Orthopedics

Question 1

A newborn has uneven gluteal folds, and their hips can be easily dislocated posteriorly. What is the diagnosis, how can the diagnosis be made, and how do you treat?

Answer 1

Developmental dysphasia of the hip

• diagnose via sonogram
• treat with Pavlik harness abduction splinting for 6 months

Question 2

A six year old with limping, decreased hip motion, hip pain, and an antalgic gait. What is the diagnosis, how is it made, and how is it treated?

Answer 2

Legg-Calve-Perthes disease (avascular necrosis of the hip)

• diagnosis via AP and lateral hip X-rays
• treat with femoral head stabilization via casting and crutches

Question 3

A chubby 13-year old boy is admitted with groin pain and new onset limping. On exam is hip is everted with the sole of his foot touching his other leg. The hip is not easily rotated and externally rotates when flexed. What is the diagnosis, how is it made, and how do you treat?

Answer 3

Slipped capital femoral epiphysis

• diagnose with X-rays
• treat surgically with pins in femoral head

Question 4

A toddler is brought to the ED with fever and refusal to walk. Mom states he won’t let anyone touch his hip, which he keeps flexed, abducted, and externally rotated. What is the diagnosis and what lab value will be abnormal?

Answer 4

Septic hip

Elevated ESR

Question 5

In a little kid with acute hematogenous osteomyelitis, what imaging morality will provide a diagnosis?

Answer 5

MRI

Question 6

Genu varum, or bowlegs, past the age of 3 is called?

Answer 6

Blount disease (surgery is required)

Question 7

Knock knee in kids 4-8 is?

Answer 7

Normal

Question 8

Treatment for teens with osgood-schlatter is?

Answer 8

RICE and extension casting for 4-6 weeks

Question 9

Due to the healing process in children, reduction and immobilization is fine in most fractures except?

Answer 9

Those involving a supracondylar fracture of the humerus or fractures of growth plates.

Question 10

A tumor in teenager’s lower femur with a sunburst pattern on X-ray is likely?

Answer 10

Osteogenic sarcoma

Question 11

A young child with a tumor in the diaphysis of the femur that shows “onion skinning” on X-ray is likely?

Answer 11

Ewing sarcoma

Question 12

An old man presents with fatigue, anemia, and localized bone pain. His x-rays show multiple punched out lytic lesions. What’s the diagnosis and what urine abnormality will be present?

Answer 12

Multiple myeloma

Bence Jones protein

Question 13

Treatment for a clavicular fracture is usually?

Answer 13

Figure of 8 device

Question 14

A colles fracture in an elderly women who fell lightly on her outstretched arm is likely easily broken from?

Answer 14

Osteoporosis

Question 15

The treatment for a fractured scaphoid bone is?

Answer 15

Thumb spica cast

Question 16

Why should a prosthesis be placed if a femoral neck fracture occurs?

Answer 16

The blood supply is compromised

Question 17

What fractures should a patient be evaluated for when they fall from a height and land on their feet?

Answer 17

Foot, leg, lumbar spine, and thoracic spine

Question 18

In a patient with lumbar disc herniation, the electrical shock that shoots down the leg is indicative of what?

Answer 18

Location of herniation
L4-L5: exciting on the big toe side
L5-S1: side of the little toe

Question 19

Cauda equina syndrome has a triad of these symptoms?

Answer 19

Distended bladder, flaccid rectal sphincter, perineal saddle anesthesia

Question 20

“Bamboo spine” is indicative of?

Answer 20

Ankylosing spondylitis

Question 21

Where do diabetic ulcers generally occur? Why do they occur?

Answer 21

Pressure points

Microvascular disease

Question 22

Patients with arterial insufficiency have these characteristics?

Answer 22

• ulcers on tips of toes devoid of granulation tissue
• absent pulses
• trophic changes
• claudication

Question 23

Venous stasis ulcers generally occur where?

Answer 23

Medial malleoli