A 47-year-old man presents with lower back pain that has been bothering him for the past 2 weeks. There are no signs of trauma or systemic symptoms, and his clinical and neurological examinations are normal. You advise him to stay active and provide him with a list of exercises to do at home. However, he requests pain relief to help him get through the day. What is the best initial medication to prescribe?
A 67-year-old male presents to eye casualty with partial loss of vision in his left eye. Upon further questioning, he reports that he has also had a temporal headache for around 2 weeks and has felt generally unwell. He denies any jaw pain when chewing but does have some scalp tenderness. Blood tests are taken which show an ESR of 65mm/hr.
He has a past medical history of type 2 diabetes and he smokes 20 cigarettes per day.
What is the most appropriate initial management for the likely diagnosis?
A 25-year-old man suffers an open tibial fracture following an incident with industrial equipment. The fracture is a simple oblique break in his distal tibia, accompanied by an 8 cm ragged wound. Despite this, the limb’s neurovascular function remains intact. What is the most suitable initial course of action?
A 65-year-old woman who has been on long-term prednisolone for polymyalgia rheumatica complains of increasing pain in her right hip joint. During examination, she experiences pain in all directions, but there is no indication of limb shortening or external rotation. An X-ray of the hip reveals microfractures and osteopenia. What is the probable diagnosis?
A 67-year-old woman visits her GP complaining of back and leg pain while walking for the past 8 months. She has noticed a decrease in her walking distance over the last 3 months due to an increase in pain severity. She finds relief from her pain when bending over. Walking downhill is difficult for her, but she can manage uphill without symptoms. She has a medical history of type 2 diabetes. On examination, there is no weakness or atrophy of the leg muscles, and distal foot pulses are present. What is the most probable diagnosis?
A 28-year-old mother of a three-month-old baby visits the clinic with a concern of experiencing wrist pain for a week. The pain is located on the radial side of her wrist, and she feels tenderness over the radial styloid process. What is the probable diagnosis?
A 57-year-old woman presents to her GP with pain in her left hand. She reports that the pain is located at the base of her left thumb and is a constant ache that worsens with movement. The patient states that the pain has been progressively worsening over the past year. She has a medical history of gout in her big toe, which is managed with allopurinol. Her mother was diagnosed with rheumatoid arthritis five years ago, and she is concerned that she may also have this condition. On examination, there is tenderness on palpation of the left thumb base, and unilateral squaring of the left thumb is observed. What is the most likely diagnosis based on this history and clinical examination?
A 15-year-old boy complains of dull, throbbing pain and swelling in his left knee that is aggravated by his routine basketball practices. The boy also experiences a sensation of the left knee joint getting stuck and a painful ‘click’ when bending or straightening the left knee. Physical examination of the knee joint reveals a slight accumulation of fluid and a detectable loose body. Furthermore, tenderness is noticeable upon palpating the femoral condyles while the knee is flexed. What is the most appropriate diagnosis for this condition?
A 25-year-old man comes to you with a history of back pain that has been getting worse over the past year. The pain and stiffness are more severe in the morning but improve with exercise. During your examination, you notice a flexural rash with poorly defined areas of erythema, dry skin, and lichenification. All observations appear normal. The blood test results show an ESR of 84 mm/hr (normal range: 0-22) and a CRP of 6 mg/L (normal range: 0-10). ANA, RhF, and Anti-CCP tests are all negative. What is the most likely diagnosis?
A 55-year-old woman complains of pain under her left thumb for the past 2 weeks. She denies any history of injury. She is left-handed and works as a writer.
During the physical examination, there is no apparent swelling or abnormality. However, there is tenderness over the ulnar styloid process. When the patient’s thumb is grasped and the hand is radially deviated, she experiences sharp pain in the proximal radius.
What is the probable diagnosis?