Musculoskeletal Disorders

Question 0

Patient refused to move right arm. Mother denies history of trauma but had pulled the patient’s arm during a dental visit:

a. Pronator strain
b. Fracture
c. Dislocation
d. Subluxation of a ligament

Answer 0

D. subluxation of a ligament

Also called Nursemaid elbow; a subluxation of a ligament rather than a subluxation or dislocation of the radial head. Injury is typically produced when a longitudinal traction force is applied to the arm, such as when a falling child is caught by the hand, or when a child is pulled by the hand. Injury usually occurs in toddlers, rarely in children >5 yo.

Question 1

Adolescent with medial knee pain:

a. Legge Calve Perthes Disease
b. Medial Collateral Ligament Sprain
c. Slipped Capital Femoral Epiphyses
d. Can’t remember

Answer 1

Nelson’s 18th: SCFE – hip disorder that affects adolescents; most often between 12-15 years old; usually presents with pain in the affected hip or groin, a change in hip range of motion, and a gait abnormality; infrequently, patient will complain only of medial knee pain, referred to the knee via the obturator and femoral nerves