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I-HUMAN CASES EXAM MUSCULOSKELETAL SYSTEM LATEST
VERSION QUESTIONS AND ANSWERS 2026 EDITION
I-Human Cases Exam: Musculoskeletal System
70 Questions with Detailed Rationales
Based on Common i-Human Virtual Simulation Scenarios
CASE 1: 72-Year-Old Female with Right Hip Pain – Osteoarthritis (Questions 1-12)
Question 1
A 72-year-old female presents with progressive right hip pain that has worsened
over the past 6 months. She reports pain when walking, especially when getting up
from a chair. She rates the pain as 5-6/10. She uses a cane but has not seen a
doctor for this issue. What is the most likely diagnosis?
A) Rheumatoid arthritis
B) Osteoarthritis
C) Septic arthritis
D) Polymyalgia rheumatica
Answer: B
Rationale: Osteoarthritis is the most common type of arthritis in older adults,
characterized by progressive joint pain, stiffness (especially after rest), and functional
limitations. Rheumatoid arthritis typically presents with symmetric joint involvement
and systemic symptoms.
Question 2
What is the most important assessment finding in a patient with suspected
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osteoarthritis?
A) Bilateral joint pain
B) Morning stiffness lasting more than 1 hour
C) Joint pain that worsens with activity and improves with rest
D) Fever and chills
Answer: C
Rationale: Osteoarthritis pain is typically mechanical, worsening with activity and
improving with rest. Morning stiffness is usually brief (<30 minutes) in OA, distinguishing
it from inflammatory arthritis. Rheumatoid arthritis has prolonged morning stiffness.
Question 3
The patient has limited flexion and internal rotation of the right hip. What is the
most appropriate imaging study?
A) X-ray of the right hip
B) MRI of the right hip
C) CT scan of the right hip
D) Ultrasound of the right hip
Answer: A
Rationale: X-ray is the first-line imaging study for suspected osteoarthritis. It can show
joint space narrowing, osteophytes, and subchondral sclerosis. MRI is reserved for
more complex cases or suspected avascular necrosis.
Question 4
What X-ray finding is most characteristic of osteoarthritis?
A) Joint space narrowing and osteophytes
B) Erosions and periarticular osteopenia
C) Joint effusion and soft tissue swelling
D) Bilateral symmetric joint involvement
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Answer: A
Rationale: Osteoarthritis is characterized by joint space narrowing, osteophyte
formation, and subchondral sclerosis. Erosions and periarticular osteopenia are more
characteristic of rheumatoid arthritis.
Question 5
What is the most appropriate first-line treatment for osteoarthritis?
A) NSAIDs and physical therapy
B) Opioids
C) Corticosteroid injections
D) Joint replacement surgery
Answer: A
Rationale: NSAIDs and physical therapy are first-line treatments for osteoarthritis.
Weight loss and exercise are also important. Opioids are not first-line. Surgery is
reserved for patients who do not respond to conservative management.
Question 6
The patient reports her pain is worse at night and wakes her up. What does this
symptom suggest?
A) Mild osteoarthritis
B) Inflammatory arthritis
C) Severe osteoarthritis
D) Fibromyalgia
Answer: C
Rationale: Night pain and pain at rest are signs of severe osteoarthritis. These
symptoms indicate significant cartilage loss and joint degeneration, often requiring
surgical intervention.
I-HUMAN CASES EXAM MUSCULOSKELETAL SYSTEM LATEST
VERSION QUESTIONS AND ANSWERS 2026 EDITION
I-Human Cases Exam: Musculoskeletal System
70 Questions with Detailed Rationales
Based on Common i-Human Virtual Simulation Scenarios
CASE 1: 72-Year-Old Female with Right Hip Pain – Osteoarthritis (Questions 1-12)
Question 1
A 72-year-old female presents with progressive right hip pain that has worsened
over the past 6 months. She reports pain when walking, especially when getting up
from a chair. She rates the pain as 5-6/10. She uses a cane but has not seen a
doctor for this issue. What is the most likely diagnosis?
A) Rheumatoid arthritis
B) Osteoarthritis
C) Septic arthritis
D) Polymyalgia rheumatica
Answer: B
Rationale: Osteoarthritis is the most common type of arthritis in older adults,
characterized by progressive joint pain, stiffness (especially after rest), and functional
limitations. Rheumatoid arthritis typically presents with symmetric joint involvement
and systemic symptoms.
Question 2
What is the most important assessment finding in a patient with suspected
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osteoarthritis?
A) Bilateral joint pain
B) Morning stiffness lasting more than 1 hour
C) Joint pain that worsens with activity and improves with rest
D) Fever and chills
Answer: C
Rationale: Osteoarthritis pain is typically mechanical, worsening with activity and
improving with rest. Morning stiffness is usually brief (<30 minutes) in OA, distinguishing
it from inflammatory arthritis. Rheumatoid arthritis has prolonged morning stiffness.
Question 3
The patient has limited flexion and internal rotation of the right hip. What is the
most appropriate imaging study?
A) X-ray of the right hip
B) MRI of the right hip
C) CT scan of the right hip
D) Ultrasound of the right hip
Answer: A
Rationale: X-ray is the first-line imaging study for suspected osteoarthritis. It can show
joint space narrowing, osteophytes, and subchondral sclerosis. MRI is reserved for
more complex cases or suspected avascular necrosis.
Question 4
What X-ray finding is most characteristic of osteoarthritis?
A) Joint space narrowing and osteophytes
B) Erosions and periarticular osteopenia
C) Joint effusion and soft tissue swelling
D) Bilateral symmetric joint involvement
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Answer: A
Rationale: Osteoarthritis is characterized by joint space narrowing, osteophyte
formation, and subchondral sclerosis. Erosions and periarticular osteopenia are more
characteristic of rheumatoid arthritis.
Question 5
What is the most appropriate first-line treatment for osteoarthritis?
A) NSAIDs and physical therapy
B) Opioids
C) Corticosteroid injections
D) Joint replacement surgery
Answer: A
Rationale: NSAIDs and physical therapy are first-line treatments for osteoarthritis.
Weight loss and exercise are also important. Opioids are not first-line. Surgery is
reserved for patients who do not respond to conservative management.
Question 6
The patient reports her pain is worse at night and wakes her up. What does this
symptom suggest?
A) Mild osteoarthritis
B) Inflammatory arthritis
C) Severe osteoarthritis
D) Fibromyalgia
Answer: C
Rationale: Night pain and pain at rest are signs of severe osteoarthritis. These
symptoms indicate significant cartilage loss and joint degeneration, often requiring
surgical intervention.
