Question Easy:
A 25-year-old rugby player presents to the A&E with severe right shoulder pain after a tackle. On examination, his shoulder appears squared off, and he has limited range of motion due to pain. What is the most likely diagnosis? 🤕🏉
A) Rotator cuff tear
B) Clavicle fracture
C) Shoulder dislocation
D) Biceps tendonitis
E) Glenoid labrum tear
Explanations & Answers:
Question Easy Answer: C) Shoulder dislocation
Question Easy Explanation:
The presentation of a “squared off” shoulder with limited motion following trauma is characteristic of an anterior shoulder dislocation, common in contact sports like rugby. According to NICE guidelines, this requires prompt reduction and immobilization.
Question Medium:
A 60-year-old woman with a 20-year history of rheumatoid arthritis is evaluated for persistent knee pain and swelling. X-rays show joint space narrowing and osteophyte formation. Which treatment is most appropriate as the first-line for her knee osteoarthritis according to NICE guidelines? 🤔
A) Oral corticosteroids
B) Paracetamol
C) Opioids
D) Methotrexate
E) Intra-articular steroid injections
Question Medium Answer: B) Paracetamol
Question Medium Explanation:
NICE guidelines recommend paracetamol as the first-line analgesic for osteoarthritis pain management. Although NSAIDs can be effective, paracetamol is often preferred due to its safer profile in terms of gastrointestinal and cardiovascular risk.
Question Hard:
A 45-year-old male avid marathon runner presents with anterior knee pain worsened by squatting and stair climbing. There’s tenderness around the inferior pole of the patella. MRI reveals thickening of the proximal patellar tendon. What is the most likely diagnosis? 🏃♂️
A) Prepatellar bursitis
B) Patellar tendinopathy
C) Osgood-Schlatter disease
D) Medial meniscus tear
E) Pes anserine bursitis
Question Hard Answer: B) Patellar tendinopathy
Question Hard Explanation:
This patient’s presentation is indicative of patellar tendinopathy (jumper’s knee), common in athletes involved in frequent jumping or running sports. NICE guidelines suggest conservative management, including rest, physiotherapy, and possible NSAIDs for pain relief.
Medical fact of the day: Did you know that rheumatoid arthritis can lead to secondary osteoarthritis in affected joints due to chronic inflammation and joint damage? This makes early diagnosis and management vital for preserving joint function.
Quote of the day: “In the heart of healing lies the unwavering spirit to learn, grow, and care. Every step you take brings you closer to the lives you’ll touch and transform.”