Challenge Bowl Musculoskeletal

Front 1

Rickets is associated with what vitamin deficiency?

Back 1

Vitamin D

Front 2

A 51 year old black male with a history of diabetes and renal failure presents with a painless soft tissue mass on his right shoulder. His phosphate level is elevated. Biopsy of the mass revealed fibroblasts and collagen fibers. Xrays of the right shoulder reveal calcification of the soft tissue mass. What is the most likely diagnosis?

Back 2

Tumoral calcinosis (soft tissue, contains chalky material, associated with DM, renal failure, hyperparathyroidism, more prevalent in blacks)

Front 3

What muscle groups are most commonly affected in dermatomyositis?

Back 3

Proximal muscle groups

Front 4

Reiter's syndrome presents with what symptoms?

Back 4

Nongonococcal urethritis, conjunctivitis, and arthritis (Can't see, can't pee, can't climb a tree)

Front 5

Mucoid medial degeneration is often seen in patients with what genetic disease?

Back 5

Marfan's syndrome (aka cystic medial necrosis)

Front 6

What ligament is lax when the knee is extended?

Back 6

PCL

Front 7

Arteritis, polyarthritis, dermatitis, glomerulonephritis, retinopathy, and calcinosis in a child is consistent with what diagnosis?

Back 7

dermatomyositis (arteritis especially suggestive, could also see dysphagia)

Front 8

Bone deformation with increased vascular supply leading to fracture and possible high output heart failure is indicative of what disease?

Back 8

Paget's disease of bone

Front 9

A patient with osteitis fibrosa cystica exhibits fibrous degeneration of bone with removal of bone matrix. This would relate to what type of increased activity?

Back 9

Osteoclastic activity

Front 10

Ankylosing spondylitis is associated with what phenotype?

Back 10

HLA B27

Front 11

What crystals are most commonly deposited in gout?

Back 11

Uric acid

Front 12

What nerve innervates the rectus femoris muscle?

Back 12

Femoral nerve

Front 13

The angle of Louis is located where?

Back 13

Midsternal 2nd rib, right below manubrium

Front 14

A 65 year old carpenter presents to your office with complaints of wrist pain. There is no tenderness to palpation, full range of motion, decreased strength, and positive Phalen's test. What is the diagnosis?

Back 14

Carpal tunnel syndrome

Front 15

What bone is associated with Kienbock's disease?

Back 15

Lunate of wrist

Front 16

What are the 5 P's associated with compartment syndrome?

Back 16

Pain, pallor, paresthesia, pulselessness, paralysis

Front 17

Where can you find the Tunnel of Guyon?

Back 17

The volar aspect of the hand

Front 18

Where is a Baker's cyst located?

Back 18

Popliteal fossa

Front 19

What are the 4 rotator cuff muscles?

Back 19

Subscapularis, supraspinatus, infraspinatus, teres minor

Front 20

What is the most common form of muscular dystrophy?

Back 20

Duchenne

Front 21

Gower's sign is an indication of what disease?

Back 21

Muscular dystrophy

Front 22

A winged scapula can result from an injury to what nerve?

Back 22

Long thoracic

Front 23

Name the hamstring muscles.

Back 23

Semitendinosus, semimembranosus, Biceps femoris

Front 24

Often injured via FOOSH mechanism, this carpal bone fracture is often unperceivable on regular xray?

Back 24

Scaphoid

Front 25

Display of a "piano key sign" after shoulder trauma indicates involvement of what joint?

Back 25

A-C joint (acromioclavicular)

Front 26

Classified by dislocation of the head of the radius from the annular ligament, this injury is common in young children.

Back 26

Nursemaid's elbow

Front 27

Innervation to the medial compartment of the thigh is supplied by this nerve.

Back 27

Obturator

Front 28

Indicative of osteoarthritis, these hard bony outgrowths occur on the proximal interphalangeal joints.

Back 28

Bouchard's nodes

Front 29

Indicative of osteoarthritis, these hard bony outgrowths occur on the distal interphalangeal joints.

Back 29

Heberden's nodes

Front 30

Indicative of rheumatoid arthritis, this deformity affects the proximal interphalangeal joints.

Back 30

Boutonneire deformity

Front 31

Indicative of rheumatoid arthritis, this deformity affects the distal interphalangeal joints.

Back 31

Swan neck deformity

Front 32

Injured structures of the "terrible triad" include:

Back 32

ACL, MCL, medial meniscus

Front 33

Kehr's sign after thoracic trauma is indicative of this condition:

Back 33

Ruptured spleen (Kehr's sign = pain radiating to left shoulder)

Front 34

Codman's triangle

Back 34

Osteosarcoma

Front 35

Heliotrope rash & scaly red rash on dorsum of hand

Back 35

Dermatomyositis (Gottron's sign = rash)