JBJS JOPA Test Your Knowledge Quiz
Quiz-summary
0 of 60 questions completed
Questions:
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25
- 26
- 27
- 28
- 29
- 30
- 31
- 32
- 33
- 34
- 35
- 36
- 37
- 38
- 39
- 40
- 41
- 42
- 43
- 44
- 45
- 46
- 47
- 48
- 49
- 50
- 51
- 52
- 53
- 54
- 55
- 56
- 57
- 58
- 59
- 60
Information
The JBJS JOPA Test Your Knowledge Quiz includes 60 multiple-choice questions covering all orthopaedic subspecialties. You are required to answer each question before proceeding to the next and you cannot return to previously answered questions. You will receive immediate feedback on whether you answered correctly after answering each question. You will have 60 minutes to complete the quiz once you begin.
The questions are of moderate difficulty in order to provide an accurate assessment tool for all PAs who practice in orthopaedics. At the end of the quiz, your score will be compared to the average score of all PAs who have taken the quiz. Please also take a minute to fill out the survey at the end of the quiz, which will help us collect valuable data on the PA profession. Good luck!
The purpose of this quiz and post-quiz survey is to give PAs a tool to assess their general orthopedic knowledge. The identity of quiz takers and individual scores will not be distributed in any form. Your privacy is important to us; individual results will be used by JBJS to compile survey data only and no individual scores will be shared.
You have already completed the quiz before. Hence you can not start it again.
Quiz is loading...
You must sign in or sign up to start the quiz.
You have to finish following quiz, to start this quiz:
Results
0 of 60 questions answered correctly
Your time:
Time has elapsed
You have reached 0 of 0 points, (0)
Average score |
|
Your score |
|
Categories
- Not categorized 0%
-
Please write down your score and take a minute to complete the post-quiz survey by clicking the link below. JBJS JOPA will be compiling survey data to determine what factors influence knowledge level in our profession. Provide your email at the survey end to receive the post-survey report once our data is compiled and analyzed. Individual results will be used by JBJS to compile survey data only and no individual scores will be shared.
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- 13
- 14
- 15
- 16
- 17
- 18
- 19
- 20
- 21
- 22
- 23
- 24
- 25
- 26
- 27
- 28
- 29
- 30
- 31
- 32
- 33
- 34
- 35
- 36
- 37
- 38
- 39
- 40
- 41
- 42
- 43
- 44
- 45
- 46
- 47
- 48
- 49
- 50
- 51
- 52
- 53
- 54
- 55
- 56
- 57
- 58
- 59
- 60
- Answered
- Review
-
Question 1 of 60
1. Question
A 16-year old female presents to the office with right ankle pain after a soccer injury. The injury occurred two days ago when she stepped and turned her ankle awkwardly on an opponent’s cleat. She has been unable to walk on the ankle since the injury. On exam, swelling and ecchymosis are noted over the lateral and medial ankle. She has tenderness to palpation over the proximal fibula, laterally over the anterior talofibular ligament, and medially over the deltoid ligament. X-rays of the proximal tibia and ankle are shown above. What is the next best step in treatment?
-
Question 2 of 60
2. Question
A 56 year-old male presented to the emergency department with severe pain in his left leg and inability to bear weight after falling up his stairs. He denied any history of knee pain or functional loss before the fall. Radiographs were taken (figures 1 and 2) and were reported as normal without acute fractures by the attending radiologist. The ED physician reported a difficult exam secondary to pain, and positive exam findings of a joint effusion and inability to bear weight. The patient was sent home from the ED with a knee immobilizer and crutches, instructed to weight bear as tolerated, and to follow up with orthopedics in one week. Based on the radiographs above, what is the most likely diagnosis of this patient’s acute knee pain?
-
Question 3 of 60
3. Question
A 68-year-old female presents to the office three weeks after sustaining a left shoulder dislocation resulting from a fall at home. The shoulder dislocation was closed reduced in the ED and she was placed in a sling immobilizer. Post-reduction x-rays show a reduced glenohumeral joint without evidence of fracture. She denies history of shoulder instability, pain, or weakness prior to her fall. On exam she has significant weakness with arm abduction and with the belly press test. What is the next best step in treatment for this patient?
