USMLE Step 2 – Musculoskeletal System
251 High-Yield Q&A for Clinical Mastery
and Exam Prep
2025 Edition
What’s Inside:✔️ 251 exam-style questions and answers✔️
Fracture types, nerve injuries, ligament tears, tendon
ruptures✔️ Diagnostic tests: Lachman, McMurray, Drawer
signs✔️ Compartment syndrome, carpal tunnel, bursitis✔️
Treatment protocols and surgical indications✔️ Ideal for
USMLE Step 2 CK & shelf exam review
,USMLE Step 2 – Musculoskeletal System | 251
High-Yield Q&A for Clinical Mastery and Exam
Prep (2025 Edition)
What type of shoulder dislocation is most common?
Anterior
(posterior quite rare. Usually only assoc. with electrocution or seizure)
What nerve is most at risk in anterior shoulder dislocation?
Axillary nerve
How will a patient usually hold their arm in an anterior dislocation of the shoulder?
Abduction and externally rotated
(opposite of posterior, where it is usually adducted and internally rotated)
What nerve is most at risk with anterior hip dislocation?
Obturator
What is the most common type of hip dislocation?
Posterior (>90%) - occurs via posterior force on internally rotated, flexed, adducted hip ("dashboard
injury")
What type of injury is associated with posterior hip dislocation?
Sciatic nerve injury
Avascular necrosis of bone
What test should be done after reduction of a hip dislocation?
CT scan
A colles' fracture most commonly involves what bone?
Distal radius fracture; dorsally displaced, dorsally angulated fracture
(image shows complete fracture)
In whom is Colles' fractures common?
, Elderly and children - esp those who fall onto outstretched hand
The treatment for a colles' fracture is usually closed reduction, followed by a long-arm cast. When is
open reduction indicated in colles' fracture?
If the fracture is intra-acrticular
What is the most commonly fractured carpal bone?
Scaphoid fracture
A fracture of the scaphoid may take up to two weeks to display on radiographs. When specific sign
will make you suspect scaphoid fracture?
When there is tenderness in the anatomical snuffbox
How is a scaphoid fracture treated?
Thumb spica cast
What is a complication of proximal 1/3rd scaphoid fractures?
Avascular Necrosis (AVN)
What causes a Boxer's fracture?
Forward trauma of a closed fist can fracture the 5th metacarpal neck
How is an uncomplicated Boxer's fracture treated?
Closed reduction + Ulnar Gutter Splint
When might Percutaneous Pinning be required in Boxer's fractures?
Displaced fractures (usually of 1st or 5th metacarpal or proximal phalanges)
Bone is put into place under X ray guidance, and metal wire run through the two bone segments to hold
in place. Metal removed in 4-6 weeks
What nerve palsy is commonly associated with humeral shaft fracture?
Radial nerve palsy - wrist drop and loss of thumb extension
A minor humoral shaft fracture is treated using a hanging arm cast (whole arm up to deltoid). How is a
severe humoral fracture treated?
Coaptation splint
What is Monteggia's fracture?
Diaphyseal fracture of the proximal ulna + subluxation of radial head
How is a Monteggia's fracture treated?
251 High-Yield Q&A for Clinical Mastery
and Exam Prep
2025 Edition
What’s Inside:✔️ 251 exam-style questions and answers✔️
Fracture types, nerve injuries, ligament tears, tendon
ruptures✔️ Diagnostic tests: Lachman, McMurray, Drawer
signs✔️ Compartment syndrome, carpal tunnel, bursitis✔️
Treatment protocols and surgical indications✔️ Ideal for
USMLE Step 2 CK & shelf exam review
,USMLE Step 2 – Musculoskeletal System | 251
High-Yield Q&A for Clinical Mastery and Exam
Prep (2025 Edition)
What type of shoulder dislocation is most common?
Anterior
(posterior quite rare. Usually only assoc. with electrocution or seizure)
What nerve is most at risk in anterior shoulder dislocation?
Axillary nerve
How will a patient usually hold their arm in an anterior dislocation of the shoulder?
Abduction and externally rotated
(opposite of posterior, where it is usually adducted and internally rotated)
What nerve is most at risk with anterior hip dislocation?
Obturator
What is the most common type of hip dislocation?
Posterior (>90%) - occurs via posterior force on internally rotated, flexed, adducted hip ("dashboard
injury")
What type of injury is associated with posterior hip dislocation?
Sciatic nerve injury
Avascular necrosis of bone
What test should be done after reduction of a hip dislocation?
CT scan
A colles' fracture most commonly involves what bone?
Distal radius fracture; dorsally displaced, dorsally angulated fracture
(image shows complete fracture)
In whom is Colles' fractures common?
, Elderly and children - esp those who fall onto outstretched hand
The treatment for a colles' fracture is usually closed reduction, followed by a long-arm cast. When is
open reduction indicated in colles' fracture?
If the fracture is intra-acrticular
What is the most commonly fractured carpal bone?
Scaphoid fracture
A fracture of the scaphoid may take up to two weeks to display on radiographs. When specific sign
will make you suspect scaphoid fracture?
When there is tenderness in the anatomical snuffbox
How is a scaphoid fracture treated?
Thumb spica cast
What is a complication of proximal 1/3rd scaphoid fractures?
Avascular Necrosis (AVN)
What causes a Boxer's fracture?
Forward trauma of a closed fist can fracture the 5th metacarpal neck
How is an uncomplicated Boxer's fracture treated?
Closed reduction + Ulnar Gutter Splint
When might Percutaneous Pinning be required in Boxer's fractures?
Displaced fractures (usually of 1st or 5th metacarpal or proximal phalanges)
Bone is put into place under X ray guidance, and metal wire run through the two bone segments to hold
in place. Metal removed in 4-6 weeks
What nerve palsy is commonly associated with humeral shaft fracture?
Radial nerve palsy - wrist drop and loss of thumb extension
A minor humoral shaft fracture is treated using a hanging arm cast (whole arm up to deltoid). How is a
severe humoral fracture treated?
Coaptation splint
What is Monteggia's fracture?
Diaphyseal fracture of the proximal ulna + subluxation of radial head
How is a Monteggia's fracture treated?
