Question Easy:
🏌️♂️ A 30-year-old avid golfer presents with pain and tenderness over the lateral aspect of his elbow, worsened by gripping or lifting activities. Which of the following is the most likely diagnosis?
A) Medial epicondylitis
B) Carpal tunnel syndrome
C) De Quervain’s tenosynovitis
D) Lateral epicondylitis
E) Rotator cuff tendinopathy
Explanations & Answers:
Question Easy Answer:
D) Lateral epicondylitis
Question Easy Explanation:
Lateral epicondylitis, also known as tennis elbow, involves pain and tenderness on the lateral side of the elbow, particularly worsened by repetitive wrist extension and gripping activities. Medial epicondylitis would present with medial elbow pain, while conditions like carpal tunnel syndrome, De Quervain’s tenosynovitis, and rotator cuff tendinopathy would involve pain in different regions.
Question Medium:
🚵♂️ A 45-year-old mountain biker complains of anterior knee pain that worsens when climbing stairs or sitting for long periods. The patient has a normal range of motion and no effusion. What is the most likely diagnosis?
A) Patellar tendinopathy
B) Osteoarthritis
C) Patellofemoral pain syndrome
D) Anterior cruciate ligament (ACL) injury
E) Meniscal tear
Explanations & Answers:
Question Medium Answer:
C) Patellofemoral pain syndrome
Question Medium Explanation:
Patellofemoral pain syndrome (PFPS) is characterised by anterior knee pain, often described as worsened by activities like climbing stairs, squatting, or prolonged sitting. Patellar tendinopathy usually presents with pain localized to the patellar tendon, while ACL injuries and meniscal tears would involve instability or mechanical symptoms, not just pain. Osteoarthritis would typically present with more than just anterior knee pain and may show other signs like crepitus or effusion.
Question Hard:
🦴 A 60-year-old woman presents with sudden onset of severe back pain after bending forward. She has a past medical history significant for prolonged corticosteroid use. Upon examination, there is marked tenderness over the T12 vertebra. What is the most likely diagnosis?
A) Muscle strain
B) Osteoporotic vertebral fracture
C) Metastatic bone disease
D) Disc herniation
E) Spinal stenosis
Explanations & Answers:
Question Hard Answer:
B) Osteoporotic vertebral fracture
Question Hard Explanation:
Given the patient’s history of prolonged corticosteroid use and the presentation of sudden severe back pain with tenderness over the T12 vertebra, an osteoporotic vertebral fracture is most likely. Corticosteroid use is a known risk factor for osteoporosis. Muscle strain would typically not present with such intense, localized pain, and metastatic bone disease, disc herniation, or spinal stenosis would have distinct clinical features not fitting the description as closely.
Medical fact of the day:
Vitamin D deficiency is a known risk factor for osteoporosis in the UK, and NICE recommends bone health assessments for at-risk populations, including those with prolonged steroid use.
Quote of the day:
“Every patient is a reminder that healing is both an art and a science—never lose sight of the empathy that guides your hands.”