-
Question 4 of 60
4. Question
Injury or entrapment of which peripheral nerve could cause winging of the scapula?
-
Question 5 of 60
5. Question
A 42 year-old male presents to your office with complaints of chronic lower back pain. He has a history of a T12 compression fracture 5 years ago from a traumatic fall. He recovered well from the injury but over the last few years his entire back has become progressively sore and stiff. AP and lateral lumbar spine x-rays show fused sacroiliac joints, vertebral body squaring, interspinous ligament calcification, flowing syndesmophytes, and posterior element fusion. These findings are consistent with which diagnosis?
-
Question 6 of 60
6. Question
A 51 year-old male presents to the emergency department (ED) with left ankle pain and deformity after tripping while hiking. He stepped awkwardly on a rock while climbing down the mountain and felt a “crack” as his ankle gave-way. He was transported to the ED where x-rays showed a left ankle fracture dislocation (figures 1 and 2). The ankle was closed reduced with the patient under conscious sedation and post-reduction x-rays confirmed reduction of the talus under the tibia (figures 3 and 4). Motor and distal pulses remained intact after the reduction. What is the next best treatment option?
-
Question 7 of 60
7. Question
A 4-month old infant girl presents to the emergency department with his parents after a full day of inconsolable crying. The father reported that he tripped while holding his child earlier in the day. He apparently lost his balance as the child fell to the ground and began crying. However, after a skeletal survey was performed and a spiral fracture of the left femur was identified, non-accidental trauma was determined. Femur x-rays are shown in figures 1 and 2 above. The patient was placed in child protective services and orthopedics was consulted. What is the best treatment option for this fracture?
-
Question 8 of 60
8. Question
A 79 year-old female presents to the emergency department with left sided hip pain after a fall 3 days ago. She resides at a nursing home and tripped while walking to the bathroom. She was brought to the ED by ambulance and was noted to have left sided superior and inferior pubic rami fractures on AP pelvis x-ray. What is the best treatment option for this patient?
-
Question 9 of 60
9. Question
A 90-year-old female is brought to the emergency room by emergency medical services (EMS) after sustaining a fall at home. She woke up in the middle of the night to use the bathroom, lost her balance, and fell on her left hip. She was unable to get up from the floor due to severe pain in the hip. The left lower extremity is shortened and externally rotated on exam. AP and lateral radiographs are shown above. What is the most appropriate treatment?
-
Question 10 of 60
10. Question
A 57-year-old male presents with knee pain and a valgus deformity to his right knee. He has failed conservative treatment for osteoarthritis and wishes to proceed forward with a right total knee arthroplasty (TKA). Bilateral weight bearing AP radiograph is shown above. Which potential postoperative complication is associated with the correction of a valgus knee deformity after TKA?
-
Question 11 of 60
11. Question
A 31 year-old female presents to the office with a left knee injury two days prior. She tripped while coming down stairs and her knee struck a railing. She had immediate pain and was unable to bear weight after. She also noticed a depression in the front of her knee beneath her knee cap after the injury. AP and lateral x-rays taken in the ED the day of injury are shown in Figures 1 and 2. Which statement below is true regarding this patient’s lateral x-ray?
-
Question 12 of 60
12. Question
A 49 year-old female presents to an orthopedic clinic one week after sustaining a back injury from a motor vehicle accident. She was taken to the emergency room by ambulance after the injury and x-rays taken were reported as normal. She was then discharged home but returned to the ED the next day for incapacitating mid-back pain. She then got a CT scan of the chest which showed a T7 compression fracture. Sagittal and coronal CT images are shown above. There are no retropulsed fragments or neurological impingement. She denies any radicular symptoms. Her bowel and bladder function is intact. What is the next best treatment option for this patient?
