Clinical Management of Musculoskeletal Disorders Flashcards

A patient is 12 weeks post-ACL reconstruction using a patellar tendon autograft. What is the primary rate-limiting factor for return to running?

Answer: Graft ligamentization (remodeling) timeline

Graft ligamentization — the biological remodeling of the autograft to ACL-like tissue — takes 12-24 months and is the primary rate-limiting biological factor, even when strength benchmarks appear adequate.

A patient presents with point tenderness over the greater trochanter, pain with resisted hip abduction, and a positive FABER test. Which diagnosis best fits this clinical picture?

Answer: Greater trochanteric pain syndrome

Greater trochanteric pain syndrome (formerly trochanteric bursitis) presents with lateral hip tenderness over the greater trochanter, pain with resisted abduction, and is not typically reproduced by the deep FADIR test used for FAI/labral pathology.

In treating a patient with complex regional pain syndrome (CRPS) Type I of the upper extremity, which therapeutic approach is supported by evidence?

Answer: Graded motor imagery and mirror therapy

Graded motor imagery (GMI) and mirror therapy progressively recalibrate cortical representation and are well-supported by evidence for CRPS management.

A 70-year-old patient presents with sudden-onset cervical pain after a fall, with upper extremity weakness and hyperreflexia below C6. What is the most likely diagnosis?

Answer: Central cord syndrome

Central cord syndrome is the most common incomplete spinal cord injury, typically occurring in older adults after cervical hyperextension, presenting with disproportionately greater upper extremity weakness and upper motor neuron signs.

Which taping technique is best supported by evidence for short-term pain relief in patellofemoral pain syndrome?

Answer: McConnell medial glide taping

McConnell medial glide taping (correcting lateral patellar maltracking) has the best evidence for short-term pain reduction in patellofemoral pain syndrome, enabling participation in rehabilitation exercises.

A patient presents with a positive Spurling's test, cervical rotation limited to 40° ipsilaterally, and pain radiating to the thumb and index finger. Which nerve root is most likely compromised?

Answer: C6

C6 radiculopathy classically presents with pain and paresthesias radiating to the thumb and index finger, weakness in wrist extension and biceps, and reduced brachioradialis reflex.

Which of the following best describes the Ottawa Knee Rules, which guide clinical decision-making for knee radiography?

Answer: Age over 55, inability to flex to 90°, tenderness at fibular head or isolated patella

The Ottawa Knee Rules indicate X-ray if: age ≥55, isolated patella tenderness, fibular head tenderness, inability to flex to 90°, or inability to bear weight for 4 steps.