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IMF-033-01-0001-en	Which two distinctions come first when sorting musculoskeletal symptoms, and why is the first one prioritised?	First urgent versus non-urgent, because threatened limb, open fracture, compartment syndrome, septic joint, spinal compression and systemic vasculitis cannot wait; then inflammatory versus predominantly mechanical disease.	Integrated Medical Foundations; chapter 33, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d07abe76edfed4dc5067123f81d3657a0e2a8d92cd0b1f9b8cccbbc426027591; editorial review pending	imf lang::en chapter::033 module::033-01 review::pending
IMF-033-01-0002-en	Why does soft-tissue injury need a balance between protection and movement rather than maximal immobilisation?	Too little protection permits repeated disruption, but prolonged immobilisation causes stiffness, atrophy, reduced matrix capacity, thrombosis and delayed return.	Integrated Medical Foundations; chapter 33, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d07abe76edfed4dc5067123f81d3657a0e2a8d92cd0b1f9b8cccbbc426027591; editorial review pending	imf lang::en chapter::033 module::033-01 review::pending
IMF-033-01-0003-en	How do the inflammatory, proliferative and remodelling phases each contribute to soft-tissue repair?	Inflammation clears debris and recruits repair cells, proliferation creates new matrix, and remodelling aligns the tissue with the load it carries.	Integrated Medical Foundations; chapter 33, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d07abe76edfed4dc5067123f81d3657a0e2a8d92cd0b1f9b8cccbbc426027591; editorial review pending	imf lang::en chapter::033 module::033-01 review::pending
IMF-033-01-0004-en	Cold, compression, elevation and analgesia relieve an acute soft-tissue injury. What determines definitive care, and what suits many stable injuries?	Definitive care depends on the injured tissue and its severity, not on symptom relief; many stable injuries do best with early protected movement and progressive loading.	Integrated Medical Foundations; chapter 33, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d07abe76edfed4dc5067123f81d3657a0e2a8d92cd0b1f9b8cccbbc426027591; editorial review pending	imf lang::en chapter::033 module::033-01 review::pending
IMF-033-01-0005-en	Why should modest pain not reassure the examiner when tendon rupture is possible?	Rupture may cause surprisingly little pain yet still produce a palpable gap, altered contour, weakness and loss of a normal mechanical test, so function must be examined.	Integrated Medical Foundations; chapter 33, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d07abe76edfed4dc5067123f81d3657a0e2a8d92cd0b1f9b8cccbbc426027591; editorial review pending	imf lang::en chapter::033 module::033-01 review::pending
IMF-033-01-0006-en	What distinguishes a low-energy fragility fracture from a pathological fracture in what it implies about the bone?	A fragility fracture implies generally reduced bone strength, whereas a pathological fracture occurs through a focal disease process in the bone.	Integrated Medical Foundations; chapter 33, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d07abe76edfed4dc5067123f81d3657a0e2a8d92cd0b1f9b8cccbbc426027591; editorial review pending	imf lang::en chapter::033 module::033-01 review::pending
IMF-033-01-0007-en	Why does an open fracture need urgent antibiotics, tetanus assessment and surgical debridement?	Because the fracture communicates with the environment; it also needs sterile coverage and stabilisation, and the wound should not be repeatedly probed.	Integrated Medical Foundations; chapter 33, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d07abe76edfed4dc5067123f81d3657a0e2a8d92cd0b1f9b8cccbbc426027591; editorial review pending	imf lang::en chapter::033 module::033-01 review::pending
IMF-033-01-0008-en	An early radiograph looks normal but focal bony signs persist. How should this be managed, and why?	Immobilise and repeat or advance the imaging, because apparently normal early radiographs can miss occult fractures.	Integrated Medical Foundations; chapter 33, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d07abe76edfed4dc5067123f81d3657a0e2a8d92cd0b1f9b8cccbbc426027591; editorial review pending	imf lang::en chapter::033 module::033-01 review::pending