-
Question 13 of 60
13. Question
A 10-year old male presents to the office with a 4 month history of right ankle pain. The pain started after he twisted his ankle during a baseball game. He was diagnosed with an ankle sprain and placed in a walking boot for 4 weeks. He then underwent 3 weeks of physical therapy before attempting a return back to sports. Unfortunately he continued to have ongoing pain and limp when participating in sports or recreational activities. On exam the patient has painful subtalar motion and direct tenderness to palpation over the talocalcaneal joint. Initial radiographs done in the office are negative. Which is the best study to determine if the patient’s pain is coming from a tarsal coalition?
-
Question 14 of 60
14. Question
Which location of a scaphoid fracture has the highest nonunion rate?
-
Question 15 of 60
15. Question
Elevation of which laboratory finding would raise suspicion of Paget’s disease?
-
Question 16 of 60
16. Question
A fracture through the epiphysis and physis, but sparring the metaphysis is what Salter-Harris type fracture?
-
Question 17 of 60
17. Question
A 45-year old otherwise healthy female presents with left sided hip pain for 6 months. The pain has increased over the last month and she is now walking with a cane. She denies any injury or precipitating event. The pain is located in the groin and lateral side of the hip. The patient denies improvement of symptoms with rest and NSAIDs. She denies a history of alcoholism, steroid use, systemic lupus, and hypercoagulable disorders. AP x-ray and coronal MRI of the left hip are shown above. What is the best treatment option for this patient?
-
Question 18 of 60
18. Question
An 11-year old female presents to the office with a one month history of left hip pain. The pain started after dance class one month ago and has continued since. The patient and mother thought the pain was a muscle strain and did not seek medical attention until now. On exam the patient walks with a limp supporting the left leg. She is tender to palpation over the left thigh and is unable to internally rotate the hip actively. Passive external rotation causes pain as well. AP pelvis and frog leg lateral x-rays are obtained (Figures 1 and 2 above). What is the best choice of treatment for this patient?
-
Question 19 of 60
19. Question
A 29 year-old male presents to the ED with left shoulder pain following a motor vehicle accident. He lost control of his vehicle and his car rolled over. He believes something hit the front of his left shoulder during the accident and he is unable to move the shoulder since. AP and outlet x-rays are shown in Figures 1 and 2. An axial CT scan done shortly after the x-rays are shown in figure 3. Which finding can be seen on the AP x-ray that helps confirm the suspected diagnosis?
-
Question 20 of 60
20. Question
Which exam test is the most sensitive for diagnosing rotator cuff tendinitis caused by impingement syndrome?
-
Question 21 of 60
21. Question
Which meniscal tear is the most amenable to being repaired?
-
Question 22 of 60
22. Question
Which physical exam test is used to reproduce the symptoms associated with sacroiliac (SI) joint?
-
Question 23 of 60
23. Question
A 16-year old patient presents to the office with a 2 day history of right knee pain after a gymnastics injury. She admits to feeling a “pop” as she fell awkwardly during a landing. She has had difficulty with ambulation since the injury. On exam the patient is guarded and difficult to evaluate. She is unable to fully extend her right knee during the exam. Sagittal MRI images of the right knee are shown above. What is the most likely diagnosis?
-
Question 24 of 60
24. Question
A 33-year old male presents with left shoulder pain for three weeks. He denies injuring the shoulder and admits the pain is getting worse with physical activities. He is employed as a security guard and works out at the gym on a daily basis. He particularly notices the pain when doing bench presses. On exam the patient has full passive and active range of motion of the left shoulder. He has a negative Neer’s sign and O’brien’s test. He has increased pain with horizontal adduction of the left arm. X-rays are shown above. What is the most likely diagnosis?
-
Question 25 of 60
25. Question
A 9-year old boy presents with a 2 month history of right heel pain that has worsened over the past two weeks. He is an avid soccer player who plays at least 2 hours a day 6-7 days a week. His parents state he is a very talented player who plays on a number of all-star teams throughout the year. On exam of the heel he has tenderness over the calcaneal apophysis that is made worse with active plantar flexion and passive dorsiflexion. A lateral x-ray is shown above. What is the most likely diagnosis?
