🔥 Musculoskeletal & Neurological Conditions

🔥 Musculoskeletal Disorders – 🔥

I. Septic Arthritis (Infectious Arthritis)

• Definition: Infection of the joint space causing inflammation, pain, and destruction of cartilage.
• Common Causative Agents:
  • Adults & Children: Staphylococcus aureus (most common).
  • Young Adults: Neisseria gonorrhoeae (Gonococcal arthritis).
  • Immunocompromised Patients: Gram-negative bacteria, Mycobacterium tuberculosis.
• Risk Factors: Diabetes, Rheumatoid arthritis, Prosthetic joints, IV drug use.
• Symptoms:
  • Acute onset of single joint pain (most commonly knee).
  • Swelling, redness, fever, restricted movement.
• Diagnosis:
  • Synovial Fluid Analysis (WBC >50,000 cells/µL, Gram stain, Culture).
  • Blood Culture, ESR/CRP (inflammation markers).
• Treatment:
  • Empirical IV Antibiotics (Vancomycin + Ceftriaxone) until culture results.
  • Joint drainage (Arthrocentesis or Surgery).

II. Gonococcal Arthritis

• Cause: Neisseria gonorrhoeae infection.
• Risk Factors: Sexually active individuals, untreated gonorrhea.
• Symptoms:
  • Migratory polyarthritis (multiple joint pain).
  • Dermatitis (small pustular skin lesions).
  • Tenosynovitis (inflammation of tendon sheaths).
• Diagnosis:
  • Synovial Fluid Culture (Chocolate Agar for Neisseria gonorrhoeae).
  • PCR for Gonorrhea in Urine or Genital Secretions.
• Treatment:
  • Ceftriaxone 1g IV daily + Azithromycin 1g single dose.
  • Treat sexual partners to prevent reinfection.

III. Osteomyelitis (Bone Infection)

• Definition: Infection of bone and bone marrow, leading to inflammation and necrosis.
• Common Causative Agents:
  • Staphylococcus aureus (most common).
  • Pseudomonas aeruginosa (IV drug users).
  • Salmonella (Sickle Cell Disease patients).
• Types:
  • Acute Osteomyelitis: Sudden onset, common in children.
  • Chronic Osteomyelitis: Bone destruction with sinus formation.
• Risk Factors: Trauma, Diabetes, Surgery, Open fractures.
• Symptoms:
  • Localized bone pain, fever, swelling, redness.
  • Draining sinus tract (chronic osteomyelitis).
• Diagnosis:
  • X-ray (Late changes).
  • MRI (Best early detection method).
  • Bone Biopsy & Culture (Gold standard).
• Treatment:
  • IV Antibiotics (6 weeks) – Vancomycin + Ceftriaxone.
  • Surgical Debridement for necrotic bone removal.

IV. Tuberculosis of the Spine & Bones (Pott’s Disease)

• Definition: Tuberculosis infection of the vertebrae (Pott’s Disease) or long bones.
• Causative Agent: Mycobacterium tuberculosis.
• Common Sites: Lumbar & Thoracic vertebrae.
• Symptoms:
  • Chronic back pain (most common symptom).
  • Kyphosis (Gibbus Deformity) – Hunchback curvature of the spine.
  • Weight loss, Night sweats, Fever.
• Complications: Spinal cord compression → Paraplegia.
• Diagnosis:
  • X-ray (Vertebral collapse, Disc space narrowing).
  • MRI (Best imaging method for spinal TB).
  • Tuberculin Skin Test (Mantoux), GeneXpert TB-PCR.
• Treatment:
  • Anti-TB Therapy (ATT) – HRZE Regimen (Isoniazid, Rifampicin, Pyrazinamide, Ethambutol) for 6-12 months.
  • Surgery (if spinal compression is severe).

