Ortho/Rheum 4

A 44-year-old woman has tight and shiny skin on her face and fingers. In addition, she has Raynaud’s phenomenon when holding a frozen package. Which of the following is the most likely diagnosis?

Martha is a 45-year-old woman who comes to the ED complaining of several weeks of worsening foot pain. The pain is aggravated with weight bearing in the morning and worsens throughout the day. She has point tenderness at the medial calcaneal tubercle. Which of the following is the most likely diagnosis?

A 58-year-old male was playing softball and fell on his right shoulder. He presents with complaints of moderate anterior shoulder pain. There is no deformity on inspection. Physical examination reveals diffuse tenderness over the deltoid, a positive apprehension sign and drop-arm test. X-ray is negative for fracture. Which of the following is the most likely diagnosis?

A 2-year-old child is brought to you because he refuses to use his right arm. He is holding the arm in a semi-flexed adducted and pronated position. Any attempt to touch it is met with a cry and the child will not hold objects in the right hand. The mother denies trauma but she did pull the child by the arm recently when he refused to go into an elevator. Which of the following is the most likely diagnosis?

Which of the following structures is the most commonly involved in a rotator cuff tear?

A 24-year-old female fell on her outstretched hand. She presents with swelling to the wrist, palmar abrasions, and marked tenderness over the anatomic snuffbox area. X-rays of the wrist are negative for fracture. Which of the following is the most appropriate treatment?

A 32-year-old man has tendinous xanthomas on his elbows. He is most likely to have which of the following conditions?

A patient suffers a blow to the back of the hand and wrist and presents with wrist pain and deformity. X-rays are obtained and are shown below. Which of the following best describes the findings?

Fracture across the epiphyseal plate, as shown in the picture below, best describes which of the following?

A fracture which crosses the epiphyseal plate and then through the end of the bone, as shown in the picture below, best describes which of the following?

Which of the following is the most likely contributing factor for adhesive capsulitis?

A patient was examined initially with an acute onset of low back pain after shoveling snow. Physical examination disclosed paraspinal muscle spasms and decreased range of motion of the right lumbosacral area, normal deep tendon reflexes, and a negative straight-leg raise. Of the following available options, which is the best management?

A 40-year-old man sustained a minimally displaced midshaft humerus fracture. The most likely complication involves which of the following nerves?

Which of the following is a characteristic of rheumatoid arthritis?

Which of the following clinical therapeutics is a characteristic for Legg-Calvé-Perthes disease?

The most likely organism to cause acute osteomyelitis due to an infection after a puncture wound of the foot:

Which of the following is the most likely complication from a symptomatic subacromial impingement syndrome?

A positive Finkelstein’s test is indicative of:

The most appropriate physical examination technique to detect scoliosis is:

A 38-year-old laborer has reproducible shoulder pain with abduction and internal rotation and a positive impingement sign. The next step in management is:

Which of the following courses of treatment would you prescribe for treatment of a buckle fracture of the distal radius?

A 36-year-old female presents with muscle weakness, bone pain, and history of several fractures. Blood work reveals a vitamin D deficiency. X-rays reveal generalized decrease in bone density and Looser lines, characteristic of pseudo fractures. You diagnose this patient with osteomalacia. Which of the following medications would you prescribe to treat this disorder?

A 40-year-old female presents with muscle weakness in the pelvic girdle and generalized bone pain. She has a history of several fractures stemming from minor traumas. X-rays reveal generalized decrease in bone density with Looser zones. Blood work reveals vitamin D deficiency. Based on the patient’s presentation, history, and test results, the likeliest diagnosis is:

The most common injury of the wrist is a fracture that results from a fall onto a dorsiflexed hand. The X-ray of this fracture is characterized by a “silver fork deformity.” Which of the following types of fracture is illustrated in this X-ray?

A 38-year-old female presents with pain in the anatomical snuffbox after a fall on the ice. Physical examination reveals swelling and ecchymosis over the affected region. The X-ray of the patient’s hand reveals a fracture in the area of pain. Based on the findings, which of the following is the most appropriate diagnosis?

A 33-year-old male presents with low-grade fever, anorexia, and malaise. He complains of back pain in the morning that lasts for more than 30 minutes. He states that long periods of inactivity make his pain worse and that his pain is relieved with exercise. Bloodwork is positive for HLA-B27 and lateral spine X-rays have a “bamboo” appearance of the vertebral spine and sacroiliac region. Which of the following is the most appropriate diagnosis?

An X-ray of a patient’s hands reveals a lesion on the proximal phalanx of the ring finger. The lesion has a lobular morphology and punctate calcifications are noted. Further analysis revealed that the lesion is composed of hyaline cartilage. This common primary bone neoplasm of the hand is known as:

A 48-year-old male presents with throbbing pain to the groin, hip, and buttocks that is relieved with rest. You suspect aseptic necrosis of the hip. Which diagnostic procedure would you obtain to confirm this diagnosis?

A 14-year-old athletic male presents with hip and thigh pain and a noticeable painful limp. X-rays reveal posterior and medial displacement of the epiphysis. Based on the patient’s presentation and test results, which of the following is the most appropriate diagnosis?

An 18-year-old male sustains a boxer’s fracture with puncture wounds. Due to the puncture wounds, what additional treatment is necessary other than splinting the affected fingers?