Skeletal Abnormalities

Question 1

In-toe gait

Answer 1

(persistent femoral anteversion) –> inwards
Tibial torsion, metatarsus adductus
associated w/ lax ligaments

Question 2

Out-toe

Answer 2

Fetal moulding → compression by uterus causing:
hip flexion
external rotation

Question 3

Genu varum

Answer 3

up to 2 years

-pathological –> rickets, skeletal dysplasia

Question 4

genu valgum

Answer 4

3-4 year

knock-knees

Question 5

slight genu valgum

Answer 5

above 9 years

Question 6

Flat feet

Answer 6

heel valgus
Pronation –> weight on the inside

also thick calf muscles
tarsal coalition

Question 7

pes cavus

Answer 7

weight on the outside, high arch
Supination

cause of pes cavus is the hereditary motor and sensory neuropathies (HMSNs), the most common subtype being Charcot-Marie-Tooth (CMT) disease. peripheral nerve myelin

Question 8

Calcaneus valgus

Answer 8

hindfoot dorsiflexion

intrauterine molding

Question 9

Sever’s disease

Answer 9

Runner’s disease, not a disease but growing pain, posterior heel pain

pain and inflammation, 9-11 years, growth plate closes and it disappears
protects against avulsion of achilles tendon

Question 10

Sprengle’s shoulder

Answer 10

Undescended scapula, sits on cervical spine

Question 11

Syndactyly

Answer 11

most common abnormality, most commonly ring and muddle finger

Question 12

trigger thumb

Answer 12

stenoosis of flexor tendon sheat, permanently flexed thumb, 50% resolve

Question 13

OBPP

Answer 13

Obstetric Brachial Plexus Palsy
difficult or asseisted delivery, ↑birth weight
nerve injury of brachial plexus
birth weight

Question 14

Erb and Klumpke’s palsy

Answer 14

Erb’s = damage to upper C5 and C6 nerves&raquo_space; partial or full paralysis of the arm
group 1- c5 and c6 90%recover

Klumpke’s = damage to the lower C8 and T1 nerves&raquo_space; paralysis of the forearm and han muscles
-group 4 –> none recover fully

Question 15

Adduction

Answer 15

towards the midline

Question 16

talipes equinovarus (plantarflexed (as in standing on one’s toes)) (Clubfoot)

Answer 16

most common, most likely in boys

Ponsetti method

Question 17

Perthes’ disease

Answer 17

Idiopathic osteonecrosis of proximal femoral epiphysis
–> hip, 4-10 years

3-10 y/o (male : female 4:1)
Younger = better prognosis
Presents with limp, and hip or knee pain.
Progression:
Sclerosis 🡪 formation of a fracture line 🡪 fragmentation 🡪 healing followed by re-ossification.

Question 18

Scoliosis

Answer 18

lateral curvature more than 10
structural or postural
right thoracic scoliosis
cor pulmonale
4:1 --> F:M

Question 19

Kyphosis

Answer 19

normal if it does not exceed 40-50 degrees, fowards
Top of the spine, thoracic spine
Scheuermann’s disease –> general back pain
3 anteriorly ledged vertebrae

Question 20

Lordosis

Answer 20

Backwards curve
Cervical and lumbar spine
bulging belly

Question 21

Rhizomelic

Answer 21

Achondroplasia,epiphyseal

Question 22

Mesomelic

Answer 22

metaphyseal, radius, ulna, tibia, fibula

Question 23

Acromelic

Answer 23

diaphyseal
distal hands, feet
Progressive diaphyseal dysplasia

Question 24

Achondroplasia

Answer 24

SHort limbs, facial involvement
growth hormone, c-natriuretic peptide
spinal kyphosis

Question 25

Trunk dysplasia

Answer 25

supper segment < lower segment

arms > height

Question 26

Morquio

Answer 26

bullet-shaped phalanges

Question 27

Osteogenesis imperfecta

Answer 27

brittle bone disease
(COLIA1/A2 mutation)
type I colagen impaired
Bisphosphonate