Rapid Review: Musculoskeletal

Question 1

Back pain that is exacerbated by standing and walking and relieved with sitting and hyperflexion of the hips

Answer 1

Spinal stenosis

Question 2

Joints in the hand affected in RA

Answer 2

MCP and PIP (DIP sparing)

Question 3

Joint pain and stiffness that worsen over the course of the day and are relieved by rest

Answer 3

Osteoarthritis

Question 4

A genetic disorder that is associated with multiple fractures and blue sclerae and is commonly mistaken for child abuse

Answer 4

Osteogenesis imperfecta

Question 5

Hip and back pain along with stiffness that improves with activity over the course of the day and worsens at rest. Diagnostic test?

Answer 5

Suspect ankylosing spondylitis. Check HLA B27

Question 6

Arthritis, conjunctivitis, and urethritis in young men. Reactive arthritis.

Answer 6

Associated with chlamydia. Also consider campylobacter, shigella, salmonella, and ureaplasma

Question 7

A 55 year old man has sudden, excruciating first MTP joint pain after a night of drinking red wine. Diagnosis, workup, and chronic treatment?

Answer 7

Gout. Needle-shaped, negatively birefringent crystals are seen on joint fluid aspirate. Chronic treatment with allopurinol or probenecid

Question 8

Rhomboid-shaped, positively birefringent crystals on joint fluid aspirate

Answer 8

Pseudogout

Question 9

An elderly woman presents with pain and stiffness of the shoulders and hips; she cannot lift her arms above her head. Labs show anemia and increased ESR

Answer 9

Polymyalgia rheumatica

Question 10

An active 13 year old boy has anterior knee pain. Diagnosis?

Answer 10

Osgood-Schlatter disease

Question 11

Bone is fractured in a fall on an outstretched hand

Answer 11

Distal radius (colles’ fracture). Also scaphoid fracture sometimes

Question 12

A complication of scaphoid fracture

Answer 12

Avascular necrosis

Question 13

Signs suggesting radial nerve damage with humeral fracture

Answer 13

Wrist drop, loss of thumb abduction

Question 14

A young child presents with proximal muscle weakness, waddling gait, and pronounced calf muscles

Answer 14

Duchenee muscular dystrophy

Question 15

A first born female who was born in breech position is found to have asymmetric skin folds on newborn exam. Diagnosis? Treatment?

Answer 15

Developmental dysplasia of the hip. If severe, consider a Pavlik harness to maintain abduction

Question 16

An 11 year old obese African American boy presents with sudden onset of limp. Diagnosis and workup?

Answer 16

Slipped capital femoral epiphysis. AP and frog leg lateral x rays.

Question 17

The most common primary malignant tumor of bone

Answer 17

Multiple myeloma