PANRE Orthopedics 3 — Questions and Answers
Question 1: A 16-year-old male presents with knee pain after playing basketball. Examination reveals tenderness at the tibial tuberosity. X-ray shows soft tissue swelling with irregular ossification. What is the diagnosis?
- Osgood-Schlatter disease (Correct answer)
- Patellar tendinopathy
- Sinding-Larsen-Johansson syndrome
- Prepatellar bursitis
Correct answer: Osgood-Schlatter disease
Osgood-Schlatter disease is a traction apophysitis at the tibial tuberosity common in adolescent athletes, caused by repetitive quadriceps contraction.
Question 2: Which of the following is the gold standard for diagnosing a meniscal tear?
- Plain radiograph
- CT scan
- MRI (Correct answer)
- Arthrography
Correct answer: MRI
MRI is the gold standard for diagnosing meniscal tears, with sensitivity and specificity both exceeding 90%.
Question 3: A 35-year-old female presents with wrist pain. Finkelstein test is positive. What tendons are involved?
- Extensor carpi ulnaris
- Abductor pollicis longus and extensor pollicis brevis (Correct answer)
- Flexor carpi radialis
- Extensor digitorum communis
Correct answer: Abductor pollicis longus and extensor pollicis brevis
De Quervain tenosynovitis affects the abductor pollicis longus and extensor pollicis brevis tendons in the first dorsal compartment, confirmed by the Finkelstein test.
Question 4: A 50-year-old diabetic male presents with painless swelling, deformity, and instability of the ankle without history of trauma. Radiographs show joint destruction, fragmentation, and new bone formation. What is the most likely diagnosis?
- Osteonecrosis
- Osteoarthritis
- Charcot arthropathy (Correct answer)
- Septic arthritis
Correct answer: Charcot arthropathy
Charcot arthropathy (neuropathic joint) occurs in patients with peripheral neuropathy, causing progressive joint destruction due to loss of protective sensation.
Question 5: Which test is used to diagnose carpal tunnel syndrome at the bedside?
- Phalen test and Tinel sign (Correct answer)
- Finkelstein test
- Allen test
- Watson test
Correct answer: Phalen test and Tinel sign
Phalen test (wrist flexion for 60 seconds reproducing symptoms) and Tinel sign (percussion over carpal tunnel) are classic bedside tests for carpal tunnel syndrome.
Question 6: A 25-year-old football player sustains a direct blow to his knee and develops immediate hemarthrosis. Which structure is most likely ruptured?
- Medial collateral ligament
- Posterior cruciate ligament
- Anterior cruciate ligament (Correct answer)
- Lateral meniscus
Correct answer: Anterior cruciate ligament
Immediate hemarthrosis following a knee injury is most commonly caused by ACL tear due to rupture of branches of the middle geniculate artery.
Question 7: A patient with rheumatoid arthritis develops atlantoaxial instability. Which X-ray view best demonstrates this?
- AP view of the cervical spine
- Lateral flexion-extension views of the cervical spine (Correct answer)
- Oblique view of the cervical spine
- Open-mouth odontoid view
Correct answer: Lateral flexion-extension views of the cervical spine
Lateral flexion-extension views demonstrate atlantoaxial instability by showing abnormal anterior displacement of C1 on C2 with the atlantodental interval exceeding 3 mm.
PANRE Orthopedics 3
A 16-year-old male presents with knee pain after playing basketball.
Examination reveals tenderness at the tibial tuberosity.
X-ray shows soft tissue swelling with irregular ossification.
What is the diagnosis?