IMF-033-01-0009-en	Why can compartment syndrome be present while distal pulses remain palpable?	The problem is raised pressure inside a closed fascial space impairing tissue perfusion, not major arterial occlusion, so pain out of proportion, pain on passive stretch, tense swelling and neurological change are the warnings.	Integrated Medical Foundations; chapter 33, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d07abe76edfed4dc5067123f81d3657a0e2a8d92cd0b1f9b8cccbbc426027591; editorial review pending	imf lang::en chapter::033 module::033-01 review::pending
IMF-033-01-0010-en	Why is compartment syndrome managed by removing constriction and seeking emergency fasciotomy assessment rather than observation?	Delay allows muscle necrosis, nerve injury, kidney damage, contracture and limb loss.	Integrated Medical Foundations; chapter 33, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d07abe76edfed4dc5067123f81d3657a0e2a8d92cd0b1f9b8cccbbc426027591; editorial review pending	imf lang::en chapter::033 module::033-01 review::pending
IMF-033-01-0011-en	Why is osteoarthritis described as whole-joint failure rather than simple cartilage wear?	It involves cartilage, subchondral bone, synovium, ligaments, capsule and muscle, with attempted repair, osteophytes, bone remodelling and intermittent synovitis accompanying cartilage loss.	Integrated Medical Foundations; chapter 33, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d07abe76edfed4dc5067123f81d3657a0e2a8d92cd0b1f9b8cccbbc426027591; editorial review pending	imf lang::en chapter::033 module::033-01 review::pending
IMF-033-01-0012-en	Which features of joint pain argue against osteoarthritis and suggest another process?	Osteoarthritis typically causes activity-related pain with brief stiffness after rest, so marked inflammation, prolonged morning stiffness, systemic features or an unusual distribution suggest something else.	Integrated Medical Foundations; chapter 33, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d07abe76edfed4dc5067123f81d3657a0e2a8d92cd0b1f9b8cccbbc426027591; editorial review pending	imf lang::en chapter::033 module::033-01 review::pending
IMF-033-01-0013-en	What can joint replacement and arthroscopy each offer in severe osteoarthritis?	Joint replacement can restore function after non-operative care fails, whereas arthroscopy does not reverse diffuse degeneration.	Integrated Medical Foundations; chapter 33, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d07abe76edfed4dc5067123f81d3657a0e2a8d92cd0b1f9b8cccbbc426027591; editorial review pending	imf lang::en chapter::033 module::033-01 review::pending
IMF-033-01-0014-en	Why does neither a normal serum urate nor the finding of urate crystals settle the diagnosis of an acute hot joint?	Serum urate can be normal during a gout flare, and needle-shaped negatively birefringent crystals support gout but do not exclude concurrent infection.	Integrated Medical Foundations; chapter 33, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d07abe76edfed4dc5067123f81d3657a0e2a8d92cd0b1f9b8cccbbc426027591; editorial review pending	imf lang::en chapter::033 module::033-01 review::pending
IMF-033-01-0015-en	How is long-term urate-lowering therapy started, and what happens to it during a flare?	Start low, titrate to a target urate and give flare prophylaxis during initiation; it can initially trigger flares but should usually continue during one.	Integrated Medical Foundations; chapter 33, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d07abe76edfed4dc5067123f81d3657a0e2a8d92cd0b1f9b8cccbbc426027591; editorial review pending	imf lang::en chapter::033 module::033-01 review::pending
IMF-033-01-0016-en	What distinguishes calcium pyrophosphate crystals from urate crystals, and what can treatment of calcium pyrophosphate deposition achieve?	They are rhomboid and weakly positively birefringent; treatment controls inflammation, but no established therapy removes the crystal burden.	Integrated Medical Foundations; chapter 33, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d07abe76edfed4dc5067123f81d3657a0e2a8d92cd0b1f9b8cccbbc426027591; editorial review pending	imf lang::en chapter::033 module::033-01 review::pending