V. Sprains (Ligament Injury)

• Definition: Stretching or tearing of ligaments (tissues connecting bones).
• Common Sites: Ankle, Knee, Wrist.
• Grading:
  • Grade 1: Mild stretch, No tear.
  • Grade 2: Partial tear, Swelling, Pain.
  • Grade 3: Complete tear, Instability, Severe pain.
• Symptoms: Swelling, Pain, Limited movement.
• Management (RICE Protocol):
  • Rest: Avoid weight-bearing.
  • Ice: Apply for 20 minutes every 2-3 hours.
  • Compression: Elastic bandage to reduce swelling.
  • Elevation: Raise limb to decrease swelling.
• Severe Sprains: May require immobilization or surgery.

VI. Dislocations

• Definition: Displacement of bone from its joint.
• Common Sites: Shoulder, Hip, Finger, Jaw.
• Symptoms: Deformity, Swelling, Inability to move the joint.
• Diagnosis: X-ray.
• Management:
  • Closed Reduction (Repositioning by manual manipulation).
  • Immobilization (Sling, Cast).
  • Physical therapy after healing.

VII. Fractures of the Spine & Extremities

• Definition: A break in the continuity of a bone due to trauma or disease.
• Types: Type Description Closed (Simple) Fracture Bone breaks but skin remains intact Open (Compound) Fracture Bone pierces through skin, high infection risk Comminuted Fracture Bone shatters into multiple fragments Greenstick Fracture Incomplete fracture, common in children Compression Fracture Common in vertebrae (osteoporosis)
• Signs & Symptoms:
  • Pain, Swelling, Deformity, Loss of function.
  • Crepitus (grating sound when moving fractured bone).
• Diagnosis: X-ray, CT scan (for complex fractures).
• Management:
  • Immobilization (Splint, Cast, Traction).
  • Surgery (Internal Fixation – Plates, Screws, Rods).
  • Pain Management (NSAIDs, Opioids).

🔥 High-Yield Key Points for Competitive Exams

✅ Most common cause of septic arthritis: Staphylococcus aureus
✅ Best test for diagnosing osteomyelitis: MRI
✅ Most common site for Pott’s disease: Thoracic & Lumbar spine
✅ Best initial management for sprains: RICE Protocol
✅ Gold standard for diagnosing tuberculosis of the spine: MRI & TB-PCR
✅ Which fracture is most common in children? Greenstick fracture
✅ Best treatment for an open fracture: Surgical debridement & Antibiotics
✅ Drug of choice for osteomyelitis: IV Vancomycin + Ceftriaxone

📝 Competitive Exam Practice MCQs

1. Which bacteria is most commonly responsible for septic arthritis?

a) Pseudomonas aeruginosa
b) Staphylococcus aureus
c) Neisseria gonorrhoeae
d) Mycobacterium tuberculosis
✅ Answer: b) Staphylococcus aureus

2. What is the most common site for Pott’s disease?

a) Cervical spine
b) Thoracic & Lumbar spine
c) Sacrum
d) Clavicle
✅ Answer: b) Thoracic & Lumbar spine

3. The best imaging modality for early osteomyelitis is:

a) X-ray
b) CT scan
c) MRI
d) Bone biopsy
✅ Answer: c) MRI

I. Degenerative Conditions of Joints & Spine

1. Osteoarthritis (OA)

• Definition: Progressive degeneration of cartilage in joints.
• Risk Factors: Aging, Obesity, Joint overuse, Genetics.
• Symptoms:
  • Joint pain worsens with activity, relieved by rest.
  • Morning stiffness (<30 minutes).
  • Crepitus (grating sound).
• Diagnosis: X-ray (Joint space narrowing, Osteophytes).
• Treatment:
  • NSAIDs (Ibuprofen, Diclofenac).
  • Physical therapy, Weight loss, Joint replacement surgery.

