MSK- Block 8

A 40-year-old runner complains of gradually worsening pain on the lateral aspect of his foot. He runs on asphalt, and has increased his mileage from 2 miles/day to 5 miles/day over the last 2 weeks. Palpation causes pain over the lateral fifth metatarsal. The pain is also reproduced when he jumps on the affected leg. When you ask about his shoes he tells you he bought them several years ago. Which one of the following is the most likely diagnosis?

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 72-year-old woman presents with left knee pain for the past several months that has been worse over the last seven days. It is worse with walking and better with rest. She takes acetaminophen to alleviate the pain. She denies any injury or previous surgery on the knee. An X-ray is ordered and shows chondrocalcinosis, narrowed joint spaces, and subarticular reactive sclerosis. Bone spur formation is also noted. What is the most likely diagnosis?

A 21-year-old college rugby player presents with pain and swelling over his distal interphalangeal joint of his fourth digit of his right hand. He injured it two hours ago while tackling an opponent from behind. On exam, he has normal capillary refill, normal sensation, and is able to actively extend all joints. He is unable to flex the DIP joint of his fourth digit. After obtaining an X-ray, which of the following is the most appropriate next step?

A soccer player presents to the emergency department after being kicked in the shin by his opponent. Upon presentation he demonstrates pain out of proportion as well as extreme pain with passive range of motion. You have a high suspicion for acute compartment syndrome. What laboratory finding is most closely associated with this disorder?

52-year-old female presents with progressively worsening weakness in her legs. She has been having difficulty walking long distances and having trouble getting up from a seated position without assistance. This has only been happening over the last few weeks. She has a past medical history of diabetes and hypertension. Physical examination shows decreased strength in the proximal upper extremities and the hip flexors. She has particular difficulty rising from sitting on a stool low to the ground. What is the most likely diagnosis?

A 50-year-old female with significant findings of rheumatoid arthritis presents for a preoperative evaluation for planned replacement of the metacarpophalangeal joints of her right hand under general anesthesia. She generally enjoys good health and has had ongoing medical care for her illness. Of the following, which one would be most important for preoperative assessment of this patient’s surgical risk?

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. Which one of the following is the most appropriate management strategy?

Which one of the following is first-line treatment for chronic Achilles tendinopathy?

A 23-year-old woman, who is 6-weeks postpartum, presents with progressive right thumb and wrist pain for the past 3 weeks. The pain worsens with movement. Physical exam reveals tenderness over the right radial styloid. The pain is reproduced when the wrist is rotated ulnarly while the woman’s fingers are folded over the thumb. Which of the following is the most likely diagnosis?