Question Easy: A 70-year-old woman presents with pain in her right hip after a fall in her home. She is unable to bear weight on her right leg, and her leg is shortened and externally rotated. What is the most likely diagnosis? 🚑
A) Hip dislocation
B) Hip fracture
C) Femoral shaft fracture
D) Ankle sprain
E) Lumbar radiculopathy
Explanations & Answers:
Question Easy Answer: B) Hip fracture
Question Easy Explanation: The presentation of hip pain after a fall with a shortened and externally rotated leg is classic for a hip fracture. In elderly patients, particularly women with osteoporosis, this is a common injury. NICE guidelines recommend prompt surgical intervention to improve mobility and reduce pain.
Question Medium: A 32-year-old man presents with sudden onset of severe elbow pain after lifting a heavy object. On examination, there is swelling and a “Popeye” sign in the upper arm. What is the most likely diagnosis?
A) Lateral epicondylitis
B) Biceps tendon rupture
C) Ulnar collateral ligament injury
D) Osteoarthritis
E) Tennis elbow
Question Medium Answer: B) Biceps tendon rupture
Question Medium Explanation: The “Popeye” sign, characterized by a bulging appearance in the upper arm, is indicative of a biceps tendon rupture. This condition is often caused by a sudden or forceful load on the tendon, typically during a heavy lift. Management includes surgical repair for younger and more active patients, as per NHS recommendations.
Question Hard: A 55-year-old woman with a history of rheumatoid arthritis presents with neck pain and neurological symptoms, including tingling in her hands and unsteady gait. An MRI of the cervical spine is requested. What finding would most likely explain her symptoms?
A) Cervical spondylotic myelopathy
B) Atlantoaxial subluxation
C) Spinal stenosis
D) Herniated cervical disc
E) Osteoporosis of the cervical spine
Question Hard Answer: B) Atlantoaxial subluxation
Question Hard Explanation: Rheumatoid arthritis can lead to cervical spine involvement, particularly atlantoaxial subluxation. This occurs due to destruction of the ligamentous structures maintaining atlantoaxial stability. The neurological symptoms and neck pain align with this condition. MRI is key in diagnosing and planning the appropriate management, which may include surgical intervention according to NICE guidelines.
Medical fact of the day: 💡 Did you know that about 1 in 3 women and 1 in 5 men over the age of 50 in the UK will experience a fracture due to osteoporosis? Keeping bones healthy through diet, exercise, and in some cases, medication, is crucial.
Quote of the day: “Every challenge in medicine is an opportunity to grow both in knowledge and compassion. Keep striving, for each patient you touch becomes a part of your own healing journey.”