-
Question 26 of 60
26. Question
A 38-year old female presents to the office with severe right lower extremity radiculopathy for 2 weeks. On exam she walks with difficultly supporting her right leg but no obvious foot drop is seen. The patient has a positive straight leg raise and weakness of the extensor hallucis longus (EHL) muscle on exam. MRI performed prior to the visit reveals a right-sided posterior lateral disc herniation at L4-L5. The patient states that oral ibuprofen and rest over the last several days are not helping with the pain. She is still having significant difficulty with activities of daily living. Which choice would be the most appropriate treatment at this time?
-
Question 27 of 60
27. Question
Which Cobb angle is an indication for surgical treatment in adolescent idiopathic scoliosis?
-
Question 28 of 60
28. Question
A 45-year old male presents with 2 weeks of left lower extremity radiculopathy. After reviewing the patients MRI images above, which physical exam findings are most likely to be found in this patient?
-
Question 29 of 60
29. Question
After reviewing the MRI above, which physical exam findings are most likely to be seen in this patient?
-
Question 30 of 60
30. Question
A 74-year old female with a history of left-sided cerebrovascular accident presented to the emergency department with a 2-day history of left hip pain. She fell at home 2 days previously and chose not to seek medical attention initially because she thought the pain would improve. The patient lives with her son, who brought her to the emergency department for evaluation. Based on the radiographs above, what would be the next best choice of treatment for this patient?
-
Question 31 of 60
31. Question
A 46-year-old male presents to your office with a history of right proximal anterolateral thigh swelling after a dirt bike accident 6 weeks ago. He was able to walk with mild discomfort after the injury and did not immediately seek medical attention. The thigh swelling developed a few days after the injury and worsened over the first week. He then saw his primary care physician, who ordered a CT scan of his right hip and thigh. The CT scan showed a large fluid collection between the subcutaneous fat and the muscle compartment of the anterior thigh (Figure 1). No fractures were visible on the CT scan. He was then referred to a wound care specialist who aspirated his thigh hematoma on four occasions, each about one week apart. Each aspirate yielded approximately 160-200 milliliters of red tinged fluid and significantly relieved his pain. However, within 4-5 days after each aspiration the swelling and pain returned. He presents to your office 6 weeks from injury for further evaluation. On exam a large fluctuant area of swelling is noted over the proximal anterolateral thigh (Figure 2). What is the name of the lesion causing this patients persistent thigh swelling?
-
Question 32 of 60
32. Question
Nonoperative treatment of the injury shown above will most likely lead to what long term deficit?
-
Question 33 of 60
33. Question
A 15-year old male presents to the emergency department with severe right leg pain after a skateboarding injury. X-rays show a displaced Salter-Harris type II distal femur fracture. What is the best treatment option for this patient?
-
Question 34 of 60
34. Question
The approach to an open Achilles tendon repair is generally through a longitudinal incision just medial to the tendon. Which nerve is at the highest risk for injury using a laterally placed incision?
-
Question 35 of 60
35. Question
A toe deformity characterized by DIP flexion, PIP flexion, and MTP hyperextension is called?
-
Question 36 of 60
36. Question
A 49-year old male presents to the office with left foot and ankle pain for approximately two years. He notes that he has been flat footed for quite some time. He states most of his pain seems to be in the medial and lateral ankle with occasional pain in the midfoot. On exam the patients right foot is in pes planus alignment and a “too many toes sign” is noted. Significant pain and limited motion is present with subtalar, calcaneal-cuboid, and talonavicular motion. What is the most likely diagnosis?
-
Question 37 of 60
37. Question
An 18-year old competitive dancer presents with several months of left foot pain. She has been seen in the past by her PCP and podiatrist who have treated her for sesamoiditis. She has tried a period of non-weight bearing, NSAIDS, custom orthotics, and physical therapy yet the pain continues to persist during dance. On exam the patient has focal tenderness over the medial sesamoid of the left great toe. X-rays are shown above including a sesamoid view. What is the best treatment option for this patient?
