Physiotherapy Year 1 MSK Questions and Graded Answers, 100%
Guarantee
Atherogenic - Joints and bones
Myogenic - Muscles and tendons
Neurogenic - Peripheral nerves, spinal cord, and brain
Others - Vascular, other soft tissues, and organs
Red flags to observe - Tumours, infection, fractures, neurological damage, and vascular
emergencies.
Signs of red flags - Excessive symptoms, pain, numbness, pins and needles, symptoms of
instability, symptoms not matching MOI/problem.
What are special questions - questions which help diagnosis e.g. any pain or numbness,
any swelling, any feelings of instability/locking/giving way, any audible pops/clicking.
What are red flag questions - questions which indicate more serious pathology e.g. cauda
equina symptoms, PMH THREADS (thyroid, heart, epilepsy, rheumatoid, diabetes,
steroids/surgery) questions.
Stages of objective assessment - preparation, observation, clearing joints, AROM &
PROM, palpation, 'special tests', muscle tests, functional testing, and outcome measures
Second part of objective assessment - Analysis, diagnosis?, identifying outcome
measures, problem list, plan/propose Rx, Rx & evaluate.
, Clearing joints - checking the joints/regions above or below the affected area
Ankle -
Special tests for the ankle - Ottawa rules palpation (ankle fracture), calf squeeze
test/Thompson (Achilles rupture), anterior draw and talar tilt (lateral ligaments ATFL/CFL) and
DF/eversion (high ankle sprain).
Functional and capacity tests - timed SLS/Y Balance, Gait analysis, running analysis,
jump tests (for distance, height, single or triple), Hop (single, triple, crossover, 6 metre timed)-
usually aim for <10% difference between affected and unaffected legs.
Outcome measures - clinician/measured or patient reported. Provide a baseline
measurement to compare within and between sessions. E.g. goniometry or knee to wall test
Ottawa rule 1 - Series of x-rays required if there is pain in malleolar zone: bone
tenderness in posterior edge of lateral malleolus (6cm up), or bone tenderness in posterior edge
of medial malleolus (6cm up), or inability to bear weight both immediately and in emergency
department.
Ottawa rule 2 - Series of x-rays required if there is pain in mid-foot zone: bone tenderness
at base of 5th metatarsal, bone tenderness at navicular, or inability to weight bear both
immediately and in emergency department
Thompson test/ calf squeeze - squeeze calf while patient is in front- if slight plantar
flexion the Achilles is intact.
Anterior draw test - start 90-degree knee flexion, 10 degree plantar, pull talus anteriorly or
push tibia posteriorly, tests integrity of AFTL- does it create dimple
Guarantee
Atherogenic - Joints and bones
Myogenic - Muscles and tendons
Neurogenic - Peripheral nerves, spinal cord, and brain
Others - Vascular, other soft tissues, and organs
Red flags to observe - Tumours, infection, fractures, neurological damage, and vascular
emergencies.
Signs of red flags - Excessive symptoms, pain, numbness, pins and needles, symptoms of
instability, symptoms not matching MOI/problem.
What are special questions - questions which help diagnosis e.g. any pain or numbness,
any swelling, any feelings of instability/locking/giving way, any audible pops/clicking.
What are red flag questions - questions which indicate more serious pathology e.g. cauda
equina symptoms, PMH THREADS (thyroid, heart, epilepsy, rheumatoid, diabetes,
steroids/surgery) questions.
Stages of objective assessment - preparation, observation, clearing joints, AROM &
PROM, palpation, 'special tests', muscle tests, functional testing, and outcome measures
Second part of objective assessment - Analysis, diagnosis?, identifying outcome
measures, problem list, plan/propose Rx, Rx & evaluate.
, Clearing joints - checking the joints/regions above or below the affected area
Ankle -
Special tests for the ankle - Ottawa rules palpation (ankle fracture), calf squeeze
test/Thompson (Achilles rupture), anterior draw and talar tilt (lateral ligaments ATFL/CFL) and
DF/eversion (high ankle sprain).
Functional and capacity tests - timed SLS/Y Balance, Gait analysis, running analysis,
jump tests (for distance, height, single or triple), Hop (single, triple, crossover, 6 metre timed)-
usually aim for <10% difference between affected and unaffected legs.
Outcome measures - clinician/measured or patient reported. Provide a baseline
measurement to compare within and between sessions. E.g. goniometry or knee to wall test
Ottawa rule 1 - Series of x-rays required if there is pain in malleolar zone: bone
tenderness in posterior edge of lateral malleolus (6cm up), or bone tenderness in posterior edge
of medial malleolus (6cm up), or inability to bear weight both immediately and in emergency
department.
Ottawa rule 2 - Series of x-rays required if there is pain in mid-foot zone: bone tenderness
at base of 5th metatarsal, bone tenderness at navicular, or inability to weight bear both
immediately and in emergency department
Thompson test/ calf squeeze - squeeze calf while patient is in front- if slight plantar
flexion the Achilles is intact.
Anterior draw test - start 90-degree knee flexion, 10 degree plantar, pull talus anteriorly or
push tibia posteriorly, tests integrity of AFTL- does it create dimple