**Question Easy:**
A 28-year-old office worker presents with wrist pain after spending long hours typing on a computer. The pain is described as a dull ache and is localized to the base of the thumb. What is the most likely diagnosis? 🖥️
A) Carpal Tunnel Syndrome
B) De Quervain’s Tenosynovitis
C) Rheumatoid Arthritis
D) Osteoarthritis
E) Gout
**Question Medium:**
A 42-year-old woman comes to the GP with persistent knee pain that worsens with activity and is relieved by rest. She has a BMI of 32. On examination, there is crepitus, and limited range of motion is observed. What is the first-line management for this condition according to NICE guidelines? 🦵
A) Arthroscopy
B) Corticosteroid injection
C) Oral NSAIDs
D) Weight loss and exercise
E) Arthroplasty
**Question Hard:**
A 76-year-old man has a history of osteoporosis and presents after a fall with severe hip pain and inability to bear weight on his right leg. X-ray confirms a displaced intracapsular neck of femur fracture. What is the most appropriate surgical treatment option for this type of fracture in a fit, active elderly patient according to NHS guidelines? 🍂
A) Dynamic hip screw
B) Bipolar Hemiarthroplasty
C) Total Hip Replacement
D) Intramedullary nail fixation
E) Conservative management
**Explanations & Answers:**
**Question Easy Answer:** B) De Quervain’s Tenosynovitis
**Question Easy Explanation:** De Quervain’s Tenosynovitis is often seen in individuals who perform repetitive wrist and thumb movements, such as typing, leading to pain at the base of the thumb. Special tests like Finkelstein’s test can help confirm the diagnosis. Management includes rest, splinting, and NSAIDs, with corticosteroid injections for more severe cases.
**Question Medium Answer:** D) Weight loss and exercise
**Question Medium Explanation:** According to NICE guidelines, the first-line management for osteoarthritis, particularly in weight-bearing joints like the knee, is non-pharmacological. This includes weight loss and exercise to improve symptoms and joint function. Oral NSAIDs can be considered if lifestyle modifications are insufficient.
**Question Hard Answer:** C) Total Hip Replacement
**Question Hard Explanation:** For an active older person with a displaced intracapsular neck of femur fracture, a Total Hip Replacement (THR) is often recommended, assuming the patient is fit for surgery. This option provides better long-term outcomes compared to hemiarthroplasty and dynamic hip screws, particularly in those who are active.
**Medical fact of the day:** Did you know that the scaphoid, one of the carpal bones, is the most frequently fractured bone in the wrist? It tends to have a poor blood supply, which can complicate healing, particularly in cases of delayed or inadequate initial treatment.
**Quote of the day:** “In the face of every challenge, let compassion guide your hands and knowledge anchor your heart.”