop cardiorespiratory failure

Answer 5

Myositis

Question 6

A female patient presents with muscle weakness that is worse after activity and improves with rest. Associated ptosis and diplopia are noted on examination

Answer 6

Myasthenia gravis

Question 7

55yo overweight woman presents with a painful knee, particularly on weightbearing. On examination, there is joint crepitus in the knee which has a limited range of active and passive movements. She later goes on to develop a similar process in her hands, which spares the MCP joints

Answer 7

OA

Question 8

45yo female smoker presents with a 6 week history of painful swollen joints in the hands, sparing the DIP joints. On examination, the joints are red and boggy

Answer 8

RA

Question 9

40yo patient presents with dactylitis and pitting. Arthritic features are noted in the DIP joints. She has a family history of psoriasis

Answer 9

Psoriatic arthritis

Question 10

25yo male presents with sacroiliitis. He is HLA-B27 positive

Answer 10

Ankylosing spondylitis

Question 11

A patient with a history of IBD presents with a Achilles’ tendonitis. What type of arthritis is he likely to develop?

Answer 11

Enteropathic arthritis

Question 12

8yo boy presents with a sacroiliitis with associated fever and rash

Answer 12

Idiopathic juvenile arthritis

Question 13

20yo male presents with an asymmetrical arthritis in his knees. He has had a previous urethritis. He is HLA-B27 positive

Answer 13

Reactive arthritis

Question 14

A 35yo known IVDU presents with an acutely swollen and painful knee. The pain is not relieved by rest, and there is associated redness and decreased ROM. He has a high fever. No other joints are affected

Answer 14

Septic arthritis

Question 15

A 45yo male presents with an acutely swollen MTP joint. The joint is red and painful, which is present at rest. On further questioning, he has a moderate alcohol consumption

Answer 15

Gout

Question 16

A 65yo patient presents with an acutely swollen shoulder. It is hot, painful and red. On joint aspiration, positively birefringent crystals are seen

Answer 16

Pseudogout

Question 17

33yo patient presents with pain over their lateral forearm, and tenderness over the common extensor origin. The patient has pain with resisted wrist and finger flexion

Answer 17

Tennis elbow

Question 18

A patient presents with nocturnal thumb, index and middle fingers of one hand. Wasting of thenar eminence of this hand is noted

Answer 18

Carpal tunnel syndrome

Question 19

A patient presents with a fixed flexion deformity of one finger

Answer 19

Trigger finger

Question 20

A patient presents with a finger in a partially flexed posture. There is fusiform swelling of the digit and passive extension is painful. What process is occurring in the finger?

Answer 20

Tenosynovitis

Question 21

A patient presents with functional restriction of both active and passive movements of one shoulder, movements are also painful. The patient has noticed gradual decline in the ROM of this shoulder over many months

Answer 21

Adhesive capsulitis

Question 22

A 22yo patient presents following an ankle injury at netball. The patient describes a painful inversion action

Answer 22

Ankle sprain

Question 23

Describe this fracture

Answer 23

Fracture of the left distal radius with ulnar styloid fracture
• Comminuted fracture
• Dorsal angulation and impaction
• Intra-articular fracture: at risk of post-traumatic OA

Question 24

Describe this fracture

Answer 24

Fracture of the radial head with associated large elbow joint effusion

Lucent triangles = fat pads which indicates fluid (usually blood) in this space

Question 25

Describe this fracture

Answer 25

Galeazzi fracture: fracture of the radial shaft at the junction of the middle and distal 1/3 with volar angulation of the distal fragment with respect to the proximal radial shaft and dorsal dislocation of the distal radioulnar joint

Question 26

What does this x-ray show?

Answer 26

A-C joint dislocation

Question 27

What does this x-ray show?

Answer 27

Anterior-inferior shoulder dislocation

Question 28

What does this x-ray show?

Answer 28

Neck of humerus fracture

Question 29

What does this MRI show?

Answer 29

Scaphoid fracture

Question 30

What does this x-ray show?

Answer 30

Subcapital right NOF fracture

Question 31

What does this x-ray show?

Answer 31

• Superior dislocation of the right total hip prosthesis
• No periprosthetic fracture is seen