Bone Disorders

Question 1

Heterotopic ossification (HO)

Answer 1

Formation of trabecular bone in a location in the body where it does not normally exist

Question 2

Causes of Heterotopic ossification

Answer 2

Truama
Burns/wounds
TBI/SCI
Spasticity
Hip dislocation
Inflammatory myopathies
Parathyroid d/o
Vitamin D excess
Immobilization

Question 3

Myositis ossificans

Answer 3

HO due to trauma at a single site

Question 4

Myositis ossificans progressive (MOP)

Answer 4

Rare, severely disabling, autosomal dominant HO with variable expressivity

Question 5

Dx of Heterotopic ossification

Answer 5

3-phase bone scan
CT scan
CBC, ESR, Alk phos

Question 6

Tx of Heterotopic ossification

Answer 6

NSAID
Bracing
Etidronate in adults

Question 7

Legg-Calve-Perthes Dz

Answer 7

Avascular necrosis of the hip in children

Question 8

Legg-Calve-Perthes Dz Clinical features

Answer 8

Walks with antalgic limp
Pain in groin, knee and thigh over weeks to mo
Muscle spasm around hip

Question 9

Slipped Capital Femoral Epiphysis (SCFE)

Answer 9

MC adolesecen hip d/o

Displacement of femoral epiphysis on he metaphysis

Question 10

Epidemiolgy of SCFE

Answer 10

Males MC
Black and Hispanic
Peak age 13 (male), 11 (female)
Bilateral 25% of time

Question 11

Risk factors of SCFE

Answer 11

Renal osteodytrophy
Radiation
Down Syndrome
Obesity
Hypothyroidism
Hypopituitarism
Rickets

Question 12

History of SCFE

Answer 12

Sudden onset of pain without trauma
Chronic pain over weeks l/t limp
Inability to ext or IR
Refusal to bear wt
Out toed gait
Abductor lurch

Question 13

Exam of SCFE

Answer 13

Loss of IR of hip
Pain with ext and IR
ER and flexed foot

Question 14

Abductor lurch

Answer 14

Pelvis drops in single leg stance, then trunk shifts toward side to with hip abductor weakness to compensate

Question 15

Transient Synovitis of the Hip

Answer 15

Idiopathic benign inflammation of the joint

Often seen in children w/ recent URI

Question 16

Transient synovitis of the hip CF

Answer 16

Unilateral knee, hip or thigh pain
Duration days to weeks
Refusal to bear wt
ADD and IR of leg elicit pain

Question 17

Osteogenesis Imperfecta

Answer 17

Heritable d/o of ABN bone quality or quantity

Question 18

Defect in Osteogenesis Imperfecta Types I-IV

Answer 18

Type I collagen

Question 19

Defect in Osteogenesis Imperfecta Types V-VIII

Answer 19

Normal collagen

Other genetic mutations

Question 20

Inheritance of Osteogenesis Imperfecta

Answer 20

Autosomal dominant

Question 21

Osteogenesis Imperfecta CF

Answer 21

Fractures: few to hundreds
Sclerae blue to gray
Short stature w/ more fractures
Relative macrocephaly
Conductive hearing loss
Scoliosis

Question 22

Osteogenesis Imperfecta Tx

Answer 22

Bisphosphonates

Growth hormone

Question 23

Primary Osteoporosis

Answer 23

Bone loss associated with loss of estrogen or aging

MC type

Question 24

Secondary Osteoporosis

Answer 24

Bone loss associated w/ other conditions

Question 25

Scoliosis CF

Answer 25

Toricollis and hip dysplasia in infants
Rib hump
Leg length discrepancy
Progression related to growth spurts

Question 26

Adams test

Answer 26

Rib hump seen when looking at back on forward bending

Question 27

Predominant scoliotic curves in infants and adolescents

Answer 27

Infants: Left thoracic
Adolescent: Right thoracic

Question 28

Risser classification

Answer 28

Estimation of skeletal maturity defined by amount of classification present in the iliac apophysial radiograph