Block 4- MSK

Stretching has no demonstrable benefit for which one of the following?

A factory worker sustains a forced flexion injury of the distal interphalangeal (DIP) joint, resulting in a small bone fragment at the dorsal surface of the proximal distal phalanx (mallet fracture). Which one of the following is the most appropriate management strategy?

A 52-year-old female with a history of well-controlled diabetes mellitus presents with right shoulder pain for 2 months. She cannot recall any injury. The pain is fairly constant, has a burning quality, and disturbs her sleep. On examination the patient has no redness or swelling. Passive and active abduction are limited to 45°. There is some limitation of shoulder flexion and internal rotation, but it is less pronounced. No focal tenderness is found. Plain films are negative. Which one of the following is the most likely diagnosis for this patient?

A 36-year-old male who participates in his neighborhood basketball league visits your office with a 3-week history of heel pain. On examination he has pain over the medial plantar region of the right heel and the pain is aggravated by passive ankle dorsiflexion. Which one of the following should you order to confirm the diagnosis?

A 42-year-old female presents with a 2-month history of right-sided shoulder pain. A history reveals that her job requires repetitive motion, including abduction of the shoulder. Ibuprofen has not been helpful and the pain interferes with her sleep. The physical examination suggests rotator cuff tendinitis. A radiograph of the shoulder is normal. You discuss treatment options and the patient decides to proceed with a corticosteroid injection. Which one of the following is the appropriate anatomic location for the injection?

A 27-year-old male complains of severe back and left leg pain that started yesterday afternoon. He states that just before the pain began he was moving some patio furniture around his back porch when he felt a sudden "pop" in his left lumbar region. Over the subsequent few hours he developed gradually increasing pain in his low back that radiates down the posterolateral side of his left leg and onto the top of his left foot. He describes the pain as lancinating and knife-like, rating it as 10/10 on a pain scale. He is unable to stand up straight or sit down comfortably for an examination. He denies any bowel or bladder dysfunction and appears to have otherwise intact strength and sensation. Prior to this event he was in good health and took no routine medications. Which one of the following is recommended at this time?

You have diagnosed a ganglion cyst (GC) on the palmar surface of a patient's wrist. Which one of the following is the most accurate information to provide to your patient regarding diagnosis, treatment, and prognosis?

Which one of the following diagnoses is most likely in an afebrile patient with long standing type 2 diabetes complicated by retinopathy and neuropathy, a one-year history of pes planus, and a normal ESR who reports sudden onset of relatively painless warmth and swelling in her left foot with no other signs of infection and a noninflammatory joint aspirate that shows no crystals?

Which one of the following is most suggestive of plantar fasciitis?

A 45-year-old female presents to your office with knee pain. She was playing volleyball yesterday when she collided with another player and was unable to continue playing because of pain in her knee. The knee was swollen this morning. She is able to walk but not without pain, and she also has pain when she attempts to bend her knee. On examination there is medial joint line tenderness and a positive Thessaly test. Which one of the following is the most likely cause of her knee pain?