Musculoskeletal

Question 1

Inflammation of the tibial tubercle as a result of repetitive stressors in patients with immature skeletal development.

Answer 1

Osgood-Schlatter Disease

Question 2

Peak ages for Osgood-Schlatter disease? What is this disease associated with?

Answer 2

11-14

rapid growth spurt

Question 3

Where is pain located in Osgood-Schlatter disease?

Answer 3

Tibial tubercle

Question 4

Management of OSD?

Answer 4

Limiting activity

Question 5

Self-limiting inflammation of the hip, most likely due to a viral or immune cause

Answer 5

Toxic Synovitis

Question 6

What ages are most affected for toxic synovitis? Who’s affected more, males or females?

Answer 6

Ages 2 - 6

males

Question 7

Signs of toxic synovitis includes a ______ limp, _____ involvement

Answer 7

Painful limp

Unilateral involvement

Question 8

What do Xrays and joint fluid aspiration show with toxic synovitis?

Answer 8

NORMAL

Question 9

When should hospitalization be considered with toxic synovitis?

Answer 9

high fever or septic arthritis is considered

Question 10

Aseptic or avascular necrosis of the femoral head

Answer 10

Legg-Calve Perthes disease

Question 11

Onset of limp is ______ in legg-calve-perthes disease and there is pain in the _____.

Answer 11

insidious

knee

Question 12

In Legg-Calve-Perthes, there is limited ______ ______ ______ and abduction of the hip joint.

Answer 12

passive internal rotation

Question 13

What is the goal of treatment for LCPD?

Answer 13

To restore range of motion while maintaining femoral head within acetabulum

Question 14

In LCPD, observation is warranted if the child is less than __ years old, and there is involvement of less than ___ of the femoral head and full ROM is preserved.

Answer 14

6 years old

1/2 of the femoral head

Question 15

Aggressive treatment is needed in LCPD when more than ___ of the femoral head is involved and the child is older than __.

Answer 15

1/2 of the femoral head

6 years old

Question 16

Spontaneous dislocation of the femoral head (capital epiphysis) both downward and backward relative to the femoral neck and secondary to disruption of the epiphyseal plate.

Answer 16

Slipped Capital Femoral Epiphysis (SCFE)

Question 17

Incidence of SCFE is greater among ____ adolescents with _____ lifestyles.

Answer 17

Obese

Sedentary

Question 18

Where is pain located with SCFE? Where is the pain referred to (2)

Answer 18

Groin

Knee or thigh

Question 19

In SCFE, you may observe limb _______, resulting from proximal displacement of metaphysis.

Answer 19

shortening

Question 20

Lateral. bowing of the tibia, often due to joint laxity

Answer 20

Genu Varum (bowleg)

Question 21

Genu Varum is a normal variant until age ___.

Answer 21

2

Question 22

When should Genu Varum patients be referred to ortho?

Answer 22

If continued after 2 years of age

Question 23

Knees are abnormally close and ankle space is increased

Answer 23

Genu Valgum

Question 24

Genu Valgum typically evolves to normal alignment by age __

Answer 24

7 years

Question 25

In Genu Valgum, distance between medial malleoli is more than ___ inches.

Answer 25

3 inches

Question 26

Lateral curvature of the spine that is idiopathic and most common in adolescence.

Answer 26

Scoliosis

Question 27

Occurs more often in ____ with an 8:1 ratio

Answer 27

Females

Question 28

In scoliosis, there is ______ of shoulders, ribs, hips, and waistline

Answer 28

Asymmetry

Question 29

What test can you do to view asymmetry in scoliosis?

Answer 29

Adam's Forward Bend Test

Question 30

Lab/diagnostic test for Scoliosis?

Answer 30

XRay

Question 31

Observation in scoliosis is warranted if less than ____ degree curvature. Refer if greater to this degree of curvature.

Answer 31

25 degrees

Question 32

Progressive genetic disorder beginning in the lower extremities progressing to the upper extremities and torso

Answer 32

Muscular Dystrophy (Duchenne)

Question 33

What is the most common inherited neuromuscular disease in children?

Answer 33

Muscular dystrophy

Question 34

Average age of diagnosis for muscular dystrophy is __ to __ years

Answer 34

3 to 5 years

Question 35

What is it called when the child "walks" hands up legs to attain standing position when getting up?

Answer 35

Gower's maneuver

Question 36

Wheelchair dependence is often seen by age ___ in MD.

Answer 36

12 years

Question 37

Death from what complication is common in MD?

Answer 37

cardiopulmonary failure

Question 38

What lab test is markedly increased in affected males?

Answer 38

Creatine Kinase (CK)

Question 39

Stretching and/or tearing of the ligaments around the ankle, typically involving the lateral ligament complex and is the most common sport injury:

Answer 39

Ankle sprain

Question 40

Ankle injuries are graded __ to __

Answer 40

1 to 3

Question 41

Stretching but no tearing of ligament and no joint instability. There is minimal edema with full ROM

Answer 41

Stage 1 ankle injury

Question 42

Partial (incomplete) tear of ligament; some joint instability but definite end-point to laxity, ROM is limited

Answer 42

Stage 2 ankle injury

Question 43

Complete ligamentous tearing; joint unstable with no definite endpoint with ligamentous stressing, severe pain, significant edema, profound ecchymoses, no weight bearing or ROM

Answer 43

Stage 3 ankle injury

Question 44

Radiographs are indicated according to what?

Answer 44

Ottawa Ankle Rule

Question 45

Ottawa Ankle Rule: There is pain near the _____ AND _____ ______ is present OR the patient is unable to bear weight for at least __ steps at the time of injury

Answer 45

malleoli bone tenderness 4 steps

Question 46

Unique to pediatric patients of varying ages, this fracture occurs in the growth plate of long bones during development. Boys are twice as likely as girls to sustain this fracture.

Answer 46

Salter-Harris Fracture

Question 47

SALTER fracture--SALTER stands for what?

Answer 47

``` S-slipped A-Above L-Lower T-Through/transverse E- R-Rammed/Ruined (rare) ```

Question 48

What is the most common type of SALTER HARRIS fracture

Answer 48

Type II, extending through both they physis and metaphysis

Question 49

Salter 1 and 2 fractures require _____ _____ and cast/splint

Answer 49

closed reduction

Question 50

Salter III and IV requires ____ ____ and internal fixation.

Answer 50

Open reduction

Question 51

Often associated with injuries resulting from straight, outstretched arm falls

Answer 51

Elbow fractures

Question 52

What does the XR show on elbow fractures?

Answer 52

Fat pad sign

Question 53

Is there a fracture visible on XR is fat pad sign is present?

Answer 53

No

Question 54

Common injury in young children resulting from swinging or pulling child's arm which causes radial head sublaxation

Answer 54

Nursemaid elbow