14577355
Description
Flashcards by Averil Tam, updated more than 1 year ago
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Created by Averil Tam
over 5 years ago
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| Question | Answer |
| 1. 13yo boy presents with a painful right foot 3 months. No injury. Onset related to cross country run. Exam findings: rigid flat foot with valgus hindfoot. A) You should consider a likely Dx of: i. Flexible flat foot ii. Ankle sprain iii. Tarsal coalition iv. Juvenile chronic arthritris v. Congenital vertical talus | iii. Tarsal coalition |
| 1. 13yo boy presents with a painful right foot 3 months. No injury. Onset related to cross country run. Exam findings: rigid flat foot with valgus hindfoot. B) TRUE/FALSE - initial management: i. Prescribe NSAI and review in a few weeks | True |
| B) TRUE/FALSE - initial management: ii. Refer for standing X-Rays of both feet | True |
| B) TRUE/FALSE - initial management: iii. Refer for MRI scan of the right foot | False. However if the clinical picture suggests tarsal coalition as the cause and the X-rays are normal, then proceed to MRI scan. |
| B) TRUE/FALSE - initial management: iv. Refer to a podiatrist for orthotics | False |
| B) TRUE/FALSE - initial management: v. Refer to an orthopaedic surgeon. | False |
| 3. 7yo girl presents with an intoeing gait. Most likely Dx? a. Rickets b. Internal tibial torsion c. Excessive femoral anteversion d. Perthes disease e. Slipped capital femoral epiphysis | C, excessive femoral anteversion. Internal tibial torsion usually resolves by age 4 years. Rickets, Perthes disease and SCFE do not typically cause intoeing. |
| 4. 4yo girl presents to you with symmetrical bow legs. TRUE/FALSE - initial management: a. Reassure a spontaneous correction is expected. | False. Bow legs at age 4 years must be pathological - should resolve by 3 years. |
| 4. 4yo girl presents to you with symmetrical bow legs. TRUE/FALSE - initial management: b. Refer to a podiatrist for orthotics. | False |
| 4. 4yo girl presents to you with symmetrical bow legs. TRUE/FALSE - initial management: c. Prescribe Vit D supplement and review in 6 months. | False. Must have a diagnosis before commencing treatment. |
| 4. 4yo girl presents to you with symmetrical bow legs. TRUE/FALSE - initial management: d. Advise against W sitting. | False, no benefit. |
| 4. 4yo girl presents to you with symmetrical bow legs. TRUE/FALSE - initial management: e. Investigate with bone biochemical screen and X-Rays. | True. DDx Rickets, Blount's disease, bone dysplasia. Must have a diagnosis before commencing treatment. Therefore initial management is refer for a bone biochemical screen and X-Rays. |
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