ATC Clinical Evaluation & Diagnosis 5

Question 1

An athlete presents with sudden sharp pain in the posterior thigh during sprinting. Ecchymosis appears distal to the ischial tuberosity 24 hours later. The most likely diagnosis is:

Accepted Answer

Proximal hamstring avulsion

Answer

Proximal hamstring avulsions often cause ecchymosis tracking distally due to bleeding from the ischial tuberosity attachment site.

Question 2

When using the Ottawa Ankle Rules, which finding indicates the need for radiographic imaging?

Accepted Answer

Bone tenderness at the posterior edge of the lateral malleolus

Answer

Ottawa Ankle Rules call for X-rays if there is bone tenderness at the posterior or distal 6 cm of either malleolus or at the base of the fifth metatarsal or navicular.

Question 3

Which clinical sign would raise concern for an acute compartment syndrome following a lower leg injury?

Accepted Answer

Pain with passive stretch of muscles within the compartment

Answer

Pain disproportionate to injury and worsening with passive stretch is a hallmark of acute compartment syndrome due to elevated intracompartmental pressure.

Question 4

During a shoulder evaluation, a patient demonstrates a 'sulcus sign' with downward traction on the arm. This finding indicates:

Accepted Answer

Multidirectional instability

Answer

The sulcus sign (indentation below the acromion during inferior traction) indicates inferior glenohumeral laxity, a hallmark of multidirectional instability.

Question 5

A gymnast reports anterior knee pain that is worse going down stairs. Palpation reveals tenderness at the inferior pole of the patella. The most likely diagnosis is:

Accepted Answer

Patellar tendinopathy

Answer

Patellar tendinopathy (jumper's knee) classically presents with inferior patellar pole tenderness exacerbated by eccentric loading such as descending stairs.

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ATC Clinical Evaluation & Diagnosis 5