Pediatric Musculoskeletal Conditions

Question 1

When does valgus peak?

Answer 1

age 4

Question 2

What is genu varum?

Answer 2

bowing of the legs– Blount’s disease

• must be corrected before age 4

Question 3

What is genu valgum?

Answer 3

knock knees

Question 4

how to correct genu valgum?

Answer 4

surgical- osteotomy

Question 5

What is Wilms tumor associated with?

Answer 5

Hemihypertrophy - real limb length difference

Question 6

How do you shorten the long limb?

Answer 6

Epiphysiodesis

Question 7

Femoral deficiency treatment

Answer 7

can surgically lengthen or amputation+ prosthetic

van nes rotationoplasty

Question 8

Tibial deficiency associated with ___

Answer 8

mirror foot

Question 9

what are the 4 club foot deformities?

Answer 9

forefoot cavus ad adductus, hindfoot varus and equinus

Question 10

club foot treatment?

Answer 10

ponseti foot casting - serial….CAVE sequence

Question 11

what is tibial bowing associated with?

Answer 11

50% have neurofibromatosis

Question 12

what is the deformity of the dislocated navicular on talus

Answer 12

congenital vertical talus

Question 13

what is calcaneovalgus foot ?

Answer 13

hyperflexion of foot

Question 14

flexible flat foot

Answer 14

no surgery unless pain

Question 15

tarsal coalition presents as what?

Answer 15

non flexible flat foot

Question 16

What is Kohler disease and how is it treated?

Answer 16

navicular collapse –> NEVER do surgery

usually self limiting

Question 17

Disease marked by idiopathic avascular necroses of the femoral head

Answer 17

Legg -calves-perthes syndrome — happens over time

Question 18

treatment of Leg-Calvep-Perth

Answer 18

keep femoral head round, through casting or brace

-Surgery if 50% collapse or impending loss of containment

Question 19

Congenital hip dysplasia is _______ or ________ or the femoral head

Answer 19

dislocation or dysplasia

Question 20

What is the Galeazzi test

Answer 20

look at limb lengths in CHD

Question 21

Ortolani test?

Answer 21

the hip click test in congenital hip dysplasia

Question 22

Normal reference for Ultrasound hips, up to 6 months of age

Answer 22

greater than 50% head coverage, up to 6 months of age

Question 23

normal shenton’s line

Answer 23

arc of obturator foramen matches line of femoral neck

Question 24

treatment for CDH

Answer 24

palvik harness- 90%

surgery after 18 months

Question 25

What is a slipped capital femoral epiphysis?

Answer 25

neck displaced anteriorly and superiorly to the epiphysis

EXTREMELY IMPORTANT TO DETECT EARLY

Question 26

What causes SCFE

Answer 26

failure of physis due to excessive load or structural weakness– trauma/obesity

Endocrinopathies

Renal osteodystrophy

Failure through proliferative and hypertrophic zones

Question 27

SCFE presentation?

Answer 27

boys - 12-16
girls 10-14
- paini in groin, hip, thigh and knee

Question 28

Congenital coxa-vera

Answer 28

neck-shaft angle <120 degrees

Question 29

SCFE treatment

Answer 29

only surgical!

..make sure you take orthogonal x-ray views