Orthopedics - aa

Question 1

Painless limp, lurch to affected side (Trendelenberg sign) with asymmetric skin folds of legs.

Answer 1

Congenital hip dysplasia

Question 2

Adducting the bent legs of infant with downward pressure that dislocates the hip.

Answer 2

Barlow sign

Question 3

Abducting the bent legs of infant with upward traction that realigns the head of the greater trochanter.

Answer 3

Ortolani sign

Question 4

Idiopathic avascular necrosis of the proximal femoral epiphysis

Answer 4

Legg-Calve-Perthes disease

Question 5

Painful limp in 4-8 year old

Answer 5

Legg-Calve-Perthes disease

Question 6

Painful limp in obese 11-12 yo boy

Answer 6

SCFE

Question 7

What three features are required to diagnose talipes equinovarus?

Answer 7

1. plantar flexion of foot at ankle
2. inversion deformity at heel
3. medial deviation of forefoot

Question 8

Treatment for Legg-Calve-Perthes?

Answer 8

If bone age < 5 years, maybe none required.

Brace; rarely surgery

Question 9

Treatment for talipes equinovarus?

Answer 9

Successive casting

Question 10

Treatment for SCFE?

Answer 10

Immediate surgery; stop weight-bearing

Question 11

Treatment for tibial torsion?

Answer 11

benign; resolves spontaneously with growth

Question 12

Acute torticullis may follow URI or mild trauma in children.

T/F

Answer 12

True

Question 13

Treatment for torticullis?

Answer 13

Passive stretching is usually effective.

Question 14

What is the most common cause of scoliosis?

Answer 14

80% are idiopathic

Question 15

You think you see lateral spine curvature in your patient.
What is the likely age and gender of this patient?
What test will you perform?
What action will you take?

Answer 15

~Girls 8-10 yo
~Forward bend test
~mild curve: watch and wait
~moderate: possibly bracing
~severe: surgery with fusion and rods

Question 16

When are genu varum & valgum normal?

Answer 16

~Genu varum is normal from infancy - 3 yo

~Genu valgum is normal from 3 yo to 8 yo

Question 17

What is the treatment for metatarsus varus?

Answer 17

Majority resolve spontaneously; maybe serial casting & corrective shoes

Question 18

What is the treatment for femoral anteversion?

Answer 18

Normal variant.

Question 19

Subluxation of radial head as a result of being lifted/pulled by hand.

Answer 19

Nursemaid’s elbow

Question 20

What will usually relieve a child’s pain from nursemaid’s elbow immediately?

Answer 20

Elbow is placed in full supination and slowly moved from full extension to full flexion. A click may be palpated at the level of the radial head.

Question 21

How long must arthritis with pain, swelling, warmth, tenderness, morning stiffness, and/or decreased ROM last in order to be considered juvenile rheumatoid arthritis?

Answer 21

6 weeks

Question 22

What is the most common type of juvenile rheumatoid arthritis?

Answer 22

Oligoarticular: arthritis of 4 or fewer joints; 20% of kids with this type develop uveitis

Question 23

What are some causes of septic arthritis in kids?

Answer 23

~usually group B strep and S. aureus in kids younger than 4 mo
~gonorrhea in adolescents