MSK Quizzes Flashcards
Pathognomic Sign of Transient (Toxic) Synovitis (paeds)
- fever
- interestingly wt bearing present
- pain on affected side
Reduced intra-uterine space is commonly associated with…?
- congenital scoliosis
Which coronal plane angulation is least likely to be physiological?
a. Bilateral genu varus aged 1
b. Bilateral genu valgus aged 5
c. Bilateral genu varus aged 4
d. Bilateral genu valgus aged 7
e. Bilateral genu varus aged 6 weeks
C = Bilateral genu varus aged 4
*all babies born with varus legs until ~2
valgus knees from 2-7yo
therefore at 4, varus is abn.
*Salenius’ Curve
Which foot deformity is not associated with TEV?
a. Hallux valgus of the forefoot
b. Cavus of the midfoot
c. Adductus of the midfoot
d. Varus of the hindfoot
e. Equinus of the ankle
A = Hallux valgus of the forefoot = Varus is associated.
* C. avus A dductus V arus E quinus
Which child with a scoliosis is ultimately, most likely to require spinal, surgical correction?
a. A 12 year old girl with a 30º non-structural scoliosis
b. A 10 year old girl with a 30º ideopathic scoliosis
c. A 12 year old girl with a 30º ideopathic scoliosis
d. A 14 year old girl with a 30º ideopathic scoliosis
e. A 16 year old girl with a 30º ideopathic scoliosis
b. A 10 year old girl with a 30º ideopathic scoliosis as greatest risk of progression, idiopathic. Threfore the younger the child = more time to grow (worse) = Sx indicated
* High risk progression: premenarchal, <12yo at presentation, size of curve at prees.
What is the mainstay of tx for Perthe’s Disease (paeds)
> Supervised neglect
Maintain hip motion; avoid painful activities
Analgesia
Pathognomic Signs of Perthe’s Disease
necrosis of growth cartilage + bone necrosis
XR: not as rounded HoFemur
Pathognomic Signs of XR SUFE
Head is. in the acetabulum but slipped capital head epiphysis
Look for Line of Klein.
Teen years
Does Transient Synovitis cause XR changes?
No
DDH RFactors
Frist brn oligohydramnios breech fhx lower limb deformities females
In a 5 year old girl with a closed, completely displaced, Salter-Harris type 2 fracture of the distal femur that has been optimally treated, which complication is least likely?
a. Overgrowth of the affected limb
b. Premature growth plate arrest
c. Non-union of the fracture
d. Knee stiffness 3 months after injury
e. Coronal angular deformity developing
c = non. union
- dmg. to growth plate will affect growth/disrupted growth/overgrowth/angular deform
- non-union = almost unknown thus least likely
Other causes of mult #and different stages of healing
NAI
or
- congenital/metabolic bone disease altered healing
Are buckle # features. of NAI?
no
Signifiance of Ortolani Test
+ = hip dislocation associated with DDH and used to test in babies
When performing a newborn baby examination, which findings are not consistent with moulding effects due to reduced intra-uterine space?
a. Metatarsus adductus
b. Congenital scoliosis
c. Plagiocephaly
d. Torticolis
e. Postural talipes equino varus
b = congen. scoliosis
*packaging problem (vs manufacturing) affecting vertebral development
Which treatment option is least appropriate in acute tibial osteomyelitis management
a. Commencing high dose IV antibiotics to cover likely organisms
b. Immobilising the affected limb in a splint
c. Encouraging regular weight-bearing exercise on the limb
d. Regular, appropriate analgesia
e. Optimising nutritional state
c. Encouraging regular weight-bearing exercise on the limb
In a patient with chronic osteomyelitis, which statement is most accurate
a. This could be a life-long condition for them
b. A 2 week course of appropriate antibiotics is likely to cure the problem
c. Skin cancer arising from a dry sinus is very likely
d. Production of an involucrum will prevent pathological fracture
e. A sequestrum can usually be located by using an U/S scan
a. This could be a life-long condition for them
Which complication of severe, distal femoral acute osteomyelitis in a child is least likely?
a. Arthritis of the hip
b. Angular deformity of the limb
c. Chronic localised osteomyelitis with a sinus
d. Limb length discrepancy
e. Bacterial endocarditis
a. Arthritis of the hip
What clinical presentation is least likely with TB of the knee joint?
a. Involuntary weight loss over several months
b. Ongoing treatment of HIV
c. No close contact with a person known to have TB
d. Swelling of the knee with restricted movement
e. Knee pain worse on exercise and relieved by rest
e. Knee pain worse on exercise and relieved by rest
Identify which statement about acute osteomyelitis is incorrect
a. It is more frequently seen in children than adults
b. If diagnosed early, it is usually treated by surgery alone
c. The infection often has spread from a different site (Haematogenous spread)
d. Often it initially presents with localised pain and few clinical signs
e. Staphylococcus aureus is the most frequent causative organism
b. If diagnosed early, it is usually treated by surgery alone
If the median nerve is completely divided at the elbow and not repaired, which clinical finding is least likely after 3 months ?
a. Wasting of the forearm muscles
b. Increased skin sweating in the distribution of the median nerve in the hand
c. Lack of sensation in the distribution of the median nerve in the hand
d. Reduced power of finger flexion
e. Wasting of the thenar eminence
b. Increased skin sweating in the distribution of the median nerve in the hand
Which patient who has suffered complete division of the ulnar nerve in the forearm that has been immediately accurately repaired by an expert has the best prognosis?
a. A young child with an injury at the level of the wrist
b. A young child with an injury at the level of the elbow
c. An 80 year old man with an injury at the level of the elbow
d. An 80 year old man with an injury at the level of the wrist
e. A young child with an injury at the level of the wrist requiring nerve grafting
a. A young child with an injury at the level of the wrist
Which structure unlikely to be found within a peripheral nerve?
a. Endoneurium
b. A Blood vessel
c. An Axon
d. Epineurium
e. Myelin
d. Epineurium
In ligamentous injury what will not be seen on microscopic examination?
a. Blood clot between the ends of the tendon at an early stage
b. Cellular infiltrate between tendon ends after a few days
c. Production of “scar tissue” between tendon ends after few weeks
d. Re-modelling of collagen structure over several months
e. A normal ligament after a few years
e. A normal ligament after a few years
