DPT Orthopedic & Musculoskeletal Therapy 4 — Questions and Answers
Question 1: A patient presents with pain and weakness at the wrist following a fall on outstretched hand. Tenderness is noted in the anatomical snuffbox. The most likely injury is:
- Colles fracture
- Scaphoid fracture (Correct answer)
- De Quervain's tenosynovitis
- Distal radius fracture
Correct answer: Scaphoid fracture
Anatomical snuffbox tenderness following FOOSH injury is the hallmark finding for scaphoid fracture, which may be radiographically occult initially.
Question 2: Which muscle is the PRIMARY restraint against anterior tibial translation on the femur?
- Posterior cruciate ligament
- Medial collateral ligament
- Anterior cruciate ligament (Correct answer)
- Popliteus muscle
Correct answer: Anterior cruciate ligament
The ACL is the primary restraint against anterior tibial translation, providing approximately 85% of the total restraining force.
Question 3: During gait analysis, which phase of the gait cycle has the highest quadriceps demand?
- Initial contact
- Loading response (Correct answer)
- Terminal stance
- Pre-swing
Correct answer: Loading response
The loading response phase (initial double-limb support) requires maximal eccentric quadriceps activity to control knee flexion and absorb impact forces.
Question 4: A patient with chronic plantar fasciitis fails conservative care. Which injection type has the strongest evidence for short-term pain relief?
- Corticosteroid injection (Correct answer)
- Platelet-rich plasma injection
- Botulinum toxin injection
- Dextrose prolotherapy
Correct answer: Corticosteroid injection
Corticosteroid injections have the strongest short-term evidence for plantar fasciitis pain relief, though effects typically diminish by 3 months.
Question 5: Which nerve is at greatest risk during anterior hip replacement surgery and presents with foot drop postoperatively?
- Femoral nerve
- Obturator nerve
- Sciatic nerve (Correct answer)
- Superior gluteal nerve
Correct answer: Sciatic nerve
The sciatic nerve is most at risk during posterior hip approaches; injury to the peroneal division causes foot drop due to anterior compartment weakness.
Question 6: The convex-concave rule in joint mobilization states that when the convex surface moves on a fixed concave surface:
- Glide and roll occur in the same direction
- Glide occurs in the opposite direction to the roll (Correct answer)
- No glide occurs; only spin is present
- Glide and roll direction depend on the joint load
Correct answer: Glide occurs in the opposite direction to the roll
When a convex surface moves on a concave surface, the joint glide occurs in the opposite direction to the bone movement (roll), per the convex-concave rule.
Question 7: A 16-year-old athlete has anterior knee pain worse with stairs and prolonged sitting. Radiograph shows fragmentation of the tibial apophysis. What is the diagnosis?
- Sinding-Larsen-Johansson disease
- Osgood-Schlatter disease (Correct answer)
- Patellofemoral pain syndrome
- Bipartite patella
Correct answer: Osgood-Schlatter disease
Osgood-Schlatter disease is an apophysitis at the tibial tubercle in adolescents, caused by repetitive traction of the patellar tendon during growth.
DPT Orthopedic & Musculoskeletal Therapy 4
A patient presents with pain and weakness at the wrist following a fall on outstretched hand.
Tenderness is noted in the anatomical snuffbox.
The most likely injury is: