Musculoskeletal System
Tissue and joint reasoning
Musculoskeletal questions combine healing biology, biomechanics, and clinical tests. Healing proceeds through inflammation (days 0-7), proliferation (about 1-3 weeks), and remodeling (weeks to months); intervention intensity should match the phase. Bone heals through hematoma, callus, and remodeling, with immobilization and controlled loading. Tendons adapt to progressive load; ligaments heal loosely and need protection early. Muscle strains and ligament sprains are graded I-III by tissue disruption.
Concepts to name
- Arthritis: osteoarthritis (cartilage loss, morning stiffness under 30 minutes) versus rheumatoid arthritis (symmetrical, prolonged stiffness, systemic).
- Osteoporosis: weight-bearing and resistance exercise, fall prevention, fracture risk.
- Special tests and their meaning; joint mobilization grades I-II for pain, III-IV for mobility.
- Red flags: unexplained weight loss, night pain, fever, bowel or bladder changes, progressive neurologic deficit, history of cancer.
- Neurovascular checks after fracture or surgery.
Traps
Questions pair an acute injury with aggressive stretching or high-grade mobilization. Early phases need protection, not end-range loading. Another trap is mistaking referred pain (hip pathology presenting as knee pain) for a local problem. Do not miss fracture or cauda equina signs.
Worked rule
Match dose to phase: in the first week after an ankle sprain, protect and manage swelling with relative rest, compression, and elevation, then add controlled range and progressive loading as pain allows. If a patient reports night pain and weight loss, stop and refer before treating mechanically.