MSK- Rx

Question 1

Arthritis, yellow-white lesions on ears and Archilles tendon. Diagnosis?

Answer 1

chronic gout

• extra-articular sites of tophi formation are Archilles tendon and external ear

Question 2

Achondroplasia is associated with what conditions in parents?

Answer 2

advanced paternal age

Question 3

Which nerve innervates biceps?

Answer 3

musculocutaneous and radial

upper trunk damage (Erb’s palsy) may lead to impaired biceps

Question 4

What kind of bone fracture is sign of child abuse?

Answer 4

spiral fracture

when adults twist child bone

Question 5

How sensation is affected in

• L4-L5 disc herniation
• L5-S1 disc herniation

Answer 5

L4-L5 herniation: L5 dermatome defect
=> lateral AND MEDIAL foot sensation

L5-S1 herniation: S1 dermatome defect
=> ONLY LATERAL foot sensation
=> MEDIAL is INTACT (S1 does NOT cover medial foot)

• this is little tricky:
  peroneal (L4-L5) is associated with lateral foot movement (eversion dorsiflexion), while tibial (L5-S1) is medial foot movement.
  BUT, in terms of SENSATION, dermatome distribution is little different.
  L5 dermatome: lateral + medial
  S1 dermatome: only lateral (although tibial mediates MEDIAL MOTION)