Ortho/Rheum 2

A 7-year-old boy fell while learning to ride his two wheel bicycle. Several days later, he develops fever of 104 degrees F, orally and he complains of severe localized pain in the lower right leg near the ankle. The painful area is very tender, swollen, with overlying erythema of the skin. White blood count is 26,000 with 94% polys. X-ray of the lower leg demonstrates periosteal elevation. Which of the following is the most diagnosis?

A 12-year-old male presents with complaints of right knee pain that is aggravated with playing basketball and tennis. He is noted to have mild to moderate swelling distal to the right patella. X-ray reveals ossification at the right tibial tubercle. Which of the following is the most likely to be included in the management of this patient?

A 24-year-old male presents with the feeling of intense knee pain he describes as if he had glass in his knee, he denies trauma. Exam reveals and oval shaped lesion over the knee. What is the diagnosis?

A 7-year-old boy has intermittent pain in the right thigh for 3 weeks. Exam shows a limp and atrophy of the proximal thigh muscles. Radiographic study of the hip shows fragmentation of the femoral head. Which of the following is the most likely diagnosis?

After having been involved in a motor vehicle accident causing a fracture of the tibia, a 27-year-old woman has persistent severe pain in her left lower leg. Compartment syndrome is diagnosed. Which of the following is the most appropriate management?

A 71-year-old woman has a 2-day history of an inflamed, painful and swollen left knee. Synovial fluid examination is diagnostic for pseudogout. Which of the following in joint fluid distinguishes this diagnosis from acute gout?

A 26-year-old woman has a 2 month history of diffuse pain in muscles and joints, tingling in the arms and legs, and fatigue. Vital signs are normal. Examination shows tender points in the trapezius muscles, lateral epicondyles, and greater trochanter areas. There is no evidence of muscle or joint inflammation. Which of the following is the most likely diagnosis?

Which of the following describes the correct positioning for a patient that requires the odontoid view of the cervical spine?

Hydroxychloroquine therapy is to be initiated in a 32-year-old woman in treatment of rheumatoid arthritis. She should be counseled to have which of the following periodic examinations?

Which of the following is the most common complication associated with fractures of the proximal humerus?

Eighty-five percent of ankle sprains involve the:

The Salter-Harris fracture that involves only the epiphyseal plate and the metaphysis is:

Which of the following conditions is most likely to present with a painful impingement?

A history of a knee-twisting injury in which a “pop” was felt and marked knee joint swelling occurred would suggest which of the following injuries?

Which of the following is the bone most commonly fractured in children?

A patient with point tenderness in the “snuffbox” would raise suspicion of:

A 61-year-old woman has recurrent back pain in her lumbar area. The pain radiates to her buttocks but is worse on the right side. Both sitting and walking aggravate the pain. She denies bowel or bladder dysfunction. On physical examination, she has diminished sensation and decreased reflexes on the right lower limb. Straight-leg raising and cross-leg raising tests are positive for reproduction of right lower limb symptoms. The patient has no spinal deformities. Which of the following is the most likely diagnosis?

A 17-year-old football player, with his foot planted, is tackled from the side, causing forced valgus stress on the knee. On examination, there is tenderness over the medial femoral condyle. No apparent effusion is noted, and a McMurray test is negative but limited secondary to pain. Varus/valgus stress testing is not possible at this time secondary to pain. Which of the following is the most likely diagnosis?

A 30-year-old woman with a history of diabetes mellitus presents with a 3-week history of hand numbness that often awakens her from sleep. The symptoms resolve after she shakes her hands for a few minutes. On examination, no sensory or motor deficit of her hands is present, but there is a positive Tinel’s sign. Which of the following is the most likely diagnosis?

A 20-year-old woman complains of proximal lateral forearm pain exacerbated by extension of the wrist against resistance with the elbow extended. She denies trauma but is an avid racquetball player. Which of the following is the most likely diagnosis?

A 29-year-old male with a history of chlamydial urethritis develops asymmetric arthritis. His physical examination reveals inflammation of the foreskin of the penis and conjunctivitis. Based on the patient’s history and physical examination, which of the following is the most appropriate diagnosis?

A 70-year-old female presents with headache, scalp tenderness, jaw pain, throat pain, and visual disturbances. Blood work reveals a markedly elevated erythrocyte sedimentation rate and C-reactive protein level. Based on the patient’s presentation and lab results, which of the following is the most appropriate diagnosis?

A 50-year-old female is diagnosed with Sjogren’s syndrome. Which of the following medications is indicated to treat symptoms of this disorder by increasing salivary flow?

Which of the following forms of childhood-onset idiopathic arthritis is characterized by spiking fevers of 102.2-104 °F with an associated salmon-pink maculopapular rash?

A 52-year-old female presents with proximal muscle weakness, difficulty swallowing, skin rash, multiple joint pain, and muscle atrophy. Lab work reveals elevated levels of creatine phosphokinase and aldolase. Based on the patient’s presentation and lab results, which of the following is the most appropriate diagnosis?

An 80-year-old female presents with unexplained neck pain, scalp tenderness, headache, and vision difficulties. Her blood work reveals marked elevations in erythrocyte sedimentation rate and C-reactive protein. You suspect this patient is suffering from giant cell arteritis. Which of the following exams would you perform to confirm your diagnosis?

Which of the following classes of medication are indicated for maintenance therapy of rheumatoid arthritis?

Wwhich of the following medical conditions, if present, would also make you suspect a diagnosis of polymyalgia rheumatica?

A 33-year-old male patient who is known to be a frequent runner arrives with severe pain in the area of his right ankle. The patient reported that he was in the middle of a low-stress run when he began to feel the pain developing. The pain is located on the right posterior calf, 2 cm above the insertion of the Achilles tendon. Which of the following diagnoses is most likely to be correct?

A male automobile accident victim arrives in the emergency room complaining of severe arm pain. The patient’s left upper arm is significantly swollen and slightly deformed. He is not holding the arm to his chest and does not appear to have any injuries to his arm ligaments or rotor cuff. Which of the following diagnoses is most likely to be correct?