Question Easy:
A 60-year-old woman presents with severe pain in her left knee that started suddenly after getting up from a chair. Her knee is swollen, and she is unable to bear weight on it. On examination, you note tenderness along the joint line and a limited range of motion due to pain. What is the most likely diagnosis? 🌟
A) Gouty arthritis
B) Septic arthritis
C) Osteoarthritis
D) Meniscal tear
E) Patellar dislocation
Question Medium:
A 25-year-old footballer presents with a popped knee after changing direction suddenly during a match. He reports hearing a “pop” sound and now feels instability in the knee. Anterior drawer test is positive. Which structure is most likely injured? ⚽
A) Anterior cruciate ligament (ACL)
B) Posterior cruciate ligament (PCL)
C) Medial collateral ligament (MCL)
D) Lateral collateral ligament (LCL)
E) Meniscus
Question Hard:
A 72-year-old man with a history of hypertension, presents with increasing pain and stiffness in his right hip over several months. He is also a smoker. X-ray shows joint space narrowing, subchondral sclerosis, and osteophytes in the hip joint. What is the most appropriate first-line treatment to manage his pain according to NICE guidelines?
A) Oral steroids
B) Opioids
C) Topical NSAIDs
D) Oral NSAIDs
E) Hyaluronic acid injection
Explanations & Answers:
Question Easy Answer:
D) Meniscal tear
Question Easy Explanation:
The sudden onset of knee pain with swelling and difficulty bearing weight following a twisting action typically indicates a meniscal tear. Osteoarthritis and gout tend to have a more gradual onset, while septic arthritis requires infection symptoms. Patellar dislocation often follows direct trauma or a sudden change in direction.
Question Medium Answer:
A) Anterior cruciate ligament (ACL)
Question Medium Explanation:
An ACL injury is commonly associated with a ‘pop’ sound and knee instability following a sudden directional change, often seen in sports like football. The positive anterior drawer test specifically supports ACL injury over other ligament or meniscal injuries, which have different clinical tests.
Question Hard Answer:
D) Oral NSAIDs
Question Hard Explanation:
According to NICE guidelines, oral NSAIDs are recommended as first-line pharmacological treatment for pain relief in osteoarthritis when appropriate after considering the patient’s risk factors. While topical NSAIDs can be used, especially for knee or hand osteoarthritis, oral NSAIDs are effective for hip OA particularly in a monitored setting, considering the patient’s medical history.
Medical fact of the day: Ligament injuries are more common in younger athletes, while tendon damage is more frequent in older individuals due to age-related degeneration. This highlights the importance of tailored preventive strategies across different age groups in sports medicine.
Quote of the day: “In the heart of healing, resilience is not just a skill, but a testament to the strength within every caregiver and the hope they inspire.”