Ian's Differentiators

Question 1

Knee sprain in a kid?

Answer 1

R/O SHI of distal femur with stress views

Question 2

Possible dx of congenital scoliosis?

Answer 2

Needs, Echo, Renal US, and MRI

Question 3

Down Syndrome, RA, OI, etc.

Answer 3

Need flex/ex, ADI and SAC calculations for AAI

Question 4

Preoperatively for DMD, OI and Turners

Answer 4

Malignant hyperthermia (*Keep kid WB)

Question 5

Why VEPTR?

Answer 5

Congenital scoliosis to treat thoracic insufficiency syndrome

Question 6

When sending a biopsy you must include?

Answer 6

Cultures (specific to what organism, fungus, TB, P Acnes etc)

Question 7

Pseudomonas Treatment - GN rod

Answer 7

Pipercillin (Maybe Pip Tazo), Cipro, 3rd gen. cefalosporin

Question 8

Pagets perioperative

Answer 8

High output cardiac failure, bleeding (don’t forget bisphosphonates)

Question 9

Buzz words for revision THA?

Answer 9

Cluster cup, consider porous metal vs. HA coated porous cup, calcar replacing, modular stem, distal fit

Question 10

Valgus knee

Answer 10

PNP

Question 11

Knee dislocation/Schatzker 4

Answer 11

ABI >0.9

Question 12

Grisel’s - what imaging investigation? What is it testing?

Answer 12

Dynamic CT, is transverse ligament intact

Question 13

Transarticular screws requirements/risk

Answer 13

Hypoplastic pars, C2 lateral mass, high riding vert

Question 14

What is the extra step to do in SCFE?

Answer 14

Decompress the femoral head (maybe in septic hip too!)

Question 15

If a diagnosis of EG what do you have to check?

Answer 15

Rule out HSC for bone and visceral involvement

Question 16

What systemic workout of a bony lesion?

Answer 16

Bone scan, local MRI, full length xrays

Question 17

AVN of femoral head

Answer 17

image both sides

Question 18

Diaphyseal femur fracture

Answer 18

image the neck

Question 19

CMT

Answer 19

DDH, Scoliosis, Cavovarus

Question 20

Myelodysplasia, NMD

Answer 20

Latex

Question 21

When assessing MRI for tumor, note?

Answer 21

NVI involvement, intra/extracapsular, articular involvement

Question 22

Why often extraarticular resection of shoulder?

Answer 22

Because of LHB

Question 23

What bone graft to use in fibrous dysplasia?

Answer 23

Cortical cancellous allograft can supplement with tricalcium phosphate

Question 24

DMD can present as?

Answer 24

Toe walkers (Idiopathic, CP, NMD, fibular hemimelia)

Question 25

If thinking chondroblastoma

Answer 25

R/O Clear cell chondrosarcoma

Question 26

ABC

Answer 26

Telangiectatic ostosarcoma

Question 27

With GCT

Answer 27

Consider brown’s tumor

Question 28

Posteromedial bowing?

Answer 28

Calcaneovalgus foot, LLD!!

Question 29

Anterolateral bowing?

Answer 29

NF

Question 30

Anteromedial bowing?

Answer 30

Fibular hemimelia (is foot reconstructable, is ankle reconstructable, is there upper extremity involvement)

Question 31

When to use BZD?

Answer 31

Facet reduction, AARD

Question 32

What do you have to check prior to soft tissue reconstruction or joint reconstructions?

Answer 32

Mechanical axis, so think correct deformity of a malunion or HTO prior to ACL

Question 33

What to rule out before ACL recon?!

Answer 33

PLC injury

Question 34

Revision ACL principles

Answer 34

1. High strength graft (don’t repeat BTB)
2. Bone graft tunnels if necessary
3. Dual fixation screw and suspensory