Question Easy: A 25-year-old rugby player presents with a swollen knee after a match. He describes a popping sensation at the time of injury and inability to continue playing due to pain. What is the most likely diagnosis? 🏉 A) Quadriceps tendon rupture B) Medial collateral ligament sprain C) Anterior cruciate ligament (ACL) tear D) Meniscal tear E) Posterior cruciate ligament (PCL) tear
Question Medium: A 40-year-old woman complains of pain in her wrist and thumb after painting her house for several hours. On examination, there is tenderness over the radial styloid and a positive Finkelstein’s test. What is the most likely diagnosis? 🎨 A) Carpal tunnel syndrome B) De Quervain’s tenosynovitis C) Scaphoid fracture D) Intersection syndrome E) Rheumatoid arthritis
Question Hard: A 70-year-old man with a history of prostate cancer presents with sudden onset of severe back pain and bilateral lower limb weakness. On examination, he has reduced power in his legs and urinary retention. What is the most likely diagnosis? 🚨 A) Lumbar disc herniation B) Cauda equina syndrome C) Spinal epidural abscess D) Spinal metastasis E) Transverse myelitis
Explanations & Answers:
Question Easy Answer: C) Anterior cruciate ligament (ACL) tear Question Easy Explanation: The classic presentation of an ACL tear includes a “popping” sound, immediate pain, and swelling due to haemarthrosis. It often results in inability to continue the activity, as seen in the case of this rugby player. According to NICE guidelines, an MRI is commonly used to confirm the diagnosis.
Question Medium Answer: B) De Quervain’s tenosynovitis Question Medium Explanation: De Quervain’s tenosynovitis is characterized by pain over the radial styloid and a positive Finkelstein’s test. It commonly affects individuals performing repetitive wrist movements. NICE recommends conservative treatment including rest, splints, and NSAIDs initially.
Question Hard Answer: D) Spinal metastasis Question Hard Explanation: This presentation suggests metastatic spinal cord compression (most likely from prostate cancer in this patient). Immediate MRI is recommended by NICE to assess for cord compression, followed by urgent oncology and spinal team referral to prevent irreversible damage.
Medical fact of the day: The Achilles tendon is the strongest and thickest tendon in the human body, enduring forces up to 10 times a person’s body weight during activities like running and jumping.
Quote of the day: “In the art of healing, it’s the compassion in your heart that touches the soul more profoundly than any medicine.”