Quiz 2 CONA
Which of the following is a common exam finding in patients diagnosed w/ the condition identified in the previous question (#13)
Excessive body weight
A patient describes experiencing an insidious onset of pain that they never felt before, when you ask them to identify the location of the pain they tell you they feel the pain in their right hip. Based on this information, in order to arrive at a correct diagnosis, the physical examination must include an evaluation of the:
Bilateral hips, knees and lumbosacral spine
A football running back is hit on the lateral surface of his knee by an opponent. He has significant pain and some immediate swelling on the medial surface of his knee. You suspect that the athlete has sustained a sprain of the MCL.What other tissue would likely be immediately affected as well?
ACL
A lacrosse player carrying the ball attempts to avoid a defender by planting his right foot firmly on the ground and cutting hard to his left. His knee gives way, and he hears a loud pop. He has intense pain immediately. Which ligament has most likely been injured
ACL
While playing soccer, an athlete kicks the soccer ball sideways and suddenly experiences an incapacitating pulling pain in the groin. Which of the following conditions in MOST LIKELY causing the patient's pain?
Adductor magnus strain
Th following is TRUE regarding hip fractures in the elderly patient
Approximately 15-20% of patients within 1 year of fracture
A 42 yo M presents complaining of an insidious onset of right sided groin pain that is exacerbated by weight bearing. He is walking with a limp. The pain was initially mild but has been getting progressively worse and is now present both with activity and at rest. It does not improve w/ activity. The patient has a long time history of alcohol abuse and hyperlipidemia. He denies sensing a feeling of clicking, locking or giving away in the hip. AROM is decreased in all ranges. The MOST LIKELY diagnosis is
Avascular Necrosis
An 11 year old boy sustains a severe injury while playing soccer. You observe a palpable defect across the entire belly of the right hamstring muscle that is associated with severe pain and swelling and complete functional loss. Based on this clinical picture, until you prove otherwise, the initial working diagnosis is
Avulsion fracture of ischial apophysis
A pt presents w/ a complaint of medial knee pain and clicking/snapping that he notices mostly while riding his bicycle. His major complaint is recurring episodes of painful psudo-locking of the knee when he sits for an extended period of time. A palpable tenderness beings on the medial aspect of the knee and extends downward into the infrapatellar fat pad. As the knee passes 15-20 degrees of flexion, a snap may be felt or heard. There is little or no swelling and no ligamentous laxity. Radiographs of the knee are unremarkable. Based on the clinical picture provided, this pt is most likely suffering from
Inflamed mediopatella plica
A 39 yo M tripped and fell while playing tennis . Shortly after the game the left leg became progressively more painful. That evening he felt intense left lower leg pain. The next day he presents to your office for care. On exam, the posterior lower leg is tense and tender to palpation. Active knee flexion is present but limited by pain. Passive knee motion, particularly knee flexion is painful. Weakness is noted w/resisted plantar flexion. Sensation is intact. Pedal pulses are present, and capillary refill over the leg and foot is normal. The working dx is?
Gastrocnemius muscle strain
Which statement is CORRECT characterization of patellofemoral syndrome?
It is primarily a soft tissue disorder
Which signs and or symptoms are pathognomonic of Osgood-Schlatter's disease?
Localized pain, tenderness, and swelling at the tibial tuberosity in high school male
A pt has just sustained an injury to their knee. Based on the mechanism of injury you suspect she either has a tear of the medial meniscus or medial collateral ligament. Which of the following is more indicative of a meniscus tear?
Locking of the knee during AROM
A pt presents to your office following a fall off their motorcycle. They are complaining of severe pain in their right knee and are unable to bare weight due to pain and a feeling of instability. Which structure should you be most concerned has been torn or damaged?
Medial Meniscus
Accord to our discussion in class which of following mechanism is indicative of an ACL tear
Non-contact injury accompanied w/ a popping sensation
Which of the following is TURE regarding avascular necrosis of the hip inthe pediatric patient?
