OCS Orthopedic Assessment & Diagnosis 1 — Questions and Answers

Question 1: What is the most common test for assessing rotator cuff tears?

MRI Scan
X-Ray
Empty Can Test (Correct answer)
Ultrasound

Correct answer: Empty Can Test

The Empty Can Test, also known as Jobe's Test, is specifically designed to assess the integrity of the supraspinatus muscle, which is the most commonly injured rotator cuff muscle. During the test, the patient's arm is abducted to 90 degrees in the scapular plane with the thumb pointing down, and resistance is applied. Pain or weakness during this maneuver is highly indicative of a supraspinatus tear or tendinopathy.

Question 2: Which muscle is primarily involved in impingement syndrome?

Infraspinatus
Supraspinatus (Correct answer)
Teres Minor
Subscapularis

Correct answer: Supraspinatus

Shoulder impingement syndrome primarily involves the compression of the rotator cuff tendons and the subacromial bursa beneath the acromion. The supraspinatus tendon is particularly vulnerable due to its anatomical position, passing through a narrow space. Repetitive overhead movements can cause this tendon to become inflamed and irritated, leading to the characteristic pain of impingement.

Question 3: Which of the following is an indicator of a positive shoulder impingement test?

Pain at 90 degrees of abduction
Pain at full flexion (Correct answer)
Swelling at the bicep tendon
Difficulty with external rotation

Correct answer: Pain at full flexion

A positive shoulder impingement test, such as Neer's or Hawkins-Kennedy, typically elicits pain when the arm is moved into positions that compress the subacromial structures. Pain at full flexion, as seen in Neer's test where the arm is passively raised, indicates impingement of the rotator cuff tendons or bursa under the acromion. This compression causes pain due to inflammation or irritation of these structures.

Question 4: Which test is typically used to assess lumbar disc herniation?

Trendelenburg Test
Straight Leg Raise Test (Correct answer)
Ankle Brachial Index
Patellar Apprehension Test

Correct answer: Straight Leg Raise Test

The Straight Leg Raise (SLR) test is a classic neurological examination used to detect lumbar disc herniation and nerve root compression. When the affected leg is passively raised, it stretches the sciatic nerve. If a herniated disc is compressing a nerve root, this stretch will elicit radiating pain down the leg, confirming nerve impingement.

Question 5: What is the typical treatment for mild ACL sprains?

Physical Therapy
Surgical Reconstruction
R.I.C.E. Protocol (Correct answer)
Steroid Injections

Correct answer: R.I.C.E. Protocol

For mild ACL sprains (Grade I), the R.I.C.E. protocol (Rest, Ice, Compression, Elevation) is the initial and often sufficient treatment. This conservative approach aims to reduce pain and swelling, allowing the ligament to heal naturally without surgical intervention. Surgical reconstruction is typically reserved for more severe tears or for athletes requiring high-level knee stability.

Question 6: Which sign is commonly associated with sciatica?

Pain in the hip area
Pain radiating from the lower back down the leg (Correct answer)
Neck pain
Pain in the upper back

Correct answer: Pain radiating from the lower back down the leg

Sciatica is characterized by pain that originates in the lower back and radiates down the path of the sciatic nerve, which extends from the lower back through the hips and buttocks and down each leg. This radiating pain is often accompanied by numbness, tingling, or weakness in the affected leg. It is typically caused by compression or irritation of the sciatic nerve roots.

Question 7: What is the most common cause of lateral epicondylitis?

Trauma
Repetitive motion (Correct answer)
Aging
Overuse

Correct answer: Repetitive motion

Lateral epicondylitis, commonly known as 'tennis elbow,' is an overuse injury primarily caused by repetitive wrist extension and forearm supination. These repetitive motions, often seen in activities like tennis, painting, or using hand tools, lead to microtrauma and inflammation of the extensor tendons originating from the lateral epicondyle. This chronic strain on the tendons is the direct cause of the condition.

Question 8: What diagnostic imaging is most useful for identifying stress fractures?

CT Scan
X-ray (Correct answer)
MRI
Ultrasound

Correct answer: X-ray

While MRI can show stress fractures, X-rays are often the first-line diagnostic imaging used to identify stress fractures, especially in later stages when bone remodeling has occurred. Although early stress fractures may not be visible on initial X-rays, follow-up X-rays after 2-3 weeks often reveal periosteal reaction or callus formation, confirming the diagnosis. X-rays are readily available and cost-effective.

Question 9: What is the first-line treatment for knee osteoarthritis?

Surgical Reconstruction
Pain medications
Physical therapy and anti-inflammatory medications (Correct answer)
Corticosteroid injections

Correct answer: Physical therapy and anti-inflammatory medications

For knee osteoarthritis, the first-line treatment typically involves a combination of conservative measures. Physical therapy focuses on strengthening surrounding muscles, improving range of motion, and reducing joint stress, while anti-inflammatory medications (like NSAIDs) help manage pain and inflammation. These interventions aim to reduce symptoms and improve function without invasive procedures.

OCS Orthopedic Assessment & Diagnosis 1

What is the most common test for assessing rotator cuff tears?