Mehl. Peds MSK random Dx table Flashcards
Talipes equinovarus aka?
Aka clubbed foot.
USMLE just wants you to know that this is treated initially with serial casting. What Dx?
Talipes equinovarus aka clubbed foot.
Talipes equinovarus aka clubbed foot. Tx?
USMLE just wants you to know that this is treated initially with serial casting.
Talipes equinovarus aka clubbed foot. Cause? in what syndrome can be seen?
Usually idiopathic; can be seen in Potter sequence.
Talipes equinovarus aka clubbed foot.
!!Not the same as rocker-bottom foot (aka congenital vertical talus), seen in Edward syndrome.
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Arthrogryposis.
You just need to know this is fancy name for a child born with multiple joint contractures.
If they give you a child with not just a clubbed foot, but also knee and/or elbow contractures, etc., the answer is arthrogryposis.
Tibia vara. Aka Blount disease.
CP?
Bowing of the tibias after the age of 2 years in a patient whom rickets has been ruled out.
Can be unilateral or bilateral.
Tibia vara. Bowing of one or both tibias is sometimes normal until age 2 years.
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Tibia vara. Tx?
Treatment is surgery (osteotomy).
Growing pains. No, this is not a joke. This is the answer straight-up on a 2CK NBME form.
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Vignette is healthy child age 3-12 who awakens from sleep with throbbing pain in the legs. Dx?
Growing pains
Growing pains. Tx?
No treatment necessary. You just need to know this Dx is exists and isn’t a troll.
The answer on USMLE if they give severe heel pain that is worst when first getting out of bed in the morning. Dx?
Plantar fasciitis
Buzzy vignette is knee pain in fast-growing teenage male who plays soccer. Don’t pigeon-hole things, but that’s classic vignette. Dx?
Osgood-Schlatter disease
Osgood-Schlatter disease. mechanism?
Inflammation of the patellar ligament at the tibial tuberosity.
Mechanism is repeated stress on the growth plate of the superior tibia.
The answer on USMLE if they say lateral knee pain, usually in a runner. Dx?
Iliotibial band syndrome
Iliotibial band syndrome. Anatomic location?
Iliotibial band runs from the hip to the knee. Pain may occur anywhere along the hip, lateral thigh, and lateral knee, but is worst in the latter.
Iliotibial band syndrome. TX?
conservative with physiotherapy; NSAIDs for pain.
“Unhappy triad” Refers to a trio injury of the ??
ACL, medial collateral ligament, and either the medial or lateral meniscus.
“Unhappy triad”. Students are sometimes fanatical about this triad as though it has yieldness. USMLE doesn’t give a fuck. I cannot recall a single NBME question that has ever assessed this. This Dx primarily resides within the domain of Qbank, not the NBME
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Medial meniscal tear.
Medial knee pain where patient experiences “locking” or “catching” of the knee in partial flexion.
….knee pain where patient experiences “locking” or “catching” of the knee in partial flexion. Dx?
Medial pain.
Medial meniscal tear.
Medial meniscal tear Dx?
Diagnosed with McMurray test -> EXTERNAL rotation of leg with concurrent knee extension causes medial knee pain / “catching.”
Diagnosed with McMurray test ???
Medial meniscal tear
….. knee pain where patient experiences “locking” or “catching” of the knee in partial flexion. Dx?
Lateral meniscal tear
Lateral meniscal tear Dx?
Diagnosed with McMurray test -> INTERNAL rotation of leg with concurrent knee INTERNAL causes … knee pain / “catching.”
Diagnosed with McMurray test -> internal rotation of leg with concurrent knee INTERNAL causes …knee pain / “catching.”
Lateral meniscal tear
…… is the answer if valgus test induces excessive medial motion of the knee compared to the unaffected side.
Medial collateral ligament injury.
Valgus test = hand placed on lateral knee and pushing inward + other hand placed on medial ankle and pulling outward. Pathology?
Medial collateral ligament injury
….. the answer if varus test induces excessive lateral motion of the knee compared to the unaffected side.
Lateral collateral ligament injury
Varus test = hand placed on medial knee and pushing outward + other hand placed on lateral ankle and pushing inward. Pathology?
Lateral collateral ligament injury
…. is answer if (+) anterior drawer test or Lachman test -> excessive anterior displacement of tibia relative to femur.
Anterior cruciate ligament injury
Classically injured when knee is hyper-extended, or with a rotational force on a fixed, planted knee. Dx?
Anterior cruciate ligament injury
…. is answer if (+) posterior drawer test -> excessive posterior displacement of tibia relative to femur.
Posterior cruciate ligament injury
Classically injured when knee hits the dashboard in car accident
Posterior cruciate ligament injury
Patellofemoral pain syndrome.
Aka chondromalacia patellae; name implies softening of cartilage in the knee.
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The answer on NBME if they say pain that worsens when sitting for long periods of time, or when going up or down stairs.
Patellofemoral pain syndrome
Classic in obesity or those who squat heavy weight (knees think you’re obese).???
Patellofemoral pain syndrome
Patellofemoral pain syndrome. Tx?
Tx = quadriceps strengthening exercises.
Lateral epicondylitis. Tennis elbow.
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pain worsened when patient extends wrist against resistance.???
Lateral elbow pain.
Lateral epicondylitis
NBME asks “extensor carpi radialis brevis” as answer for site of inflammation. Dx?
Lateral epicondylitis
Medial/lateral epicondylitis. Tx = ?
“forearm strap” on 2CK FM forms
Medial epicondylitis. Golfer elbow.
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…. pain worsened when patient flexes wrist against resistance.
Medial elbow
Medial elbow, iflammation of what?
Inflammation at flexor carpi radialis and pronator teres.
Radial head subluxation. “Nursemaid elbow”; HY for 2CK Peds.
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Child stops using arm + arm pronated and partially flexed.
Radial head subluxation.
Hx of child having arm pulled/yanked, or child holding hands and running with older sibling + the child falls, resulting in elbow pull.
Radial head subluxation.
Radial head subluxation. Tx?
Tx = hyper-pronation, OR supination when arm partially flexed. Either is correct. Both will not be listed at the same time as answers.
nereikia daryt xray!!! buvau sita pazymejus
Inflammation of patellar tendon.?
Patellar tendonitis (“Jumper’s knee”)
The answer on USMLE if they describe anterior knee pain that initially occurs only after finishing sports (e.g., basketball game), then progresses to more chronic pain. Dx?
Patellar tendonitis (“Jumper’s knee”)
Patellar tendonitis (“Jumper’s knee”), Tx?
“quadricep strengthening exercises.”
Patellofemoral instability. Presentation is annoyingly similar to patellar tendonitis, but do not confuse.
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Patellofemoral instability is misalignment of the patella at the trochlear groove of the femur. Q can mention crepitus.
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Shows up on 2CK Peds CMS form 6 as teenage girl who has knee pain worse after jumping or running + has crepitus, answer=?
answer = “patellofemoral instability” (patellar tendonitis / “jumper’s knee” not listed as answer).
