Question Easy:
A 55-year-old woman presents with knee pain exacerbated by walking. There is no history of trauma. Physical examination reveals crepitus and limited range of motion. What is the most likely diagnosis?
A) Rheumatoid arthritis
B) Gout
C) Osteoarthritis
D) Septic arthritis
E) Meniscal tear
Explanations & Answers:
Question Easy Answer:
C) Osteoarthritis
Question Easy Explanation:
Osteoarthritis is the most common form of arthritis and typically affects older adults. It results in cartilage breakdown and joint degeneration, leading to symptoms such as pain, crepitus, and reduced range of motion. According to NICE guidelines, the diagnosis is usually clinical and based on the presence of these symptoms without the need for imaging.
Question Medium:
A 30-year-old runner presents with pain in the anterior knee that worsens with prolonged sitting or climbing stairs. There is no swelling or trauma. Examination shows tenderness over the patella and a positive Clarke’s test. What is the most likely diagnosis?
A) Patellar tendinitis
B) Iliotibial band syndrome
C) Osteoarthritis
D) Patellofemoral pain syndrome
E) Meniscal tear
Explanations & Answers:
Question Medium Answer:
D) Patellofemoral pain syndrome
Question Medium Explanation:
Patellofemoral pain syndrome, often known as “runner’s knee,” is common in individuals who engage in activities like running. Symptoms include anterior knee pain that worsens with activities that put stress on the patellofemoral joint. A positive Clarke’s test (pain elicited by compressing the patella) supports this diagnosis.
Question Hard:
A 45-year-old man presents with sudden onset of severe right shoulder pain after lifting a heavy object. The pain is constant and aggravated by movement. Physical examination reveals tenderness over the bicipital groove, weakness in shoulder flexion, and a positive Speed’s test. What is the most likely diagnosis?
A) Rotator cuff tear
B) Acromioclavicular joint dislocation
C) Biceps tendinitis
D) Supraspinatus tendinitis
E) Glenohumeral joint dislocation
Explanations & Answers:
Question Hard Answer:
C) Biceps tendinitis
Question Hard Explanation:
Biceps tendinitis is characterized by inflammation of the biceps tendon, often presenting with pain in the anterior shoulder, tenderness over the bicipital groove, and weakness in shoulder flexion. A positive Speed’s test, where pain is elicited by resistant flexion of the shoulder with the elbow extended and the forearm supinated, further supports the diagnosis. Management includes rest, NSAIDs, and physiotherapy as per NHS guidelines.
Medical fact of the day:
Did you know? Approximately 1 in 5 adults over the age of 45 in the UK have osteoarthritis in their knees, according to Arthritis Research UK.
Quote of the day:
“In the heart of medicine lies a simple truth: every patient is an opportunity to make a difference. Let’s embrace the journey with compassion and dedication.”