Musculoskeletal

Question 1

pencil in cup x-ray appearance, sausage fingers

Answer 1

psoriatic arthritis

Question 2

wrist drop

Answer 2

radial nerve palsy

Question 3

dinner fork or swan neck deformity in wrist

Answer 3

displaced Colles fracture

Question 4

pain/tenderness in anatomical snuff box

Answer 4

scaphoid fracture

Question 5

feels like walking on pebbles

Answer 5

advanced RA in feet - subluxation of the MTP joints

Question 6

Reiter’s syndrome:

Answer 6

arthritis + uveitis + urethritis
(can’t see, can’t pee, can’t bend the knee)
- Reactive arthritis

Question 7

foot drop

Answer 7

common fibular nerve (peroneal nerve)

Question 8

fractures at risk of AVN:

Answer 8

proximal scaphoid
intracapsular femoral
femoral condyles
humeral head
capitellum
proximal talus

Question 9

hanging rope sign

Answer 9

AVN

Question 10

negative birefringent, needle shaped crystals

Answer 10

gout - urate crystals

Question 11

envelope shaped/rhomboid, mildly positive birefringent crystals

Answer 11

pseudogout - calcium pyrophosphate crystals

Question 12

positive anterior drawer test

Answer 12

ACL tear/rupture

Question 13

pain on internal rotation and extension of the knee at 90 degrees

Answer 13

lateral meniscal tear

Question 14

painful arc (pain on abducting between 70-120 degrees)

Answer 14

damaged supraspinatus tendon

frozen shoulder

Question 15

dry eyes, mouth and skin

+ve Schirmer’s test (to diagnose dry eyes)

Answer 15

Sjogren’s syndrome

with infiltration, often with RA

Question 16

dry eyes, mouth, vagina

bronchitis

Answer 16

Sicca syndrome

no infiltration, no signs of arthritis

Question 17

locked knee

Answer 17

bucket handle meniscal tear

Question 18

bamboo spine on xray

sacroiliitis

Answer 18

ankylosing spondylitis

Question 19

question mark posture

Answer 19

ankylosing spondylitis

Question 20

shortened leg and externally rotated

Answer 20

displaced fractured neck of femur

Question 21

shortened leg and internally rotated

Answer 21

dislocated femoral head

Question 22

‘onion peel’ sign

Answer 22

Ewing’s sarcoma

Question 23

‘sunray spiculation’ of bone on X-ray

Answer 23

osteosarcoma

Question 24

‘popcorn calcification’ of bone on X-ray

Answer 24

chondrosarcoma

Question 25

‘soap bubble’ appearance on X-ray

Answer 25

giant cell tumour (benign)

Question 26

scalp tenderness and jaw claudication

Answer 26

GCA - temporal arteritis

Question 27

Gower’s sign positive

Answer 27

Duchenne muscular dystrophy

Question 28

swollen ‘woody’ calves

Answer 28

Duchenne or Becker MD

Question 29

‘Hatchet-like’ face

Answer 29

myotonic dystrophy