Test your clinical knowledge | cyriax.eu

Test your clinical knowledge

 

Cyriax Modern Orthopaedic Medicine, a must ?

Test your clinical knowledge...

Discover why Cyriax Modern Orthopaedic Medicine is an added value for therapists involved with soft tissue lesions of the locomotor system :

 

A patient is coming in our practice complaining of a shoulder problem...

  •  What is the diagnosis ??

 We perform a specific history, a clinical examination and hope to reach a conclusion, before starting a treatment plan.

 At this point we could ask ourselves an honest "to the point" question : can we make the clinical distinction between :

  • a shoulder stage III arthritis
  • a supraspinatus tenoperiostal tendinitis
  • a chronic subdeltoid bursitis
  • an acromioclavicular lesion ?

 These are all typical lesions which can be distinguished on clinical grounds and which have different treatment strategies.

 

Yes, can you make the clinical distinction ?  Great !
or, 
rather not at this point....? 

... then the updated Cyriax model will be a useful tool in order to increase the diagnostic efficiency, by using a standardized assessment protocol.

 

Do the Cyriax test...

A quick clinical reasoning test in orthopaedic medicine :

Try to answer following multiple choice questions : Minimum one answer up to all answers could be correct…

The correct answers can be found at the end of this page

  1. Shoulder : in which cases can a painful arc during active elevation be a « localizing sign » ?
    (a localizing sign helps us to determine the exact localisation of the lesion)

a) supra-, infraspinatus and teres minor tendinitis
b) supra-, infraspinatus and subscapularis tendinitis
c) infraspinatus, biceps and subscapularis tendinitis
d) Acromioclavicular joint sprain, deep part
e) 
supraspinatus, biceps and teres minor tendinitis


 2. Shoulder : the passive horizontal adduction is clearly positive as a complementary test in case of 

a) chronic subdeltoid bursitis
b) acromioclavicular joint lesion
c) supraspinatus tendinitis
d) subcoracoid bursitis
e) subscapularis tendinitis
f) traumatic arthritis 


3. Spine : where can the pain be felt in case of a unilateral sacroiliac arthritis or a unilateral facet joint lesion 

a) Unilateral segmental referred pain
b) Unilateral multisegmental (more than 3 dermatomes) referred pain
c) Spinal pain on the midline
d) Local pain over the joint
e) Bilateral low lumbar or gluteal pain

 

4. The clinical image in which  passive movement in a joint is limited and painful in only one direction and is not limited, but possibly painful, in other directions makes us think of…

a) internal derangement
b) acute ligamentous lesion
c) acute tendinous lesion
d) acute muscle belly lesion
e) chronic muscle belly lesion

 

5. Shoulder : if one or more  isometric resisted test(s) is/are painful AND weak, the underlying lesion can be

a) arthritis stage III
b) mononeuritis
c) arthritis stage I
d) complete tendinous rupture
e) fracture
f) partial tendinous rupture


6. The clinical image of a « dysfunction syndrome » is defined by

a) End range pain on repeated testing, no limitation of movement, after testing symptoms are not worse-not better
b) End range pain on repeated testing, possibly small limitation of movement, after testing symptoms are better
c) Mid range pain on repeated testing, no limitation of movement, after testing symptoms are not worse-not better
d) End range pain on repeated testing, possibly small limitation of movement, after repeated testing symptoms are not worse-not better

 

7. Soft tissue lesions can refer pain : the pattern of referred pain is

a) always unilateral
b) always bilateral
c) unilateral or bilateral, depending on the lesioned structure
d) always multisegmental
e) segmental reference form the dura mater
f) possibly multisegmental pain
g) possibly segmental pain

  

8. Wrist : which clinical elements can we find in case of a scaphoid fracture ?

a) gross limitation of passive extension only + muscle spasm
b) capsular pattern + muscle spasm
c) pain on passive radial deviation
d) pain on passive ulnar deviation

 

9. Lumbar spine : an « adherent nerve root », also known as a dysfunction syndrome, presents itself clinically as

a) Passive Straight Leg Raise and flexion in standing are very painful end range
b) Only SLR is slightly limited and painful end range
c) A painful arc on SLR
d) P
assive SLR and active flexion in standing are slightly limited and painful end range
e) On repeating the SLR test, during the functional examination, the symptoms get better

 

10. Lumbar spine : in case of a smaller, reducible, internal derangement (disc protrusion) with pressure against the dura mater or the nerve root, we might find following signs :

a) SLR test is negative
b) SLR is painful, limited and motor deficit
c) A painful arc on SLR
d) SLR is painful end range
e) SLR is negative, although there is excessive motor deficit

  

11. Lumbar spine : clinically , a clear lumbar lateral deviation, without rotational component, points in the direction of

a) A small internal derangement
b) A bigger internal derangement
c) A sacroiliac dysfunction
d) Severe scoliosis

 

 

Solutions :

  1. B, c, d
  2. B, d, e
  3. A, d
  4. A, d
  5. E, f
  6. D
  7. C, f, g
  8. B, c
  9. D
  10. A, c, d
  11. B

 

Invest in efficient knowledge and visit our Modern Orthopaedic Medicine (Cyriax) compact courses.

 

 

We wish to respect your privacy at all times

General Data Protection Regulation - European Privacy Regulation

How do we collect your personal data such as name and email address ?

When you are an ETGOM course participant automatically you enter the ETGOM newsletter
When you send us an email with an information request regarding the ETGOM seminars or publications
When you participate at an ETGOM webinar
When you download the free ebook
When we meet in person (e.g. conference)
Or when you register on our “Tips and Tricks in orthopaedic medicine” newsletter

How do we use your personal data

Your data are exclusively used by the ETGOM Teaching Team and organisation partners to inform you about ETGOM activities and publications
Your data will not be transferred to any third party which is not related to orthopaedic medicine continuing education

Your rights

You have the right at all times to view, to update or to delete your personal data
You can unsubscribe from our newsletters, mailing list, at any time
You can refuse or limit the use of your personal data
You can visit the website of OM Consult bvba/ETGOM unrestricted and furthermore consult information about our company, products and services without giving any personal data of you. Only if you want to contact us via the web form, you have to share you personal data. Each time you provide personal information, OM Consult bvba will handle them in accordance with the policy written down in here and the legal liabilities concerning the handling of personal data.

Confidential handling of personal data 
The personal data collected by OM Consult bvba/ETGOM, are saved on a protected place, which is not open for the public. The file can only be consulted by a restricted number of persons who are in service of OM Consult bvba/ETGOM and only if they need this information for practice there job. The data will only be processed for internal purposes. Om Consult bvba ordinarily doesn’t give any personal data to third persons, except to comply with legal liabilities and in case of an express request from the judicial authority or police. In the exceptional case that OM Consult bvba/ETGOM gives information to organizations or companies with which they work together, it will be expressly mentioned or you will be expressly asked for your agreement.

Purpose of handling 
OM Consult bvba/ETGOM handles the collected personal data to identify you and if necessary to contact you and to give you an optimal service. The data can also be used to give you information about news items, new services and new products of OM Consult bvba/ETGOM. If you don’t want to receive such information, you can mention this to OM Consult bvba/ETGOM by e-mail ( info@cyriax.eu) or by letter.