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Orthopedics: Pediatric Primary Care

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Orthopedics: Pediatric Primary Care Which of the following disorders is usually associated with adduction of the forefoot? a. Internal femoral torsion b. Talipes equinovarus congenita c. Genu valgum d. Internal tibial torsion *** b. Talipes equinovarus congenita (clubfoot) The most common rheumatoid disease of childhood is: a. SLE b. Kawasaki disease c. JIA d. Legg-Calve-Perthes disease *** c. JIA Radiographic findings of disease progression and sphericity of the femoral head is helpful in the diagnosis and follow-up of:

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Orthopedics: Pediatric Primary Care
Which of the following disorders is usually associated with adduction of the forefoot?

a. Internal femoral torsion
b. Talipes equinovarus congenita
c. Genu valgum
d. Internal tibial torsion *** b. Talipes equinovarus congenita (clubfoot)

The most common rheumatoid disease of childhood is:

a. SLE
b. Kawasaki disease
c. JIA
d. Legg-Calve-Perthes disease *** c. JIA

Radiographic findings of disease progression and sphericity of the femoral head is
helpful in the diagnosis and follow-up of:

a. Transient synovitis of the hip
b. Osgood-Schlatter disease
c. Legg-Calve-Perthes disease
d. Slipped capital femoral epiphysis *** c. Legg-Calve-Perthes disease

LCPD develops from an infarction of the bony epiphysis of the femoral head and often
presents as avascular necrosis of the femoral head. Radiograph depicts stages of
progression and remodeling and is important in diagnosis and tx.

A 4-year-old boy is brought in by his mother, who is concerned about sudden onset of a
painful limp in his right leg 2 days ago. Today he has a low-grade fever. Which of the
following diagnoses is most likely?

a. Osgood-Schlatter
b. JIA
c. Osteomyelitis
d. Transient synovitis of the hip *** d. Transient synovitis of the hip

Which of the following would be the most appropriate initial management of a newborn
diagnosed with developmental dysplasia of the hip?

a. Observe and reexamine at 2-week well-child visit
b. Triple diapering in nursery
c. Pavlik harness
d. Surgical reduction *** c. Pavlik harness

A physical finding not usually associated with clubfoot is:

, a. Contracture of the IT bands
b. Deep crease on medial border of foot
c. Atrophy of calf muscles
d. Small foot with limited dorsiflection *** a. Contracture of the IT bands

A characteristic feature of polyarticular JIA disease is:

a. The involvement of five or more inflamed joints
b. Confinement to lower extremity joints, knees, and ankles
c. Asymmetric involvement
d. High, daily intermittent spiking fevers *** a. The involvement of five or more
inflamed joints

JIA is the most common rheumatologic disease with an autoimmune basis and
represents a group of conditions with onset of sx in children at or younger than 16 years
of age with chronic inflammation of at least one synovial joint for 6 weeks or more.

ANA seropositivity for antibodies:

a. is a valuable diagnostic marker for JIA
b. is not positive in any childhood diseases
c. is more commonly found in older boys
d. has 100% sensitivity and specificity *** a. is a valuable diagnostic marker for JIA

ANA consists of immunoglobulins directed against structures within the cell. It is found
in various autoimmune diseases.

Dislocation of the hip of a child 6 months or older may typically present with:

a. Asymmetry of skin folds
b. Atrophied hip muscles
c. Positive Galeazzi sign
d. Negative Trendelenburg sign *** c. Positive Galeazzi sign

The Galeazzi maneuver can depict a leg length discrepancy. The exam is reliable in
children with dislocatable, but not dislocated, hips or in children with bilateral hip
dislocation.

For a newborn, the correct management of hip dislocation should include:

a. Use of a flexion-abduction device such as a Pavlik harness to stabilize the hip
b. Following and observing closely for 3-4 weeks, and then referring to an orthopedist
c. Surgical reduction
d. Traction for 6 weeks *** a. Use of a flexion-abduction device such as a Pavlik
harness to stabilize the hip

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