Only presenting symptom in some patients may be knee pain
13 yo boy is an avid soccer player presents w/ a complaint of right-sided knee pain. The pain is worse with activity. Rest is palliative. The pain has been present intermittently for several month. This is the first time medical evaluation and swelling at the tibial tuberosity. Knee joint exam is normal but the chief complaint is reproduced by extending the knee against resistance. Based on the clinical picture provided , this pt is most likely suffering from
Osgood-schlatter Disease
A 14 yo high school basketball player complains of diffuse pain in her left anterior knee. She has been experiencing this pain for several weeks. The pt complains of pain in the anterior aspect of the knee while walking and running; worse when ascending stairs and squatting, she has tightness of the hamstrings, and increased Q angle, excessive pronation in her left foot, and weakness in her vastus medialis obliques (VMO). The working dx is?
Patellofemoral pain syndrome
A pt does a lot of work on their knees. There is significant swelling on the anterior aspect of their patella. The swelling is found to be extracapsular and some redness is present on the knee. Based on the clinical picture provided, this pt is most likely suffering from?
Prepatellar bursitis
A 27-yr old patient presents complaining of right sided hip pain. During the history you uncover the following information: The patient is a non-smoker, she does not have a person or family history of cancer and she denies a history of menstrual irregularities, GI? GU complaints, or recents infection, fever, weight loss or bowel and bladder problems, Rest is palliative. Based on the information collected from the history thus far, which of the following is the most likely diagnosis
Referred pain of the lumbar spine
Hip pathology will include all the following EXCEPT
Sarcrotuberous ligament strain
TL is a 16 yo boy complaining of left-sided knee pain. 6 wks ago TL visited his general practitioner complaining at that time, of a 4 wk history of intermittent pain in the left knee. He denied a history of trauma, or metabolic disease and reported that the pain came on gradually and was exacerbated when playing sports. On exam, his GP reported that no abnormality was found in the left knee. Today, you observe that TL is walking w/a limp and the affected extremity appears externally rotated while walking and during your postural assessment. While all ranges of motion of the hip provoke pain, flexion and internal rotations are most limited. There is a leg discrepancy w/ the left leg being shorter than the right. The rest of his history is unremarkable. A final working diagnosis is gained from the x-rays of the affected area. Based on the clinical picture provided, the MOST likely diagnosis is
Slipped Capital Epiphysis
A 5 year old female patient has pain and tenderness in her right hip when she adducts her thigh and with standing. An audible clunking is elicited when you passively abduct her thigh. These findings so far are consistent with which of following diagnosis?
Slipped capital epiphysis of femur
A patient who is an avid soccer player is recovering from a grade 2 hamstring muscle strain. On your advice, he has refrained from playing soccer during the rehab and recovery phase of care but he is anxious to return to play. Which of the following is the BEST indicator that the patient is ready to safely return to playing soccer?
Strength of the injured muscle is almost equivalent ~10% to strength in the uninjured side
A 48 y.o. F is an avid runner presents w/ a complaint of pain at her left lateral hip. The pain is provoked when she goes on a run and with other ambulatory activities. The pain radiates along her left lateral thigh. The pain often wakes her at night when she rolls onto the left side. Physical exam reproduces the cheif complaint and reveals tenderness and swelling over the greater trochanter leg-length discrepancy, and hypertonicity of the left iliotibial band along w/ hyperpronation of both feet. Left hip range of motion is limited in internal rotations and Patrick's Test (FABERE)elicits pain in the left hip. The MOST LIKELY diagnosis is
Subtrochanteric bursitis
A meniscus will be painful if?
Swelling compresses adjacent tissue
Which of the following statement regarding tendonosis is true?
Tendon recovery may be impaired by the use of anti-inflammatory medication
You are a team chiro and an athlete under your supervision sustains an acute injury to their knee during a game. You evaluate the pt on the field by performing a quick regional exam. You want to determine the extent of the injury and whether you should initiate treatment or if x-rays are first required. For this pt, which of the following criteria would indicate plain film radiographs
There is isolated tenderness at the patella
