Peds

Question 1

most common tumor a/w back pain in children

Answer 1

osteoid osteoma

Question 2

idiopathic osteonecrosis of the hip

Answer 2

legg calve perthes

Question 3

child presents with unilateral hip pain and has limp. how to dx and tx?

Answer 3

xray will be negative initially in legg-calve perthes. tx: maintain femoral head within acetabulum with splints. non-weight bearing until ortho referral

Question 4

infants are born with laxity in hip joint that resolves within the first few weeks of life. How to diagnose developmental hip dysplasia in child?

Answer 4

If less than 6 weeks - PE is more diagnostic. If more than 6 weeks old, US or radiographs more accurate

Question 5

Positive trendelenberg+ when hip is passively flexed, the thigh of the leg abducts and externally rotates. suggestive of

Answer 5

slipped capital femoral epiphysis

Question 6

Most common malignancy to present with joint pain in children

Answer 6

leukemia

Question 7

If leg length descrepancy less than 1 inch compared to greater than 1 inch?

Answer 7

less than 1 inch- use shoe lift. greater than 1 inch- refer to ortho for surgical procedure

Question 8

displacement of capital femoral epiphysis through the physeal plate

Answer 8

slipped capital femoral epiphysis

Question 9

Positive ortolani and barlo, galeazzi, and klisic test

Answer 9

developmental hip dysplasia

Question 10

what position babies a/w developmental hip dysplasia

Answer 10

breech

Question 11

child with activity related anterior knee pain. Pain with resisted knee extension. what do you think it is?

Answer 11

osgood schlatter

Question 12

osteonecrosis of subchondral bone

Answer 12

osteochondritis dissecans

Question 13

overuse injury that leads to the separation of the patellar tendon from tibial tubercle

Answer 13

osgood schlatter

Question 14

Child presents with activity related knee pain, crepitus, catching/locking of joint. ROM intact. Wilsons sign positive.dx and tx?

Answer 14

osteochondritis dissecans. REFER.

Question 15

knock knees aka

Answer 15

genu valgum

Question 16

bow legs aka

Answer 16

genu varum

Question 17

when are genu valgum and varum normal?

Answer 17

valgum- between 2-5 and its symmetric and asymptomatic. varus- birth to 24 months

Question 18

abnormal finding in genu valgum

Answer 18

more than 8 mm. between medial malleolus (abnormal at any age)

Question 19

abnormal finding in genu varum

Answer 19

more than 6 mm. between femoral condyles (abnormal at any age)

Question 20

tx in genu valgum

Answer 20

if less than 10, observe. if more than 10, consider surgery

Question 21

tx in genu varum

Answer 21

DO NOT brace. surgery may be needed

Question 22

high arched foot

Answer 22

pes cavus

Question 23

flat foot

Answer 23

pes planus

Question 24

take pes cavus seriously?

Answer 24

yes, should be considered a manifestaion of a neuromuscular disease until proven otherwise

Question 25

sever’s disease aka

Answer 25

calcaneal apophysitis

Question 26

radial head subluxation in kids 1-4 yo

Answer 26

nursemaids elbow

Question 27

mechanism of action in nursemaids elbow

Answer 27

axial traction on pronated elbow in extension

Question 28

when does pain occur in child with nursemaids elbow

Answer 28

pain occurs even with mild supination. passive ROM is normal

Question 29

inflammation of the growth plate at calcaneus at the insertion point of the achilles tendon

Answer 29

calcaneal apophysitis

Question 30

common cause of heel pain in kids 8-12

Answer 30

calcaneal apophysitis

Question 31

most common primary bone malignancy of bone in children and adolescents and most common site

Answer 31

osteosarcome- metaphyses of long bones

Question 32

most common type of injuries in child abuse

Answer 32

soft tissue injuries, then fractures

Question 33

when are DEXA scans helpful in child abuse cases?

Answer 33

when differentiating between child abuse and osteogenesis imperfecta.

Question 34

most common elbow fracture in child

Answer 34

supracondylar fracture (distal humerus)

Question 35

etiology of supracondylar fracture

Answer 35

FOOSH

Question 36

tx of supracondylar fracture

Answer 36

EMERGENT ortho referral- potential for neuro compromise, evaluate for compartment syndrome

Question 37

spiral fracture in distal one third to 1/4 of tibia in toddler. dx and tx?

Answer 37

childhood accidental spiral tibial fracture (CAST) or toddler’s fracture. tx with long leg cast for several weeks

Question 38

bowing fracture (bone is bent, not a fracture)

Answer 38

plastic deformation

Question 39

tx of plastic deformation

Answer 39

if deformity less than 20 degrees or in child less than 4 yo, angulation with immobilization. if deformity more than 20 degrees or in older child, closed reduction or surgery

Question 40

bone is bent with a fracture but does not extend completely through the width of the bone

Answer 40

greenstick fracture

Question 41

incomplete fracture at the junciton between the metaphysic and diaphysis

Answer 41

buckle (torsion/torus) fracture

Question 42

buckle fracture tpically occur in..

Answer 42

distal radius after FOOSH

Question 43

plastic deformation most common occur in..

Answer 43

radius and ulna d/t FOOSH

Question 44

physeal fracture most commonly occur in..

Answer 44

distal growth plates of ulna and radius

Question 45

30% of physeal fx result in..

Answer 45

growth disturbance

Question 46

patients with hearing loss, bone fragility, short stature, blue sclera

Answer 46

osteogenesis imperfecta