Question Easy: A 58-year-old woman presents with pain in her right knee after recently increasing her walking regimen. She now experiences stiffness particularly in the mornings lasting about 30 minutes. On examination, there is crepitus and restricted range of motion, but no swelling or warmth. What is the most likely diagnosis?
A) Rheumatoid arthritis
B) Septic arthritis
C) Osteoarthritis 🦵
D) Gout
E) Psoriatic arthritis
Question Medium: An 18-year-old rugby player presents with shoulder pain after a high-impact tackle. He supports his right arm with the other due to pain. On examination, the shoulder has a noticeable step or prominence at the acromioclavicular joint. What is the most likely diagnosis?
A) Clavicle fracture
B) Anterior shoulder dislocation
C) Acromioclavicular joint dislocation
D) Rotator cuff tear
E) Proximal humerus fracture
Question Hard: A 65-year-old man presents with sudden, severe back pain following a minor trip and fall. He is otherwise well. X-rays of the spine reveal a vertebral compression fracture. Which underlying condition is most likely responsible for this presentation?
A) Osteoporosis
B) Osteomalacia
C) Multiple myeloma
D) Metastatic bone disease
E) Ankylosing spondylitis
Explanations & Answers:
Question Easy Answer: C) Osteoarthritis 🦵
Question Easy Explanation: The symptoms of joint pain, morning stiffness lasting less than an hour, and crepitus point towards osteoarthritis. NICE guidelines emphasize these as typical features, especially in weight-bearing joints. The absence of significant swelling or warmth also makes inflammatory conditions like rheumatoid arthritis less likely.
Question Medium Answer: C) Acromioclavicular joint dislocation
Question Medium Explanation: The prominence at the acromioclavicular joint following trauma is characteristic of an AC joint dislocation, which is common in contact sports like rugby. Clinical examination often reveals the classic “step-off” at the shoulder. Management often involves conservative treatment, but surgical options are considered depending on the degree of instability.
Question Hard Answer: A) Osteoporosis
Question Hard Explanation: A vertebral compression fracture following minimal trauma is a hallmark of osteoporosis, especially in older adults. NICE and NHS recommendations typically include assessing bone mineral density and considering pharmacologic treatment to prevent further fractures, with lifestyle modifications and possibly bisphosphonate therapy.
Medical fact of the day: Did you know? Osteoarthritis is the most common form of arthritis in the UK, affecting more than 8 million people, making it a leading cause of disability among adults.
Quote of the day: “The care you give may be invisible, but the impact you make is indelible. Keep changing the world, one patient at a time.”