-
Question 38 of 60
38. Question
Which arrow points to the Haglund’s deformity?
-
Question 39 of 60
39. Question
A 61-year old male was pulling his boat engine cord and caught his right ring finger. He noticed immediate pain and loss of flexion at the DIP joint. Radiographs were obtained and are shown above. What is the likely diagnosis?
-
Question 40 of 60
40. Question
A 3-year old boy is playing with his brother and catches his finger on the edge of a desk drawer. He sustains a laceration to his right ring finger. On exam, he is unable to actively bend his ring finger at the DIP joint. He has 90 degrees of flexion at the PIP joint. What tendon did he lacerate?
-
Question 41 of 60
41. Question
A 57-year old male presents with several years of right wrist pain. He believes the pain started after a dirt bike accident when he was in college. He remembers falling off his bike onto his outstretched hand. He never sought medical attention after the injury and has had pain off and on since. The pain seems to be worse over the last couple weeks and he is having increasing weakness with his golf swing. X-rays of the wrist taken at an urgent care office recently show chronic degenerative changes of the wrist associated with prior avascular necrosis of the scaphoid (figures 1 and 2 above). The patient had minimal relief from prior wrist injections done a couple years ago. What choice is the next best step in treatment?
-
Question 42 of 60
42. Question
A 56-year old male presents with several months of progressive weakness of the right hand. He works in construction and has had difficulty grasping objects. On exam you notice atrophy to the first dorsal web space shown in the image above. This physical exam finding is consistent with entrapment of which nerve?
-
Question 43 of 60
43. Question
A 9-year old girl presents to the office with right arm pain after falling down a few steps at home. She felt her arm twist as she grabbed the rail to catch her fall. On x-ray a pathological fracture of the proximal humerus is found. The patient denies any pain in the arm prior to the fall. What is the best treatment option?
-
Question 44 of 60
44. Question
A 47-year old female presents to the emergency department with severe right hip pain after a standing height fall at home. She took a few steps off her front porch and her right leg collapsed from underneath her. She was unable to bear weight and was brought to the ED by EMS. X-rays of the right femur reveal a pathological subtrochanteric femur fracture. The patient was diagnosed with small cell lung cancer in the right upper lobe 6 months ago and is currently undergoing chemotherapy treatments. PET/CT scan one month ago revealed invasion into the mediastinum and right paravertebral area. You are called to evaluate the patient in the ED. Which choice is the next best step in treating this patient?
-
Question 45 of 60
45. Question
A 17-year old male presents to the office with a mass on the lateral aspect of his right knee. He noticed the mass approximately 6 months ago and doesn’t believe it has grown since. He denies pain at rest but he is starting to have pain over the mass when running. On exam the patient has a firm, nontender 2 cm mass over the lateral supracondylar femur. A positive Ober’s test is noted. AP and lateral x-rays are shown above. What is the most likely diagnosis?
-
Question 46 of 60
46. Question
A 13-year old male presents with left ankle pain after a fall 5 days ago. X-rays done at an outside urgent care facility show no evidence of a fracture (Figures 1 and 2 above). His exam reveals pain to palpation over the distal fibula physis consistent with a Salter-Harris type 1 fracture. An incidental bone cyst is noted in the distal tibia and the patient’s parents would like to know if the lesion requires further treatment. Which choice is the most appropriate recommendation?