2. Rheumatoid Arthritis (RA)

• Definition: Chronic autoimmune disease causing inflammation of joints.
• Symptoms:
  • Morning stiffness (>1 hour), Bilateral joint pain.
  • Deformities (Swan-neck, Boutonniere).
• Diagnosis:
  • Rheumatoid Factor (RF), Anti-CCP Antibodies.
  • X-ray (Joint erosion, Swan-neck deformity).
• Treatment:
  • DMARDs (Methotrexate, Hydroxychloroquine).
  • Steroids, NSAIDs, Biologics (Infliximab).

3. Spondylosis (Degenerative Spine Disease)

• Types:
  • Cervical Spondylosis: Neck stiffness, Radiating pain.
  • Lumbar Spondylosis: Low back pain, Sciatica.
• Diagnosis: X-ray, MRI (Disc degeneration).
• Treatment:
  • NSAIDs, Physiotherapy, Surgery if severe.

II. Tumors, Amputation & Prosthesis

1. Bone Tumors

Type	Common Site	Key Features
Osteosarcoma	Long bones (Femur, Tibia)	Most common primary bone cancer, Sunburst pattern on X-ray
Ewing’s Sarcoma	Pelvis, Long bones	Onion skin appearance on X-ray
Chondrosarcoma	Cartilage (Pelvis, Shoulder)	Slow-growing, resistant to chemotherapy
Multiple Myeloma	Bone marrow	Punched-out lesions on X-ray

2. Amputation

• Indications: Trauma, Gangrene, Tumors, Diabetes.
• Complications:
  • Phantom limb pain (treated with Gabapentin).
  • Infection, Prosthesis fitting issues.

3. Prosthesis

• Types:
  • Upper Limb Prosthesis: Myoelectric hands, Hook prosthesis.
  • Lower Limb Prosthesis: Below-knee (BK), Above-knee (AK) prosthetics.

III. Deformities – Congenital & Acquired

1. Congenital Deformities

Condition	Description
Congenital Talipes Equinovarus (Clubfoot)	Foot inward & downward
Developmental Dysplasia of Hip (DDH)	Hip dislocation in newborns
Scoliosis	Lateral curvature of the spine

2. Acquired Deformities

Condition	Description
Kyphosis	Hunchback curvature
Lordosis	Excess inward spine curve
Bow Legs (Genu Varum)	Knees apart when standing
Knock Knees (Genu Valgum)	Knees touch, ankles apart

IV. Range of Motion (ROM) Exercises

• Purpose: Prevent stiffness, Improve mobility, Strengthen muscles.
• Types:
  • Active ROM: Patient moves independently.
  • Passive ROM: Movement assisted by a therapist.
  • Resistive ROM: Movement against resistance.

V. Care of Patients in Orthopedic Treatment

1. Skin & Skeletal Traction

Type	Purpose	Example
Skin Traction	Uses skin tapes/straps	Buck’s Traction (Hip Fractures)
Skeletal Traction	Uses pins/wires in bone	Halo Traction (Cervical Spine Injury)

Care:
✅ Monitor for pressure sores, infection (pins, skin irritation).
✅ Keep weights free-hanging, do not remove traction.

2. Orthopedic Splints

• Used for immobilization and support after fractures.
• Types:
  • Static Splint: Maintains joint position.
  • Dynamic Splint: Allows controlled movement.

VI. POP (Plaster of Paris) Application & Removal

1. Application of POP Cast

✅ Check skin integrity before application.
✅ Apply padding under the cast.
✅ Ensure proper drying (24-48 hours for POP, 3-4 hours for fiberglass).
✅ Elevate limb to reduce swelling.

2. POP Removal

✅ Use a cast cutter (oscillating saw).
✅ Inspect skin for irritation, atrophy.
✅ Encourage gradual weight-bearing after removal.

