EMQs in Clinical Medicine.pdf - Peshawar Medical College

120 Orthopaedics and rheumatology
50 Shoulder problems
A
B
C
D
E
F
ruptured long head of biceps
Sprengel’s shoulder
tendonitis, long head of biceps
osteoarthritis
impingement syndrome
rheumatoid arthritis
G
H
I
J
K
L
posterior dislocation shoulder
anterior dislocation shoulder
fracture clavicle
fractured neck of humerus
adhesive capsulitis
fractured scapula
For each clinical scenario below, give the most likely cause for the clinical findings.
Each option may be used only once.
1 A 21-year-old woman presents with a very painful shoulder locked in medial
rotation after an epileptic fit.
2 A 55-year-old man complains of shoulder pain aggravated in abduction of arm
between 60° and 120°.
3 A 30-year-old bodybuilder presents with an aching shoulder. Flexing elbow
reveals a prominent lump in the upper arm.
4 A 50-year-old man complains of a 9-month history of stiffness in the shoulder.
The shoulder was originally extremely painful but now only the stiffness remains.
5 A 65-year-old woman presents with shoulder pain and restricted movement in all
directions. Her radiograph shows reduced joint space and subchondral sclerosis.
Answers: see page 133.