Musculoskeletal

Question 1

Describe the X-ray findings seen in rickets?

Answer 1

Widening of the joint space
Metaphyseal cupping
Metaphyseal irregularities (splaying)
Metaphyseal flaring (ragged fraying)

Question 2

Imaging for suspected NAI in children under 1 year old?

Answer 2

Skeletal survey and CT head immediately - skeletal survery should be repeated in 11-14 days

Question 3

Imaging for suspected NAI in children under the age of 2?

Answer 3

Skeletal survey only - which should be repeated 11-14 days later

Question 4

Imaging in the twin of a child with suspected NAI?

Answer 4

The twin should undergo exactly the same imaging

Question 5

What condition is described when lytic lesions and periosteal reaction is present?

Answer 5

Osteomyelitis

Question 6

Characteristics of Kawasaki Disease?

Answer 6

At least 5 days of fever
Redness and dry fissured lips - strawberry tongue
Bilateral non-purulent conjunctivitis
Cervical Lymphadenopathy
Rash (polymorphous)
Oedema of the extre - which then becomes desquamated 10 days later mities

Question 7

Characteristic ECG finding in rheumatic fever?

Answer 7

Prolonged PR interval (1st degree heart block)

Question 8

How is JIA defined?

Answer 8

The onset of disease before the age of 16 with joint pain, swelling and stiffness for greater than 6 weeks duration

Question 9

5 year old patient presents with haematuria, aplastic anaemia and faltering growth +/- absent thumbs/ radii?

Answer 9

Fanconi’s Anaemia

Question 10

Teenager presents with pain and an antalgic gait and an externally rotated hip?

Answer 10

SUFE

Question 11

Uneven skin folds?

Answer 11

Think DDH

Question 12

Salmonella osteomyelitis is associated with which condition?

Answer 12

Sickle cell disease

Question 13

Investigations for Juvenille Dermatomyositis?

Answer 13

MRI of affected area
Skin Biopsy

Question 14

Symptoms of HSP in order of incidence?

Answer 14

Rash - all patients
Joint Pain - 75% of patients
Abdominal pain - 60% of patients
Renal disease - 50% of patients

Question 15

Most common complication of Kawasaki Disease?

Answer 15

Coronary Aneurysm

Question 16

Polyarticular JIA affects how many joints?

Answer 16

Four or more joints affected in a six month period

Question 17

What are the five diagnostic criteria of dermatomyositis?

Answer 17

Cutaneous disease/ typical rash of DM
Progressive, proximal symmetrical weakness
Elevated CPK levels
Abnormal findings of muscle biopsy
Myopathic changes on EMG (electromyography)

Question 18

XR changes in Perthes disease?

Answer 18

Radiolucency of the femoral head and sclerotic areas

Question 19

HLA-B27 is linked with …?

Answer 19

Ankylosing Spondylitis

Question 20

What are the poor prognostic factors of Ewing’s sarcoma?

Answer 20

Male sex
Age >18 years
Elevated LDH levels
Anaemia (demonstrates infiltration of the bone marrow)
Poor response to chemotherapy
Location of the tumour (i.e. central lesions have a poorer prognosis)

Question 21

What does Gena-Varum mean?

Answer 21

“Bowed legs”