Question Easy:
A 28-year-old woman presents to the GP with a painful swollen knee after a fall during a netball match yesterday. She describes hearing a “pop” when she fell. On examination, there is significant swelling, and she cannot fully extend her knee. Which structure is most likely injured? 🤾♀️
A) Medial collateral ligament
B) Lateral collateral ligament
C) Anterior cruciate ligament
D) Posterior cruciate ligament
E) Meniscus
Question Medium:
A 55-year-old man presents with chronic shoulder pain and stiffness over the past year. He has a history of diabetes mellitus. On examination, the shoulder movement is restricted in both active and passive range of motion. What is the most likely diagnosis?
A) Rotator cuff tear
B) Adhesive capsulitis
C) Subacromial bursitis
D) Glenohumeral osteoarthritis
E) Acromioclavicular joint arthritis
Question Hard:
A 74-year-old woman presents to A&E after slipping on ice and landing on her left hip. She is unable to bear weight on the affected side. X-ray reveals an intracapsular fracture of the femoral neck. What is the best surgical treatment option for this patient according to NICE guidelines? 🏥
A) Dynamic hip screw
B) Hemiarthroplasty
C) Total hip replacement
D) Cannulated screws
E) Non-operative management
Explanations & Answers:
Question Easy Answer: C
Question Easy Explanation: The anterior cruciate ligament (ACL) is commonly injured in sports involving sudden stops and changes in direction, such as netball. The “pop” sound and inability to extend the knee are classic signs of an ACL injury. The swelling is due to haemarthrosis.
Question Medium Answer: B
Question Medium Explanation: Adhesive capsulitis, also known as frozen shoulder, is characterized by pain and global restriction of shoulder movement, both active and passive. It is associated with diabetes mellitus, and the insidious onset with progressive stiffness aligns with this diagnosis.
Question Hard Answer: C
Question Hard Explanation: According to NICE guidelines, a total hip replacement is recommended for active, older adults with a displaced intracapsular fracture, especially if they have no pre-existing hip conditions or significant comorbidities. This approach improves outcomes and function in this patient cohort.
Medical fact of the day: Osteoarthritis is the most common form of arthritis and primarily affects weight-bearing joints like the knees and hips. In the UK, it affects an estimated 8.75 million people! 🚶♂️
Quote of the day: “Every small step in caring for others is a leap towards healing the world.” – Anonymous