VII. Neurogenic Bladder

• Definition: Loss of bladder control due to neurological conditions (Spinal cord injury, Stroke, Multiple Sclerosis).
• Types:
  • Overactive Bladder (Spastic): Frequent, urgent urination.
  • Underactive Bladder (Flaccid): Urinary retention, Overflow incontinence.
• Management:
  • Intermittent Catheterization.
  • Bladder training, Medications (Oxybutynin, Bethanechol).

VIII. Preparation for Bone Surgery

✅ Preoperative:

• CBC, Electrolytes, Blood Type (for transfusion).
• Consent, Skin preparation, Prophylactic antibiotics.

✅ Postoperative:

• Monitor vital signs, Pain management.
• Prevent complications (DVT, Infection, Pressure ulcers).
• Early mobilization, Physiotherapy.

🔥 High-Yield Key Points for Competitive Exams

✅ Most common degenerative joint disease: Osteoarthritis
✅ Best imaging for spine deformities: X-ray & MRI
✅ Best medication for phantom limb pain: Gabapentin
✅ Most common site of osteosarcoma: Distal femur, Proximal tibia
✅ Best management for neurogenic bladder: Intermittent catheterization
✅ Which splint is used for hip fractures? Buck’s traction
✅ Key precaution in skeletal traction: Keep weights hanging freely

📝 Competitive Exam Practice MCQs

1. Which traction is commonly used for hip fractures?

a) Dunlop’s Traction
b) Buck’s Traction
c) Bryant’s Traction
d) Halo Traction
✅ Answer: b) Buck’s Traction

2. The best diagnostic test for osteosarcoma is:

a) CT Scan
b) X-ray
c) Bone Biopsy
d) MRI
✅ Answer: c) Bone Biopsy

3. The first-line treatment for neurogenic bladder is:

a) Foley Catheterization
b) Intermittent Catheterization
c) Bladder Irrigation
d) Surgery
✅ Answer: b) Intermittent Catheterization

🔥 Musculoskeletal & Neurological Conditions – High-Yield Notes for Competitive Exams 🔥

I. Degenerative Conditions of Joints & Spine

1. Osteoarthritis (OA)

• Definition: Progressive degeneration of cartilage in joints.
• Risk Factors: Aging, Obesity, Joint overuse, Genetics.
• Symptoms:
  • Joint pain worsens with activity, relieved by rest.
  • Morning stiffness (<30 minutes).
  • Crepitus (grating sound).
• Diagnosis: X-ray (Joint space narrowing, Osteophytes).
• Treatment:
  • NSAIDs (Ibuprofen, Diclofenac).
  • Physical therapy, Weight loss, Joint replacement surgery.

2. Rheumatoid Arthritis (RA)

• Definition: Chronic autoimmune disease causing inflammation of joints.
• Symptoms:
  • Morning stiffness (>1 hour), Bilateral joint pain.
  • Deformities (Swan-neck, Boutonniere).
• Diagnosis:
  • Rheumatoid Factor (RF), Anti-CCP Antibodies.
  • X-ray (Joint erosion, Swan-neck deformity).
• Treatment:
  • DMARDs (Methotrexate, Hydroxychloroquine).
  • Steroids, NSAIDs, Biologics (Infliximab).

3. Spondylosis (Degenerative Spine Disease)

• Types:
  • Cervical Spondylosis: Neck stiffness, Radiating pain.
  • Lumbar Spondylosis: Low back pain, Sciatica.
• Diagnosis: X-ray, MRI (Disc degeneration).
• Treatment:
  • NSAIDs, Physiotherapy, Surgery if severe.

II. Tumors, Amputation & Prosthesis

1. Bone Tumors

Type	Common Site	Key Features
Osteosarcoma	Long bones (Femur, Tibia)	Most common primary bone cancer, Sunburst pattern on X-ray
Ewing’s Sarcoma	Pelvis, Long bones	Onion skin appearance on X-ray
Chondrosarcoma	Cartilage (Pelvis, Shoulder)	Slow-growing, resistant to chemotherapy
Multiple Myeloma	Bone marrow	Punched-out lesions on X-ray

2. Amputation

• Indications: Trauma, Gangrene, Tumors, Diabetes.
• Complications:
  • Phantom limb pain (treated with Gabapentin).
  • Infection, Prosthesis fitting issues.

