Clinical Management of Musculoskeletal Disorders Flashcards

A patient presents with pain and weakness in resisted elbow flexion and supination, with a palpable 'Popeye' deformity. What is the most likely diagnosis?

Answer: Distal biceps tendon rupture

Distal biceps tendon rupture presents with the classic 'Popeye' deformity (proximal muscle belly bunching), weakness in supination and flexion, and often a palpable gap at the cubital fossa.

When prescribing a therapeutic exercise program for osteoporosis, which loading type is most effective at stimulating bone formation?

Answer: Progressive high-impact and resistance training

Progressive high-impact and resistance training applies mechanical strain to bone through ground reaction forces and muscle pull, stimulating osteoblast activity most effectively.

A cyclist presents with lateral knee pain that is worst during the downstroke at 30° of knee flexion. An Ober test is positive. What is the most likely diagnosis?

Answer: Iliotibial band syndrome

Iliotibial band syndrome classically presents with lateral knee pain at approximately 30° knee flexion (the impingement zone) and is confirmed by a positive Ober test indicating ITB tightness.

Which joint position best isolates the inferior glenohumeral ligament during examination?

Answer: 90° abduction with external rotation

The inferior glenohumeral ligament (IGHL) is the primary restraint to anterior translation with the arm at 90° abduction and external rotation, the position used in apprehension and relocation tests.

A patient with rheumatoid arthritis presents to physical therapy. Which sign warrants immediate referral before cervical manipulation?

Answer: Upper extremity paresthesias with cervical flexion

Upper extremity paresthesias with cervical flexion suggest atlantoaxial instability (C1-C2 subluxation), a contraindication to cervical manipulation and requiring urgent referral.

Which muscle is the primary dynamic stabilizer preventing anterior translation of the humeral head during overhead activity?

Answer: Subscapularis

The subscapularis is the largest rotator cuff muscle and the primary dynamic anterior stabilizer, resisting anterior humeral head translation during overhead activities.

A patient has limited lumbar extension and a positive extension quadrant test reproducing right leg pain. The most likely pain-generating structure is:

Answer: Right-sided intervertebral foramen or facet joint

A positive extension quadrant test (extension with ipsilateral lateral flexion and rotation) compresses the right foraminal space and loads the right facet, implicating right-sided foraminal or facet pathology.