Question Easy: A 70-year-old woman with osteoarthritis in her right knee presents to the clinic. She reports pain and stiffness, particularly in the morning, which improves as the day progresses. What is the first-line management for her symptoms according to NICE guidelines? 😊
A) Paracetamol
B) Ibuprofen
C) Codeine
D) Physiotherapy
E) Intra-articular steroid injection
Question Medium: A 45-year-old man presents with pain and a limited range of motion in his right shoulder after playing tennis. He describes the pain as sharp and exacerbated by overhead movements. Based on these symptoms, which condition is most likely? 🎾
A) Adhesive capsulitis
B) Rotator cuff tear
C) Biceps tendonitis
D) Osteoarthritis
E) Subacromial bursitis
Question Hard: A 60-year-old woman complains of chronic, dull hip pain which sometimes radiates to her groin and is associated with a clicking sensation. She had a history of developmental dysplasia of the hip treated in childhood. What is the most likely diagnosis? 🤔
A) Trochanteric bursitis
B) Femoroacetabular impingement
C) Avascular necrosis
D) Labral tear
E) Lumbar radiculopathy
Explanations & Answers:
Question Easy Answer: A) Paracetamol
Question Easy Explanation: According to NICE guidelines, paracetamol is recommended as the first-line analgesic for managing pain in osteoarthritis. It’s a safer option with fewer side effects compared to NSAIDs, especially in elderly patients. Consistent dosing helps manage baseline pain effectively.
Question Medium Answer: B) Rotator cuff tear
Question Medium Explanation: The symptoms described are classic for a rotator cuff tear, which often presents with pain exacerbated by overhead activities and a decreased range of motion. This condition is common in active individuals and can result from acute injuries or overuse.
Question Hard Answer: D) Labral tear
Question Hard Explanation: Given the patient’s history of developmental dysplasia of the hip and the symptoms of groin pain with a clicking sensation, a labral tear is the most likely diagnosis. The labrum may be damaged or torn due to altered joint biomechanics stemming from previous hip pathology.
Medical fact of the day: In the UK, osteoporosis-related fractures are more common than heart attacks, strokes, and breast cancer combined. This highlights the importance of bone health assessments, particularly in postmenopausal women and older adults.
Quote of the day: “In the practice of medicine, compassion is as essential as knowledge. Heal with heart as much as with hands.”