-
Question 47 of 60
47. Question
A 61-year-old woman presents to your office with pain and deformity of the left second toe. The toe has been bothering her for years, but the pain recently has worsened. It is particularly made worse when she wears dress shoes. She went to a podiatrist a year ago, and a toe crest and foam toe caps were recommended; however, these failed to provide relief. She also dislikes wearing shoes with high toe boxes because she wears dress shoes to work. On examination, you note a hammer-toe deformity of the left second toe that does not correct passively or with ankle plantar flexion. The hammer-toe deformity is shown in Figures 1 and 2. Which treatment option would be the best choice for this patient? -
Question 48 of 60
48. Question
A 36-year-old woman presents to the emergency department with a severe injury to the right wrist after a motor vehicle accident. She had been a passenger when the vehicle was hit head-on. She sustained the wrist injury when the right arm braced for impact. Anteroposterior and lateral radiographs made in the emergency department are shown in Figures 1 and 2, respectively.Which choice is the next best step in this patient’s treatment? -
Question 49 of 60
49. Question
A 55-year-old woman presents to your office with neck pain and upper-extremity weakness after a motor vehicle accident that occurred 1 week prior. She reports that her car had been hit from behind, and she had sustained a whiplash injury. She notes that she had not lost consciousness, and she had been transferred from the accident scene to the emergency department for additional evaluation. Computed tomography (CT) was negative for cervical fractures and instability, and she had been discharged home wearing a soft cervical collar. Upon presentation to your office 1 week later, she notes severe bilateral arm weakness, “clumsy hands,” and mild lower-extremity weakness with walking. On examination, the bilateral upper-extremity muscle groups have a strength of 3 of 5, and the lower-extremity muscle groups have a strength of 5 of 5. Sensation remains intact throughout the upper and lower extremities. The patient does not report any bowel or bladder changes. Anteroposterior and lateral radiographs were made in the office (Figs. 1 and 2 above). What is the most likely diagnosis? -
Question 50 of 60
50. Question
A 15 year-old girl presents to your office after sustaining a primary patella dislocation of her right knee 3 days ago. She was playing volleyball and went for the ball when she felt a pop and her knee gave way. There was an obvious deformity to the knee and she was transported to the hospital by ambulance. The attending emergency room physician reduced the patella dislocation upon arrival. Post-reduction x-rays confirmed the patella had been reduced. The emergency rooms notes from the encounter confirm the patient’s story. On exam the patient is guarded and has difficulty moving the knee. She is able to extend her knee and the patella remains reduced with passive range of motion from 0 to 40 degrees of flexion. She has a +1 joint effusion and tenderness to palpation medially over the retinaculum. Post-reduction x-rays show no evidence of fracture. A sunrise view taken in the office shows a centrally located patella with a normal trochlea groove. An axial MRI image shows a moderate osseous contusion at the anterior lateral femoral condyle and inferomedial pole of the patella consistent with a previous lateral patella dislocation. There is a slight amount of high signal in the medial retinaculum without signs of tearing or rupture. There is no evidence of cartilage defect or loose body. What is the next best step in this patient’s treatment?
-
Question 51 of 60
51. Question
Which choice below does NOT cause an increased risk of patella instability?
-
Question 52 of 60
52. Question
A 14-year old male presents to your office with a history of left thumb pain after sliding into a base hand first during a game. He felt immediate pain after the thumb hit the base and he was unable to continuing playing after. He has also noticed weakness with grip strength since the injury. AP and lateral radiographs taken at urgent care show no fracture or abnormalities. On exam the metacarpalphalangeal (MCP) joint of the thumb is noted to have significant instability when valgus force is applied in extension and in 30 degrees of flexion. He has tenderness over the ulnar side of the proximal phalanx where a small mass is palpated. What would be the next appropriate step in treatment?
-
Question 53 of 60
53. Question
A 13‐year old girl presents to your office with a 4 month history of anterior lateral right knee pain. She believes the pain started when she took a fall while skiing. She has since played through her basketball season and is now playing lacrosse. She had occasional swelling after games and episodic “popping” with knee extension, especially with sports and going down stairs. She denies any locking or giving way of the knee. X‐rays done in the office show no abnormalities or fracture. Sagittal MRI image of the right knee shows a discoid lateral meniscus with extensive horizontal tearing. What is the recommend treatment for this patient’s discoid lateral meniscus tear?