3. Prosthesis

• Types:
  • Upper Limb Prosthesis: Myoelectric hands, Hook prosthesis.
  • Lower Limb Prosthesis: Below-knee (BK), Above-knee (AK) prosthetics.

III. Deformities – Congenital & Acquired

1. Congenital Deformities

Condition	Description
Congenital Talipes Equinovarus (Clubfoot)	Foot inward & downward
Developmental Dysplasia of Hip (DDH)	Hip dislocation in newborns
Scoliosis	Lateral curvature of the spine

2. Acquired Deformities

Condition	Description
Kyphosis	Hunchback curvature
Lordosis	Excess inward spine curve
Bow Legs (Genu Varum)	Knees apart when standing
Knock Knees (Genu Valgum)	Knees touch, ankles apart

IV. Range of Motion (ROM) Exercises

• Purpose: Prevent stiffness, Improve mobility, Strengthen muscles.
• Types:
  • Active ROM: Patient moves independently.
  • Passive ROM: Movement assisted by a therapist.
  • Resistive ROM: Movement against resistance.

V. Care of Patients in Orthopedic Treatment

1. Skin & Skeletal Traction

Type	Purpose	Example
Skin Traction	Uses skin tapes/straps	Buck’s Traction (Hip Fractures)
Skeletal Traction	Uses pins/wires in bone	Halo Traction (Cervical Spine Injury)

Care:
✅ Monitor for pressure sores, infection (pins, skin irritation).
✅ Keep weights free-hanging, do not remove traction.

2. Orthopedic Splints

• Used for immobilization and support after fractures.
• Types:
  • Static Splint: Maintains joint position.
  • Dynamic Splint: Allows controlled movement.

VI. POP (Plaster of Paris) Application & Removal

1. Application of POP Cast

✅ Check skin integrity before application.
✅ Apply padding under the cast.
✅ Ensure proper drying (24-48 hours for POP, 3-4 hours for fiberglass).
✅ Elevate limb to reduce swelling.

2. POP Removal

✅ Use a cast cutter (oscillating saw).
✅ Inspect skin for irritation, atrophy.
✅ Encourage gradual weight-bearing after removal.

VII. Neurogenic Bladder

• Definition: Loss of bladder control due to neurological conditions (Spinal cord injury, Stroke, Multiple Sclerosis).
• Types:
  • Overactive Bladder (Spastic): Frequent, urgent urination.
  • Underactive Bladder (Flaccid): Urinary retention, Overflow incontinence.
• Management:
  • Intermittent Catheterization.
  • Bladder training, Medications (Oxybutynin, Bethanechol).

VIII. Preparation for Bone Surgery

✅ Preoperative:

• CBC, Electrolytes, Blood Type (for transfusion).
• Consent, Skin preparation, Prophylactic antibiotics.

✅ Postoperative:

• Monitor vital signs, Pain management.
• Prevent complications (DVT, Infection, Pressure ulcers).
• Early mobilization, Physiotherapy.

🔥 High-Yield Key Points for Competitive Exams

✅ Most common degenerative joint disease: Osteoarthritis
✅ Best imaging for spine deformities: X-ray & MRI
✅ Best medication for phantom limb pain: Gabapentin
✅ Most common site of osteosarcoma: Distal femur, Proximal tibia
✅ Best management for neurogenic bladder: Intermittent catheterization
✅ Which splint is used for hip fractures? Buck’s traction
✅ Key precaution in skeletal traction: Keep weights hanging freely

📝 Competitive Exam Practice MCQs

1. Which traction is commonly used for hip fractures?

a) Dunlop’s Traction
b) Buck’s Traction
c) Bryant’s Traction
d) Halo Traction
✅ Answer: b) Buck’s Traction

