Orthopaedics/MSK

Question 1

Degenerative cervical myelopathy presentation

Answer 1

Pain (neck, upper or lower limbs)
Loss of motor function - loss of digital dexterity, difficulty holding a fork/doing up buttons, arm/leg weakness or stiffness
Numbness
Loss of autonomic function - urinary/faecal incontinence, impotence
Hoffman’s sign - flick on finger, other fingers twitch in response

Question 2

Degenerative cervical myelopathy investigations

Answer 2

MRI C spine - disc degeneration, ligament hypertrophy, cord signal change

Question 3

Degenerative cervical myelopathy management

Answer 3

Urgent referral to specialist spine services for decompressive surgery

Question 4

Stable intertrochanteric fracture

Answer 4

Dynamic hip screw

Question 5

Undisplaced intracapsular hip fracture

Answer 5

Internal fixation OR hemiarthroplasty if unfit

Question 6

Displaced intracapsular hip fracture

Answer 6

Total hip replacement OR hemiarthroplasty if unfit/cognitive impairment