MSK part 2

Question 1

What is another name for Developmental Dysplasia of the hip?

Answer 1

Congenital hip dislocation

Question 2

What causes Developmental Dysplasia of the Hip?

Answer 2

Excessive hip flexion in utero (breech) causes lax posterior hip capsule musculature which can result in posterior dislocation of the femoral head

Question 3

What can you observe that may point towards a diagnosis of Developmental Dysplasia of the Hip?

Answer 3

With the hips and knees flexed, the dislocated side will have a lower knee
– Also asymmetric inguinal skin folds
– Also limited abduction

Question 4

If you see an infant with asymmetric inguinal skin folds or limited leg abduction, what should you be concerned for?

Answer 4

Developmental Dysplasia of the Hip

Question 5

What 2 maneuvers can help assess for Developmental Dysplasia of the Hip?

Answer 5

Barlow
Ortolani

Question 6

Describe the Barlow Maneuver

Answer 6

With posterior pressure, adducting the hip causes the femoral head to dislocate
= Audible clunk

Question 7

Describe the Ortolani Maneuver

Answer 7

With anterior pressure, abducting the hip reduces the femoral head back into the acetabulum with a soft click

Question 8

Without treatment, what 2 conditions may result from Developmental Dysplasia of the Hip?

Answer 8

Joint contracture
AVN of the femoral head

Question 9

What is the treatment for Developmental Dysplasia of the hip for < 6 months, 6-15 months, > 15 months?

Answer 9

< 6 months = Splint to maintain F/Abd
6-15 months = Spica cast
> 15 months = Open reduction + Spica cast

Question 10

At what ages is Legg-Calve-Perthes Disease common in boys?

Answer 10

4-10 years old

Question 11

What is Legg-Calve-Perthes Disease?

Answer 11

AVN of the femoral head

Question 12

What are the signs of Legg-Calve-Perthes Disease?

Answer 12

PainLESS limp
Thigh atrophy
Impaired Abduction/IR

Question 13

Legg-Calves-Perthes Disease - unilateral or bilateral?

Answer 13

Unilateral

Question 14

What will an XR show with Legg-Calve-Perthes Disease?

Answer 14

Normal or flattened femoral head

Question 15

If full ROM is present with Legg-Calve-Perthes Disease, what is the treatment?

Answer 15

Observation

Question 16

If there is decreased ROM present with Legg-Calve-Perthes Disease, what is the treatment?

Answer 16

Bracing or Osteotomy

Question 17

If a young boy presents with a painless limp, what should you suspect?

Answer 17

Legg-Calve-Perthes Disease

Question 18

What 2 motions are impaired with SCFE and Legg-Calve-Perthes Disease?

Answer 18

Abduction and IR

Question 19

SCFE

Answer 19

Slipped Capital Femoral Epiphysis

Question 20

At what ages is SCFE common in boys? Another risk factor?

Answer 20

OBESE 10-16 year olds

Question 21

What is SCFE?

Answer 21

Displacement of the femoral head (epiphysis) from the femoral neck through the growth plate

Question 22

The femoral head remains in the joint capsule with SCFE, but where does it displace?

Answer 22

Medial and Inferior

Question 23

What else may be present in the obese boys that have SCFE?

Answer 23

Endocrinopathies

Question 24

What are the signs of SCFE?

Answer 24

PainFUL limp
Inability to bear weight
Impaired Abduction/IR

Question 25

How will patients hold their leg with SCFE?

Answer 25

ER

Question 26

SCFE - unilateral or bilateral?

Answer 26

May be bilateral

Question 27

Painful limp in a teenage boy, what should you suspect?

Answer 27

SCFE

Question 28

What is the treatment of SCFE?

Answer 28

Surgical fixation and non-weight bearing

Question 29

What is the child with untreated SCFE at risk for?

Answer 29

AVN and OA

Question 30

What defines Scoliosis?

Answer 30

Lateral curvature of the spine > 10 degrees

Question 31

Treatment for scoliosis curve < 20?

Answer 31

Observation

Question 32

Treatment for Scoliosis curve 20-49 degrees?

Answer 32

Bracing

Question 33

Treatment for Scoliosis curve > 50 degrees?

Answer 33

Surgery

Question 34

If Scoliosis is severe enough, what may be a complication?

Answer 34

Restrictive lung disease