2. The best diagnostic test for osteosarcoma is:

a) CT Scan
b) X-ray
c) Bone Biopsy
d) MRI
✅ Answer: c) Bone Biopsy

3. The first-line treatment for neurogenic bladder is:

a) Foley Catheterization
b) Intermittent Catheterization
c) Bladder Irrigation
d) Surgery
✅ Answer: b) Intermittent Catheterization

🔥 Orthopedic Assistive Devices, Alternate Therapies & Drugs – High-Yield Notes for Competitive Exams 🔥

I. Use of Orthopedic Assistive Devices

Orthopedic assistive devices are used for mobility support, injury recovery, and rehabilitation.

1. Crutches

✅ Used for: Non-weight bearing or partial weight-bearing conditions (Leg fractures, Post-surgery, Paralysis).
✅ Types of Crutches:

Type	Description	Used For
Axillary Crutches	Placed under the armpit, padded top	Short-term use (Fractures, Sprains)
Lofstrand (Forearm) Crutches	Cuff around forearm for support	Long-term disability (Cerebral Palsy, Polio)
Platform Crutches	Forearm rests on a platform	Patients with weak hand grip (Arthritis, Stroke)

✅ Gait Patterns with Crutches:

• Two-Point Gait: Crutch and opposite leg move together (Partial weight-bearing).
• Three-Point Gait: Both crutches move together with injured leg (Non-weight bearing).
• Four-Point Gait: Each crutch and leg moves separately (Full weight-bearing, Weakness).
• Swing-to/Swing-through Gait: Both crutches move, followed by both legs (Paraplegia).

✅ Precautions:

• Do not rest axilla on crutches → Risk of Axillary Nerve Palsy.
• Maintain proper crutch height (2 inches below axilla).

2. Canes

✅ Used for: Minimal support in mild balance impairments, Arthritis, Stroke recovery.
✅ Types of Canes:

Type	Description	Used For
Single Point Cane	One tip, basic support	Mild balance issues
Quad Cane	Four tips, more stable	Stroke, Hemiplegia
Adjustable/Folding Cane	Height adjustable, portable	Temporary mobility support

✅ Proper Cane Use:

• Hold the cane on the stronger side to support the weak side.
• Advance the cane first, followed by the weaker leg, then the stronger leg.

3. Walker

✅ Used for: Maximum stability, Post-surgical rehabilitation, Severe weakness (Elderly, Stroke, Parkinson’s).
✅ Types of Walkers:

Type	Description	Used For
Standard Walker	Four legs, no wheels	Maximum stability
Wheeled Walker	Front wheels, easier movement	Weak arms, Parkinson’s
Rollator (Four-Wheeled Walker)	Brakes, seat for rest	Long-term use, COPD patients

✅ Proper Use of a Walker:

• Advance walker first, then step forward with the weaker leg, followed by the stronger leg.
• Do not push walker too far ahead.

II. Alternate Therapies for Musculoskeletal Disorders

Alternative therapies complement traditional treatments and help in pain relief, inflammation reduction, and mobility improvement.

1. Physiotherapy

✅ Used for: Post-fracture recovery, Stroke rehabilitation, Chronic joint pain (Osteoarthritis, Rheumatoid Arthritis).
✅ Types:

• Active & Passive Exercises – Improves joint mobility.
• Hydrotherapy (Water Therapy) – Used in arthritis & muscle rehabilitation.

2. Chiropractic Therapy

✅ Used for: Spinal conditions, Back pain, Cervical Spondylosis.
✅ Technique: Manual spinal adjustments & manipulations to relieve pressure on nerves.

3. Acupuncture

✅ Used for: Chronic back pain, Fibromyalgia, Arthritis, Sciatica.
✅ Mechanism: Needle insertion stimulates nerve endings & releases endorphins (pain relief).

