trigger ortho

Question 1

where does the tibial spine attatch to

Answer 1

the ACL!

Question 2

McCmurray test tests for what

Answer 2

meniscal tears

Question 3

hyperextension of the knee with concurrent rotation of femur on tibia

Answer 3

tibial spine fracture MOI

Question 4

tx of non displaced vs displaced tibial spine fracture

Answer 4

• non-displaced: immobilize knee in full extension and orhto referall
• displaced: needs reduction and IMMEDIATE ortho consult

Question 5

these fractures frequently acocmpany ligament tears, meniscal injuries and patellar dislocations

Answer 5

osteochondral fractures

Question 6

caused by sudden, forcefull contraction of the quadriceps to a flexed knee

sudden stop from full sprint, landing after jumping

Answer 6

patellar sleeve fracture

quadriceps exceed the strength of the patella

Question 7

tx for patellar sleeve avulsion fracture

Answer 7

immobilization of knee w ortho surgery referall

Question 8

as this disease progresses it can cause demineralization and detatchement of bone and overlying cartilage

Answer 8

osteochondritis dissecans

Question 9

tx for osteochondritis dissecans

Answer 9

immbolization for 3-6 mo.

Question 10

this diagnosis, if left untreated, can lead to premature arthritis

Answer 10

osteochondritis dissecans

Question 11

what is the MC reason for inflammatory childhood limp

Answer 11

toxic synovitis

occurs after recent URI

Question 12

ortho problem that can occur after URI

Answer 12

toxic synovitis

hips and knees effected most!!!

Question 13

When do you use the Kosher Criteria and what are the kosher criteria

Answer 13

to determine severity of septic arthritis (like in the hip!)

1. fevr >101.3
2. ESR>40
3. WBC>12
4. inability to bear weight

Question 14

How do you treat suspected septic arthritis

Answer 14

I&D of the hip PRN and aspiration of joint fluid

ABX that cover staph Aureus

Question 15

what is the treatment for metatarsus adductus

Answer 15

• stretching for mild/mod
• Casting for severe

Question 16

shortened achilles tendon is associated with what diagnosis

Answer 16

clubfoot/ talipes equinovarus

Question 17

what is the proper term for clubfoot

Answer 17

talipes equinovarus

I just know ima forget this

Question 18

what is the MC type of clubfoot

Answer 18

congenital (idiopathic)

Question 19

Ponseti method is used when

Answer 19

Clubfoot

manipulation w serial castings for 4-10 applicaitons

Question 20

what is the indication for treating tibial torsion

Answer 20

if feet are turned greater than 15 degrees by age 5

Question 21

if an eaminer can is able to passively correct the deformity into the middle position but no farther what level of metatarsus adductus is this

mild, moderate or severe

Answer 21

moderate

Question 22

what are the MCC for intoeing in:
- less than 1 yr
- 1-3 yrs
- 3+ yrs

Answer 22

• less than 1 yr = metarsus aDDuctus
• 1-3yrs = internal tibial torsion
• 3+ yrs = femoral anteversion

Question 23

Femoral derotational osteotomy is a treatment of what

Answer 23

a child w severe dysfunction or deformity caused by femoral anteversion

Question 24

hip adducted w posteriorly directed pressure is defining what maneuver

Answer 24

barlow maneuver

Question 25

hip is abducted while lifting the trochanter anteriorly

Answer 25

ortolani maneuver

Question 26

what are the indications for screening for DDH in an infant what is the screening method of choice? how does this change once a child reaches 4 months old?

Answer 26

US is method of choice! - any child w hip instability - any male/female born breech >34 wks gestation - FHx of DDH - any child >4 mo with instability, limp or unstable gait uses xray for screening eval

Question 27

what is the treatment for a positive: * ortaloni * barlow

Answer 27

* ortolani = US, refer to specialist * barlow = US, observe and follow

Question 28

treatment of DDH

Answer 28

Question 29

pain/tenderness to the tibial tubercle w/wo edema

Answer 29

osgood schlatter disease

Question 30

what is inflamed in osgood schlatter disease

Answer 30

patellar tendon

Question 31

tx for osgood schlatter dz

Answer 31

ice 20-30 min BID, NSAIDs, stretching quads, PT PRN | benign and self limiting. NO crutches or knee immobilizers!!!

Question 32

degeneration of cartilage d/t poor alignment of the kneecap

Answer 32

patellofemoral syndrome

Question 33

who has theatre sign and what is theatre sign

Answer 33

* people w patellofemoral syndrome * theatre sign = aggravation of syndrome by activity or prolonged sitting w bent knees!!

Question 34

tx of patellofemoral syndrome

Answer 34

* strengthening quads and hammies * NSAIDS, Ice, DC activity causing pain. | dx is clinical but you may see it on xray

Question 35

pt comes in w two months of hip pain that has now developed a limp and he is no longer able to weight bear on his left leg. what is the diagnostic of choice? what is the dianosis and tx?

Answer 35

- xray, US, MRI (just one) - SCFE - tx= internal fixation w single cannulated screw placed in center of epiphysis | I feel like this could also be describing legg calve perths disease!

Question 36

this disease can lead to avascular necrosis of the femoral head

Answer 36

SCFE can also lead to chondrolysis at the hip joint and osteoarthritis

Question 37

what is legg-Calve perthes disease

Answer 37

idiopathic necrosis of the hip

Question 38

Xray of the hip shows joint effusion with widening of joint space and periarticular swelling

Answer 38

legg calve perthes disease

Question 39

what are indications for bracing or surgery in scoliosis?

Answer 39

* >20 degrees or progression of >5 degrees

Question 40

what is a toddlers fracture

Answer 40

spiral fracture of distal 1/2 of the tibia

Question 41

how do you treat X linked hypophosphatemia

Answer 41

calcitriol, amiloride and HCTZ

Question 42

mutation of the phosphate regulating gene is the mechanism for which disease

Answer 42

X linked hypophosphatemia

Question 43

asude from short stature of the lower limbs, what are some other s/s that you would see with x linked hypophosphatemia

Answer 43

* dental abnormalities (delayed with abscesses) * deafness * chiari malformation of brian * calcification of tendons/ligamentts/joints * craniosyntosis