Musculoskeletal and Orthopedic Conditions Flashcards

A patient presents with acute monoarthritis of the first MTP joint with overlying erythema and severe pain. Synovial fluid shows negatively birefringent crystals. The diagnosis is:

Answer: Gout

Gout is caused by monosodium urate crystals, which appear needle-shaped and negatively birefringent under polarized light microscopy.

Which imaging modality is first-line for evaluating suspected rotator cuff tear?

Answer: MRI

MRI is the gold standard for evaluating soft tissue structures including the rotator cuff, providing excellent detail of tear size and location.

A 16-year-old male basketball player presents with anterior knee pain below the patella that worsens with activity. The most likely diagnosis is:

Answer: Osgood-Schlatter disease

Osgood-Schlatter disease causes tibial tubercle apophysitis due to repetitive quadriceps traction in adolescent athletes.

Which maneuver is used to test for anterior cruciate ligament (ACL) integrity?

Answer: Lachman test

The Lachman test is the most sensitive clinical test for ACL rupture, assessing anterior tibial translation at 20–30° knee flexion.

First-line treatment for acute uncomplicated low back pain in a 40-year-old without neurological deficits includes:

Answer: NSAIDs and continued activity

NSAIDs combined with continued physical activity are evidence-based first-line treatments for acute low back pain without red flags.

Which finding on physical exam is a 'red flag' in a patient presenting with low back pain?

Answer: Bilateral lower extremity weakness and saddle anesthesia

Bilateral weakness, saddle anesthesia, and bowel/bladder dysfunction suggest cauda equina syndrome, a surgical emergency.