4. Yoga & Meditation

✅ Used for: Osteoarthritis, Rheumatoid Arthritis, Chronic Pain, Fibromyalgia.
✅ Benefits: Improves joint flexibility, Muscle strength, Mental relaxation.

5. Herbal & Ayurveda Therapy

✅ Common Herbs Used:

Herb	Uses
Turmeric (Curcumin)	Anti-inflammatory (Arthritis, Joint pain)
Boswellia (Shallaki)	Reduces swelling in Osteoarthritis
Ginger	Natural pain reliever
Epsom Salt (Magnesium Sulfate)	Relieves muscle cramps & joint pain

III. Drugs Used in Treatment of Musculoskeletal Disorders

1. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)

✅ Used for: Pain relief, Inflammation control (Osteoarthritis, Rheumatoid Arthritis, Sprains).
✅ Examples:

• Ibuprofen, Naproxen – Mild pain.
• Diclofenac, Indomethacin – Moderate pain.
• Celecoxib (COX-2 inhibitor) – GI-safe option.

2. Corticosteroids

✅ Used for: Severe inflammation in Autoimmune Arthritis, Lupus, Gout.
✅ Examples:

• Prednisolone, Dexamethasone – Systemic steroids.
• Intra-articular Steroid Injections – Directly injected into joints.

3. Disease-Modifying Anti-Rheumatic Drugs (DMARDs)

✅ Used for: Rheumatoid Arthritis, Psoriatic Arthritis, Ankylosing Spondylitis.
✅ Examples:

• Methotrexate (First-line DMARD for RA).
• Hydroxychloroquine, Sulfasalazine – Mild cases.
• Leflunomide, Azathioprine – Severe cases.

4. Biologic Agents (Targeted Therapy)

✅ Used for: Autoimmune diseases resistant to DMARDs.
✅ Examples:

• TNF Inhibitors: Etanercept, Infliximab, Adalimumab.
• IL-6 Inhibitors: Tocilizumab (RA).

5. Muscle Relaxants

✅ Used for: Spasticity, Muscle stiffness (Cerebral Palsy, Stroke, Multiple Sclerosis).
✅ Examples:

• Baclofen – Spinal cord spasticity.
• Tizanidine, Cyclobenzaprine – Muscle spasms.

6. Osteoporosis Drugs

✅ Used for: Preventing fractures & strengthening bones.
✅ Examples:

• Bisphosphonates (Alendronate, Risedronate).
• Selective Estrogen Receptor Modulators (SERMs) – Raloxifene.
• Denosumab (Monoclonal Antibody).

7. Gout Medications

✅ Used for: High uric acid levels & Gout attacks.
✅ Examples:

• Acute Attack: Colchicine, NSAIDs, Prednisone.
• Chronic Prevention: Allopurinol, Febuxostat.

🔥 High-Yield Key Points for Competitive Exams

✅ Which crutch type is best for long-term use? Lofstrand (Forearm) Crutches
✅ Best cane for stroke patients? Quad Cane
✅ Best drug for Rheumatoid Arthritis? Methotrexate (First-line DMARD)
✅ Which muscle relaxant is best for spinal cord injuries? Baclofen
✅ Most commonly used NSAID for arthritis? Ibuprofen, Diclofenac
✅ Best osteoporosis drug for preventing fractures? Bisphosphonates (Alendronate)
✅ Best alternative therapy for back pain & arthritis? Acupuncture, Yoga

📝 Competitive Exam Practice MCQs

1. Which crutch gait pattern is used for paraplegic patients?

a) Two-point gait
b) Four-point gait
c) Swing-through gait
d) Three-point gait
✅ Answer: c) Swing-through gait

2. Which drug is first-line treatment for acute gout attacks?

a) Allopurinol
b) Colchicine
c) Methotrexate
d) Diclofenac
✅ Answer: b) Colchicine