NPTE: MSK Advanced Differentials and Interventions

A patient presents with reports of pain and numbness in the right arm extending to the thumb. The physical therapist performs the special test, as shown in the picture below. If the test is positive, which is the MOST APPROPRIATE intervention?

Stretch the right pec minor and SCM muscles (grade 3 manips of the first and second ribs was wrong answer because you need a grade 5)

The patient reports of numbness and tingling in the forearm. The

physical therapist decides to perform upper limb tension test on the

patient. The test in the picture below is found to be positive. Based on

the findings, which nerve is MOST LIKELY causing the numbness and

tingling?

musculocutaneous

Median, anterior interosseous nerve bias

MAIN

Median, Axillary, Musculocutaneous nerve bias

MAM

Radial nerve bias

Ulnar, C8, T1 nerve bias

Subacromial impingement

RTC tear

Slap labrum tear

AC joint injury

A patient reports pain in the right shoulder, particularly with horizontal

adduction and active elevation beyond 120°. The lag sign and clunk test

were negative. This finding is MOST INDICATIVE of which shoulder

pathology?

Acromioclavicular joint injury

Painful arc is ___-___ degrees

60-120

Coracoacromial Arch

A key site of pathology and an active treatment site

• Superior Labrum Anterior Posterior (SLAP) lesion is superior

labrum tearing or pulling away by the biceps insertion, which is

under the subacromial arch

Repair of a SLAP lesion

A patient has undergone a repair of a full-thickness infraspinatus tear.

The patient is now 5 weeks post-surgery and reports improvements in

pain and range of motion. Which of the following exercises is currently

CONTRAINDICATED?

D2 upper extremity flexion

RTC rehab KEY POINTS

The patient presents to physical therapy with a 2-month history of pain along

the radial side of the right wrist. The patient reports that the pain worsens

with activities, such as lifting their infant and gripping objects. On

examination, there is tenderness over the first dorsal compartment of the

wrist. The Phalen's and Tinel's signs are negative. Range of motion of the

thumb is limited due to pain. Which of the following structures is MOST

LIKELY involved in the patient's condition?

Abductor Pollicis Longus and Extensor Pollicis Brevis (presentation consistent with de quervains tenosynovitis)

apple and extra peanut butter for APL and EPB

important MSK shoulder topics

Dequervain's tenosynovitis

Carpal tunnel syndrome

thenar muscle atrophy --> ape hand

Colles vs smith fracture

call me back for dinner

Elbow and wrist conditions

Opening, closing, protrusion, retraction, lateral deviation TMJ muscles and normal ROM

opening: L (say L with mouth open)

closing: MMT (say M with mouth closed)

A patient presents with right sided temporomandibular joint dysfunction. On examination, the patient has mouth opening of 25 mm and jaw deviates to the right side while opening. There is no significant pain or swelling. What is the MOST LIKELY diagnosis based on the patient's symptoms?

Hypomobility

TMJ hypomobility

Decreased mouth opening and deviation to same side

TMJ Hypermobility

Increased mouth opening and deviation to opposite side

TMJ Disc displacement with reduction

Clicking heard. No deviation, no difficulty with mouth opening

TMJ Synovitis

Pain and limited mouth opening, no deviation

TMJ Capsulitis

Pain, limited mouth opening and deviation to same side

Legg calve perthes vs slipped capital femoral epiphysis

What is the most appropriate intervention for legg calve perthes

Improving the containment of the femoral head in acetabulum using the brace

What is the most appropriate orthotic used in legg calve perthes disease?

scottish rite brace

A patient presents with pain and catching sensation in the right knee, which

started after twisting their knee while playing basketball. On examination,

there is tenderness over the joint line, pain with right knee hyperextension and

maximal right knee passive flexion. The patient MOST LIKELY has which of the

following diagnosis?

Meniscal tear

Meniscus injury key points

Popping, locking, catching sensation during movement,

joint line tenderness, swelling, pain with knee hyperextension and full flexion

Patellofemoral pain syndrome

Peripatellar pain, lateral patellar tracking, pain with squatting, prolonged sitting (movie theatre sign), commonly seen in young females

Osgood schlatter syndrome

Pain at tibial tuberosity, enlarged tibial tubercle, excessive activity in adolescents and poor flexibility

ACL vs PCL MOI, symptoms, special tests

A soccer player is seen at a physical therapy clinic 3 weeks post ACL reconstruction surgery. Which of the following is MOST APPROPRIATE while exercising this patient?

Partial squats between 0°-45° of flexion

A patient presents with numbness, tingling, and burning pain along the

medial ankle, radiating into the plantar surface of the foot. The

symptoms worsen with prolonged standing and walking. Upon

examination, the physical therapist notes tenderness posterior to the

medial malleolus and a positive Tinel's sign. Passive ankle dorsiflexion

and eversion aggravate the symptoms. What is the MOST LIKELY

diagnosis?

tarsal tunnel syndrome

Tarsal tunnel syndrome

Medial tibial stress syndrome

Achilles tendinitis

Plantar fascitis

A physical therapist is treating a patient who underwent Achilles tendon repair

surgery of the right lower extremity after experiencing a fall. The patient is currently at four and half week post-op status. Which of the following is most likely to be CONTRAINDICATED at this stage?

CAM orthosis that allows free dorsiflexion