Source / episode info

• **Episode:**620
• **Title:**DIP Ep 620: USMLE MSK Series (Knee, Hip)
• **Published:**2025-08-18
• Source:Episode page

One-liner

This episode covers high-yield musculoskeletal topics including the differential diagnosis of knee pain (PFPS, ITBS, bursitis), specific ligament stability testing maneuvers (ACL/PCL/MCL/LCL), hip osteonecrosis risk factors (alcoholism, steroids, sickle cell), and pediatric orthopedic conditions (DDH, SCFE, LCPD).

High-yield summary

• Patellofemoral Pain Syndrome (PFPS): Classically seen in young, active women (<45 years old); diagnosis is clinical (reproducing pain by pressing on the patella or moving it) and management is conservative (activity modification, quadriceps strengthening).
• Ligament Tears: Specific physical exam maneuvers are required: Anterior Drawer test challenges the ACL; Posterior Drawer test challenges the PCL; Valgus stress (lateral push) challenges the MCL; Varus stress (medial push) challenges the LCL.
• Osteonecrosis of the Hip/Femoral Head: High-risk factors include sickle cell disease, chronic steroid use, alcoholism/cirrhosis, and lupus. Diagnosis is typically confirmed by MRI showing a necrotic femoral head.
• Bursitis Syndromes: Acute pre-patellar bursitis requires ruling out infection; Pes anserine bursitis classically presents with medial knee pain below the joint in older adults.
• Pediatric Hip Pathology: Developmental Dysplasia of the Hip (DDH) is suspected in newborns; Slipped Capital Femoral Epiphysis (SCFE) occurs in adolescents (>10 years, often obese); Legg-Calvé-Perthes Disease (LCPD) affects children (<10 years).

Learning objectives

• Differentiate between common causes of anterior, medial, and lateral knee pain (PFPS, ITBS, bursitis).
• Perform and interpret physical exam tests for major knee ligaments (ACL, PCL, MCL, LCL).
• Identify the classic risk factors and presentation of osteonecrosis affecting the femoral head.
• Differentiate between pediatric hip pathologies based on age and mechanism (DDH, SCFE, LCPD).
• Understand the conservative management principles for most MSK complaints (RICE, strengthening) versus when surgery is indicated.

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