MSK/Rheum

Question 1

Osteonecrosis

Answer 1

Femoral head, XR density, Idiopathic or sickle cell, boys 5-13

Question 2

JIA

Answer 2

Joints (symm upper lower ext), Inflammation (fever, rash worse w fever), Anemia, SCREEN FOR UVEITIS

DDX ARF must have preceding strep infx 2 weeks prior

Question 3

Transient synovitis

Answer 3

Can bear weight DDX osteomyelitis

Question 4

Kawasaki

Answer 4

COREL (conjunctivitis oral rash extremities LAD), tx IVIG aspirin

Question 5

Spondylolisthesis

Answer 5

Slow onset Back pain neuro sx L5-S1

Question 6

ARF

Answer 6

2 weeks post
2 JONES (joint, <3, nodules, erythema marginatum, syndenham chorea)
OR 1 + 2 minor FEAP (Fever, ESR/CRP, arthralgias, long PR)

Question 7

Osgood-Schlatter

Answer 7

Rapid growth 10-12 girls 13-14 boys, quads pull on patellar tendon insertion site on tibial tuberosity

Question 8

Trendelenburg sign

Answer 8

Gluteus weakness

Question 9

Slipped capital femoral epiphysis

Answer 9

Surgical pinning

Question 10

Peds bone tumors

Answer 10

Malignant:
Osteosarcoma (sunburst, metaphyses)
Ewing sarcoma (moths eating onions ew, diaphyses of long bones)

Benign:
Osteoid osteoma (RELIEVED BY NSAIDs, diaphyses, XR small round lucency)
Giant cell (epiphyses, soap bubble)
Osteochondroma

Question 11

Matatarsis Adductis v clubfoot

Answer 11

Forefoot only v forefoot + hindfoot

Reassurance v serial casting

Question 12

Myotonic dystrophies

Answer 12

These kids DBM (don’t be movin’)
Duchenne <5yo, absent dystrophin, die of resp or cardiac (hypertrophic cardiomyopathy)
Becker 5-15, dec dyst, die of cardiac
Myotonic, teenagers

Question 13

Osteomyelitis imaging

Answer 13

Tec-99

Question 14

Hip dysplasia

Answer 14

Shallow acetabulum