MSK/Ortho

Question 1

Internal tibial torsion intervention?

Answer 1

Usually self resolve, referral to ortho if persist past 8 years old, interfere with activity, or for cosmesis

Question 2

Blount disease

Answer 2

Varus malformation due to abnormal slow growth of medial proximal tibia. Clx: Obese, black, bowing leg, pain, palpable metaphyseal beak. Tx: Braces

Question 3

Chronic anterior knee pain that worsens after going up or down stairs, or with prolonged sitting

Answer 3

Patellofemoral pain syndrome

Question 4

Very painful bone at night, XR shows round metaphyseal lucency surround by sclerotic bone (dz and tx)

Answer 4

Osteoid osteoma = benign, NSAID

Question 5

Periosteal elevation with “onion skin” or “moth eaten” appearance

Answer 5

Ewing sarcoma

Question 6

Mixture of radiodense and radiolucent areas with periosteal new bone formation, lifting of the cortex, and formation of a “Codman triangle”, and soft tissue mass in radial or sunburst pattern

Answer 6

Osteosarcoma

Question 7

Small radiolucency at joint surrounded by well-demarcated, thin, linear fragment of subchondral bone which may be attached, partially attached, or free within joint space (dz and tx)

Answer 7

Osteochondritis dissecans => restrict activity if sxs

Question 8

Buckle handle fracture vs buckle fracture

Answer 8

Buckle handle fracture = metaphyseal fracture in infants: high specificity for child abused

Buckle fracture = distal radius fracture, not abuse