DPT Orthopedic & Musculoskeletal Therapy 2 — Questions and Answers
Question 1: A patient presents with lateral elbow pain that worsens with resisted wrist extension and grip. Which structure is most likely affected?
- Medial epicondyle
- Common extensor tendon at lateral epicondyle (Correct answer)
- Ulnar collateral ligament
- Radial head
Correct answer: Common extensor tendon at lateral epicondyle
Lateral epicondylitis (tennis elbow) involves degeneration of the common extensor tendon, particularly the ECRB, at its attachment on the lateral epicondyle.
Question 2: Which special test is most specific for anterior cruciate ligament insufficiency?
- McMurray test
- Valgus stress test
- Pivot shift test (Correct answer)
- Dial test
Correct answer: Pivot shift test
The pivot shift test is highly specific for ACL insufficiency, reproducing the subluxation-reduction phenomenon of anterolateral rotatory instability.
Question 3: A patient with shoulder impingement has a positive Hawkins-Kennedy test. Which structure is most likely being compressed?
- Infraspinatus tendon
- Subscapularis tendon
- Supraspinatus tendon (Correct answer)
- Long head of biceps tendon
Correct answer: Supraspinatus tendon
The Hawkins-Kennedy test internally rotates the shoulder at 90° flexion, compressing the supraspinatus tendon against the coracoacromial ligament.
Question 4: The Thomas test is used to assess flexibility of which muscle group?
- Hip extensors
- Hip flexors (Correct answer)
- Hip external rotators
- Hip abductors
Correct answer: Hip flexors
The Thomas test assesses hip flexor tightness; a positive test (inability to fully extend the non-tested hip) indicates iliopsoas or rectus femoris tightness.
Question 5: In Achilles tendinopathy, which loading strategy has the strongest evidence for pain reduction and tendon remodeling?
- Complete rest and ice
- Eccentric heel drop exercises (Correct answer)
- Passive stretching only
- Ultrasound therapy
Correct answer: Eccentric heel drop exercises
Eccentric heel drop exercises (Alfredson protocol) have the strongest evidence for promoting collagen remodeling and reducing pain in Achilles tendinopathy.
Question 6: A patient has loss of shoulder external rotation and inability to lift their arm above 90°. MRI shows a full-thickness tear. Which rotator cuff muscle is most commonly involved?
- Subscapularis
- Infraspinatus
- Supraspinatus (Correct answer)
- Teres minor
Correct answer: Supraspinatus
The supraspinatus is the most commonly torn rotator cuff muscle due to its passage through the subacromial space and high mechanical load during elevation.
Question 7: Which grading system is used to classify ligament sprains based on structural integrity and functional loss?
- Kellgren-Lawrence scale
- Outerbridge classification
- Grade I–III sprain classification (Correct answer)
- ASIA impairment scale
Correct answer: Grade I–III sprain classification
Ligament sprains are graded I (mild stretch, intact), II (partial tear, some laxity), and III (complete rupture, gross instability).
DPT Orthopedic & Musculoskeletal Therapy 2
A patient presents with lateral elbow pain that worsens with resisted wrist extension and grip.
Which structure is most likely affected?