MSK - Lower Limb Orthopaedic Pathology

Question 1

osteoarthritis is

a. worse on activity , asymmetrical

b.worse at rest, symmetrical

Answer 1

a. worse on activity , asymmetrical

Question 2

patient with osteoarthritis is wanting surgery, they say they have lost weight and decreased their activity in order to qualify as suitable for surgery they have also been using supports and are currently taking paracetamol should they be referred for surgery

a.yes
b.no

Answer 2

b.no

haven’t tried steroid injections yet

all conservative management must be trialled before surgery

Question 3

investigations for a limping child general rules

Answer 3

ultrasound scan and x ray
bloods
re examine - take a second look and get a second opinion

Question 4

SUFE

Answer 4

slipped upper femoral epiphysis

NEVER MISS THIS

Question 5

overweight, male,african American and puberty are risk factors for which condition

a.SUFE
b.Perthes disease
c.septic arthritis
d.reactive arthritis

Answer 5

a.SUFE

Question 6

child with pain in the knee and limp on exam there is externally rotated gait and a knee x ray is performed . no signs of damage are seen what should be done next

a.bloods
b.ultrasound knee
c.hip x ray
d.ultrasound hip

Answer 6

c.hip x ray

check for sufe

slipped upper femoral epiphysis

Question 7

a normal Klein line on hip x ray should…

a. transect a small part of the epiphysis
b.not transect the epiphysis

Answer 7

a. transect a small part of the epiphysis

femoral head should have a ice cream cone appearance where it meets acetabulum

Question 8

patient male 2-10 yrs, gradual onset intermittent limp, what is the most likely cause

a.SUFE
b.Perthes disease
c.septic arthritis
d.reactive arthritis

Answer 8

b.Perthes disease

top of femur collapses and is rebuilt in a different shape

have to let it run its natural cause

Question 9

what happens if a sufe goes undetected

Answer 9

ongoing pain
ongoing limp
leg length discrepancy
earlier onset arthiritis

Question 10

child with a. limp and pain on exam they have a raised temp , appear upset and have a raised wcc, an ultrasound is done and shows a large effusion, the patient is given paracetamol but does not ease the pain what is the most likely diagnosis

a.SUFE
b.Perthes disease
c.septic arthritis
d.reactive arthritis

Answer 10

c.septic arthritis

Question 11

child with a. limp and pain on exam they do not want to walk but are otherwise well, bloods are done and come back normal and ultrasound shows a small effusion patient is given ibuprofen and symptoms ease what is the likely diagnosis

a.SUFE
b.Perthes disease
c.septic arthritis
d.reactive arthritis

Answer 11

d.reactive arthritis

Question 12

suspected septic or reactive arthritis investigations

Answer 12

pain relief
exam
bloods
uss