Question Easy: A 65-year-old woman presents with knee pain that exacerbates with activity and improves with rest. On examination, crepitus is noted. What is the most likely diagnosis? 🦵
A) Osteoarthritis
B) Rheumatoid arthritis
C) Gout
D) Septic arthritis
E) Reactive arthritis
Question Medium: A 45-year-old man presents with sudden onset back pain after lifting a heavy box. His examination reveals tenderness over the lumbar region but no neurological deficits. What is the most appropriate initial management?
A) MRI of the lumbar spine
B) Bed rest for 2 weeks
C) Oral non-steroidal anti-inflammatory drugs (NSAIDs)
D) Immediate referral to orthopaedics
E) Spinal surgery
Question Hard: A 35-year-old tennis coach presents with lateral elbow pain and tenderness over the lateral epicondyle. He reports difficulty in gripping objects. What is the best initial treatment strategy for his condition? 🎾
A) Surgical intervention
B) Corticosteroid injection
C) Physiotherapy and activity modification
D) Oral antibiotics
E) Elbow arthroscopy
Explanations & Answers:
Question Easy Answer: A) Osteoarthritis
Question Easy Explanation: Osteoarthritis is the most common form of arthritis in the UK, often affecting older individuals. It presents with pain that is typically exacerbated by activity and relieved by rest, along with crepitus due to articular cartilage degeneration.
Question Medium Answer: C) Oral non-steroidal anti-inflammatory drugs (NSAIDs)
Question Medium Explanation: According to NICE guidelines, the first-line treatment for non-specific acute low back pain is the use of oral NSAIDs, unless contraindicated. Bed rest is not recommended, and imaging is not initially indicated unless there are red flags.
Question Hard Answer: C) Physiotherapy and activity modification
Question Hard Explanation: This presentation is typical of lateral epicondylitis, commonly known as tennis elbow. The recommended initial treatment involves physiotherapy and modification of activities that exacerbate symptoms. Corticosteroid injections are only considered if conservative strategies fail.
Medical fact of the day: Did you know? The human foot contains 26 bones, making up nearly a quarter of all the bones in the body! This complexity allows for a range of movements and functions essential to our daily activities.
Quote of the day: “Every step in healing begins with the courage to carry on, no matter the obstacles. Keep moving forward, one patient at a time.” 🌟