-
Question 54 of 60
54. Question
A 19-year old female presents to your office 5 days after injuring her right arm during a bike accident. She was thrown over the handle bars and landed on her right elbow. X-rays taken in the ED show a displaced midshaft humerus fracture (x-ray above). She was placed in a coaptation fiberglass splint to the right arm in the ED and was instructed to follow-up with orthopedics. On exam of the arm, gross motor function and sensation remains intact. Which choice is the best treatment option for this patient? -
Question 55 of 60
55. Question
A 19 year-old female presents to the office with chronic instability of the left ankle. She is an avid soccer player and has had multiple sprains over the last few years. She has tried bracing and ankle taping before games and still has instability episodes. She has also had several months of physical therapy without resolution of symptoms. On exam the patient has an increased anterior drawer test and slight talar tilt compared to the contralateral ankle. X-rays of the left ankle show no abnormalities. She was seen by a foot and ankle specialist recently who recommended a surgical procedure called a Modified Brostrum procedure to help stabilize her ankle for a return to sports. Which ligaments does the modified Brostrum procedure repair in order to correct ankle instability?
-
Question 56 of 60
56. Question
A 56 year-old female presents to your office with a several month history of left forefoot pain. She denies prior injury or known precipitating event. The pain seems to be located between the 2nd and 3rd toes and is made worse with tight shoes. She really notices the pain when she wears high heels and works out at the gym. On exam you note increased pain when squeezing the metatarsal heads together. AP and lateral x-rays of the left foot show no abnormalities. Which choice below would best help confirm the patient’s diagnosis?
-
Question 57 of 60
57. Question
A 49 year-old female presents with a 4 month history of left shoulder pain. She enjoys going to the gym and cross training but her shoulder has been bothering her with overhead activities. She received a subacromial injection 2 months ago then did several weeks of physical therapy with minimal relief. AP and outlet radiographs show no abnormalities. MRI shows a partial thickness articular sided rotator cuff tear of the left shoulder. The patient is taken to the operating for a left shoulder arthroscopy which reveals a partial tear through 60% of the depth of the supraspinatus tendon. What would be the next best step in treatment?
-
Question 58 of 60
58. Question
A 38 year-old male presents to emergency department by way of ambulance after sustaining a right leg injury. He was doing land clearing and had a wood log roll on his leg. X-rays taken in the ED show a closed displaced midshaft tibia fracture. He was placed in a posterior long leg splint and admitted for intramedullary nail fixation the next day. However, in the middle of the night the patient began to complain of excruciating calf pain that was increasing despite additional intravenous pain medication given over the last few hours. You examine the patient with the splint off and note firm compartments of the right lower leg and severe pain that is made worse with passive dorsiflexion of the ankle. You suspect compartment syndrome and decide to measure the compartments of the affected lower extremity. When measuring the compartments, which choice below would indicate compartment syndrome and the need for emergent fasciotomy?
-
Question 59 of 60
59. Question
An 88 year-old male presents to your office complaining of right thigh pain for 2 months. The pain started after a large piece of ice fell on his thigh when he was shoveling around the house. He presented to the emergency department the day of the injury and x-rays of the right femur did not reveal there to be any fractures or abnormalities. He had follow up with his primary care physician on a few occasions over the last few months for his thigh swelling, bruising, and pain which has been slow to subside. Rest, ice, elevation, and NSAIDS seem to be helping. He states the swelling has improved slightly, however he still gets pain in the lateral mid-thigh and he is having a hard time with knee motion. On exam of his right lower extremity he has no obvious swelling or erythema to the right thigh. He has mild tenderness to palpation over a small firm mass on the lateral mid-thigh. He also has diminished active motion of the hip and knee secondary to right lateral thigh pain. Repeat x-rays taken in the office show a calcified mass on the right lateral midshaft femur (marked with a white arrow in figure 1 above). What is the next best step in treatment for this patient? -
Question 60 of 60
60. Question
Which of the following choices is the gold standard screening tool for osteoporosis?