Question Easy:
A 65-year-old man is in the clinic with a complaint of increasing knee pain over the past several years. The pain worsens with activity and improves with rest. On examination, there is crepitus and reduced range of motion. What is the most likely diagnosis?
A) Rheumatoid arthritis
B) Osteoarthritis
C) Gout
D) Septic arthritis
E) Psoriatic arthritis
Question Medium:
A 30-year-old woman presents with stiff, swollen fingers and a history of morning stiffness lasting over an hour for the last 6 months. Blood tests reveal raised ESR and CRP, and the patient is positive for rheumatoid factor and anti-CCP antibodies. Which joint is typically spared in this condition?
A) Wrist
B) MCP joints
C) PIP joints
D) DIP joints
E) Knee
Question Hard:
A 16-year-old boy presents with anterior knee pain that is worse with jumping and climbing stairs. On examination, there is tenderness at the inferior pole of the patella. You suspect patellar tendinopathy. What is the primary management strategy for this condition?
A) Corticosteroid injection
B) Rest and avoidance of activities
C) Physiotherapy focusing on eccentric exercises
D) Surgical intervention
E) NSAIDs
Explanations & Answers:
Question Easy Answer:
B) Osteoarthritis
Question Easy Explanation:
The symptom pattern given—pain worsened by activity and relieved by rest, along with crepitus and reduced range of motion—fits classic signs of osteoarthritis 🌟. According to NICE guidelines, osteoarthritis is common among the elderly and closely associated with joint degeneration. Management focuses on lifestyle modifications, weight management, and physical therapy.
Question Medium Answer:
D) DIP joints
Question Medium Explanation:
Rheumatoid arthritis typically affects synovial joints like the wrists, MCP, and PIP joints, while sparing the DIP joints. According to the NHS, RA is an autoimmune disease characterized by inflammation of the synovium that usually spares the distal interphalangeal joints, which are classically involved in osteoarthritis instead.
Question Hard Answer:
C) Physiotherapy focusing on eccentric exercises
Question Hard Explanation:
Patellar tendinopathy, also known as jumper’s knee, benefits significantly from physiotherapy that focuses on eccentric exercises 🙌. NHS guidance suggests that while rest is initially beneficial, structured rehabilitation via eccentric strengthening has shown the best outcomes in promoting tendon healing. NICE guidelines recommend avoiding corticosteroid injections due to potential tendon damage.
Medical fact of the day:
Did you know that tennis elbow (lateral epicondylitis) is more prevalent in the UK office working population due to increased use of computers and mobile technology? Regular breaks and ergonomic workplaces can help prevent this common MSK condition. 💻🎾
Quote of the day:
“Every incision holds the hope of a healed life, and every diagnosis the promise of relief.” 🌟