many other diseases in this manner. While allergic and chemical exposures may be a possible
cause of the rash, this patient's SLE should make you consider vasculitis
4. Two weeks ago, Mary started a job which requires carrying 40-pound buck- ets. She
presents with elbow pain worse on the right. On examination, it hurts her elbows to
dorsiflex her hands against resistance when her palms face the floor. What condition does
she have?
A. Medial epicondylitis (golfer's elbow)
B. Olecranon bursitis
C. Lateral epicondylitis (tennis elbow)
D. Supracondylar fracture:
ANSWER C
Feedback: Mary's injury probably occurred by lifting heavy buckets with her palms down
(toward the bucket). This caused her chronic overuse injury at the lateral epicondyle. Medial
epicondylitis has reproducible pain when palmar flexion against resistance is performed and also
features tenderness over the involved epicondyle. Olecranon bursitis produces erythema and
swelling over the olecranon process. A supracondylar fracture of the humerus is a major injury
and would present more acutely.
4 of 156 9/5/2024, 2:48
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