UPSC-CMS 2016 - Orthopaedics PYQs Practice Questions

Q: With reference to frozen shoulder, consider the following statements: 1. It is associated with diabetes and heart disease. 2. It may follow minor trauma. 3. Its differential diagnosis are infection and fractures. 4. Treatment of choice is surgery. Which of the statements given above are correct?

1, 2 and 3. ***1, 2 and 3*** - **Frozen shoulder** (adhesive capsulitis) has a higher incidence in individuals with **diabetes mellitus** and **cardiovascular diseases**, indicating systemic associations. - It can be triggered by minor trauma or surgery, but often it has **no identifiable cause** (idiopathic). - The differential diagnoses for shoulder pain and restricted motion include serious conditions like **infection (septic arthritis)** and **fractures**, which must be ruled out. *1 and 2 only* - This option correctly identifies the association with diabetes and heart disease, and the possibility of minor trauma. - However, it incorrectly excludes the importance of considering infection and fractures in the differential diagnosis. *3 and 4 only* - This option correctly identifies the importance of differential diagnosis (infection and fractures). - However, **surgery is generally not the first-line treatment for frozen shoulder**; it is reserved for severe cases unresponsive to conservative measures. - It also fails to acknowledge the associations with diabetes and heart disease, or the role of minor trauma. *2, 3 and 4* - This option correctly notes that frozen shoulder can follow minor trauma and that infection and fractures are important differential diagnoses. - However, it incorrectly states that **surgery is the treatment of choice**, when **conservative management is usually first-line**. - It also misses the crucial association with **diabetes and heart disease**. [Practice more Orthopaedics PYQs on OnCourse]

Q: The prognosis in reduced or unreduced fractures involving epiphyseal plate is very poor if the fracture line:

Crushes the epiphyseal plate. ***Crushes the epiphyseal plate*** - A crushed epiphyseal plate (Salter-Harris Type V) leads to **irreversible damage to the growth plate**, resulting in almost certain growth arrest and significant limb length discrepancy. - This type of injury directly destroys the proliferative and hypertrophic zones responsible for longitudinal bone growth, making its prognosis exceptionally poor. *Runs along the epiphyseal plate* - This typically describes a Salter-Harris Type I or II fracture, where the fracture line separates the epiphysis from the metaphysis **without damaging the growth plate itself**. - While requiring careful reduction, the prognosis is generally good as long as there is no significant displacement or vascular compromise, and the **growth plate remains viable**. *Crosses the epiphyseal plate* - This description is vague but could refer to a Salter-Harris Type III or IV fracture, which involves **articular surface involvement** and crossing the physis. - While these types have a poorer prognosis than Type I and II due to potential for incongruity and **growth arrest**, they are not as universally dire as a crush injury, provided proper anatomical reduction is achieved. *Extends into epiphysis* - This describes a Salter-Harris Type III fracture, where the fracture line extends from the growth plate into the epiphysis and often involves the **articular cartilage**. - The prognosis is generally good if **anatomical reduction** and fixation are achieved, but there is a risk of growth disturbance and **arthrosis** if displacement is not corrected. [Practice more Orthopaedics PYQs on OnCourse]

Question 1

With reference to frozen shoulder, consider the following statements:

1. It is associated with diabetes and heart disease.

2. It may follow minor trauma.

3. Its differential diagnosis are infection and fractures.

4. Treatment of choice is surgery.
Which of the statements given above are correct?

Accepted Answer

1, 2 and 3

Answer

1 and 2 only

Answer

3 and 4 only

Answer

2, 3 and 4

Question 2

The prognosis in reduced or unreduced fractures involving epiphyseal plate is very poor if the fracture line:

Accepted Answer

Crushes the epiphyseal plate

Answer

Runs along the epiphyseal plate

Answer

Crosses the epiphyseal plate

Answer

Extends into epiphysis

UPSC-CMS 2016 — Orthopaedics