IMF-033-01-0017-en	A healthy afebrile adult has a hot swollen painful joint. Why is it still treated as septic arthritis, and what is done before antibiotics?	Healthy people are not exempt and fever may be absent, so blood cultures and urgent synovial fluid for cell count, Gram stain, culture and crystals are obtained, then antibiotics start without harmful delay and drainage is arranged.	Integrated Medical Foundations; chapter 33, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d07abe76edfed4dc5067123f81d3657a0e2a8d92cd0b1f9b8cccbbc426027591; editorial review pending	imf lang::en chapter::033 module::033-01 review::pending
IMF-033-01-0018-en	Why does chronic osteomyelitis need source control rather than antimicrobials alone?	Chronic disease may form necrotic bone, sinus tracts and biofilm, so treatment combines source control, targeted antimicrobials guided by deep-tissue or bone microbiology, perfusion and pressure management, and stabilisation.	Integrated Medical Foundations; chapter 33, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d07abe76edfed4dc5067123f81d3657a0e2a8d92cd0b1f9b8cccbbc426027591; editorial review pending	imf lang::en chapter::033 module::033-01 review::pending
IMF-033-01-0019-en	What does a positive anti-citrullinated-peptide antibody add in suspected rheumatoid arthritis, and what does a negative result fail to do?	It is more specific than rheumatoid factor and may predict erosive disease, but negative antibodies or normal markers do not exclude clinical synovitis.	Integrated Medical Foundations; chapter 33, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d07abe76edfed4dc5067123f81d3657a0e2a8d92cd0b1f9b8cccbbc426027591; editorial review pending	imf lang::en chapter::033 module::033-01 review::pending
IMF-033-01-0020-en	Why is rheumatoid arthritis treated early with disease-modifying drugs aiming at remission rather than with analgesia?	Immune-mediated synovitis can destroy cartilage, bone, tendon and ligament, and early disease-modifying treatment improves long-term outcome; the aim is remission or low activity.	Integrated Medical Foundations; chapter 33, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d07abe76edfed4dc5067123f81d3657a0e2a8d92cd0b1f9b8cccbbc426027591; editorial review pending	imf lang::en chapter::033 module::033-01 review::pending
IMF-033-01-0021-en	How does inflammatory back pain of spondyloarthritis differ from typical degenerative back pain, and where does HLA-B27 fit?	It often improves with movement, disturbs the second half of the night and begins younger; HLA-B27 supports risk in context but is not diagnostic.	Integrated Medical Foundations; chapter 33, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d07abe76edfed4dc5067123f81d3657a0e2a8d92cd0b1f9b8cccbbc426027591; editorial review pending	imf lang::en chapter::033 module::033-01 review::pending
IMF-033-01-0022-en	Why is a positive antinuclear antibody alone insufficient to establish lupus likelihood or activity?	It is sensitive but poorly specific, so more specific antibodies, complement, blood counts, urine sediment, protein excretion, kidney function and phenotype are needed.	Integrated Medical Foundations; chapter 33, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d07abe76edfed4dc5067123f81d3657a0e2a8d92cd0b1f9b8cccbbc426027591; editorial review pending	imf lang::en chapter::033 module::033-01 review::pending
IMF-033-01-0023-en	In suspected vasculitis, what role do autoantibodies play compared with biopsy or vascular imaging?	Autoantibodies support the diagnosis but do not replace the clinical phenotype, whereas biopsy or vascular imaging often establishes it.	Integrated Medical Foundations; chapter 33, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d07abe76edfed4dc5067123f81d3657a0e2a8d92cd0b1f9b8cccbbc426027591; editorial review pending	imf lang::en chapter::033 module::033-01 review::pending
IMF-033-01-0024-en	Why should immune therapy not be reflexively escalated when an immunosuppressed patient develops fever?	Fever may reflect infection, disease flare or both, so dangerous infection must be excluded before escalating immunosuppression.	Integrated Medical Foundations; chapter 33, TTS module 1; https://theisegoria.github.io/medical-textbook/integrated-medical-foundations-expanded-english.md; module SHA256 at export: d07abe76edfed4dc5067123f81d3657a0e2a8d92cd0b1f9b8cccbbc426027591; editorial review pending	imf lang::en chapter::033 module::033-01 review::pending