The bacterial organism isolated in drug abusers is most commonly:
Chronically ill patients receiving long-term intravenous therapy or parenteral nutrition are known to have osteomyelitis harboring which of the following organisms:
Which of the following Bacterial organisms has dropped considerably in infants following the use of a vaccine against it:
The causative organism that can be identified in what percent of patients, suspecting to have septic arthritis, following a blood culture?
Skeletal changes, such as periosteal reaction or bony destruction, generally are not seen on plain films until which of the following days into the infection (osteomyelitis)?
All of the following statements are true concening Indium 111 scintigraphy except:
Which of the following statements is least true concerning the use of CT scans in osteomyelitis:
The best test, used to follow the success of treatment in a patient with septic arthritis, would be:
Should prevalence of MRSA occur in a community, the antibiotics of choice would be:
The most common organism seen in nail puncture wounds through tennis shoes, would be:
The most common site for a discitis to appear, would be:
All the following are complications of chronic osteomyelitis except:
When tuberculosis involves the spine the most common location would be at:
A 12-year-old boy sustained a grade III open tibial fracture 1 week ago and underwent multiple debridements and fracture fixation. He now has a soft-tissue defect that measures 6 cm × 6 cm, with an area of exposed bone and muscle on the distal medial leg that is a few centimeters proximal to the ankle. Management of the soft-tissue defect should now consist of
A 6-year-old child sustained a closed nondisplaced proximal tibial metaphyseal fracture 1 year ago. She was treated with a long leg cast with a varus mold, and the fracture healed uneventfully. She now has a 15-degree valgus deformity. What is the next step in management?
A patient who underwent closed reduction of the hips as an infant now reports pain. An abduction internal rotation view shows an incongruous joint. Based on the findings shown in the Figure below, what is the most appropriate type of pelvic osteotomy for the right hip?
An 18-month-old boy with obstetric brachial plexus palsy is being evaluated for limited right shoulder motion. Physical therapy for the past 6 months has failed to result in improvement of the contracture. Which of the following studies is necessary prior to any shoulder reconstruction?
Where is the underlying defect in a rhizomelic dwarf with the findings shown in the Figure below?
A 2-year-old boy has complete absence of the sacrum and lower lumbar spine. What is the most likely long-term outcome if no spinal pelvic stabilization is performed?
Which of the following findings is most prognostic for the ability of a young child with cerebral palsy to walk?
A 2-year-old girl has had a 2-day history of fever and refuses to move her left shoulder following varicella. Laboratory studies show an erythrocyte sedimentation rate of 75 mm/h and a peripheral WBC count of 18,000/mmP3P. What is the most common organism in this scenario?
Which of the following is considered the best method to measure limb-length discrepancy in a patient with a knee flexion contracture?
What is the most important consideration in the preoperative evaluation of a child with polyarticular or systemic juvenile rheumatoid arthritis (JRA)? a.Cervical spine assessment b.Temporomandibular joint (TMJ)/jaw assessment
A 15-year-old boy has a mass at the knee. Radiographs show an aggressive tumor involving the proximal tibia, and biopsy findings reveal a high-grade osteosarcoma. Staging studies show that the tumor invades the neurovascular bundle. The tumor enlarged during preoperative chemotherapy. Management should now consist of
Of the following clinical situations, which is most likely to lead to osteonecrosis associated with a slipped capital femoral epiphysis (SCFE)?
An 8-year-old boy has had pain and swelling around the right knee for the past 4 weeks. He recalls bumping it about 4 weeks ago. He has no pain in other joints, and denies any fevers, chills, or other symptoms. A radiograph is shown in the Figure below. Laboratory studies show a WBC count of 9,700/mmP3P, an erythrocyte sedimentation rate of 18 mm/h, and a C-reactive protein level of 3.7 mg/L. What is the next most appropriate step in management?
A 12½-year-old boy reports intermittent knee pain and limping that interferes with his ability to participate in sports. He actively participates in football, basketball, and baseball. He denies any history of injury. Examination shows full range of motion without effusion. Radiographs reveal an osteochondritis dissecans (OCD) lesion on the lateral aspect of the medial femoral condyle. MRI scans are shown in the Figures below. Initial treatment should consist of:
What is the most common primary malignant bone or cartilage tumor in children?
In obstetrical brachial plexus palsy, which of the following signs is associated with the poorest prognosis for recovery in a 2-month-old infant?
A 6-year-old boy with acute hematogenous osteomyelitis of the distal femur is being treated with intravenous antibiotics. The most expeditious method to determine the early success or failure of treatment is by serial evaluations of which of the following studies?
The Figure below shows the radiograph of a 7-year-old boy who sustained a pathologic fracture of the left humerus 1 day ago. Initial management should consist of:
The Figure below shows the AP radiograph of a 5-year old child who has mild short stature and a painless bilateral gluteus medius lurch. Initial work-up should include 1- a bone scan. 2- a skeletal survey. 3- MRI of the hips. 4- CT of the hips. 5- a CBC count and a C-reactive protein
A 14-year-old boy reports a 4-month history of increasing backache with difficulty walking long distances. His parents state that he walks with his knees slightly flexed and is unable to bend forward and get his hands to his knees. He denies numbness, tingling, and weakness in his legs and denies loss of bladder and bowel control. A lateral radiograph of the lumbosacral spine is shown in the Figure below. What is the best surgical management for this condition?
Duchenne’s muscular dystrophy is a genetic disorder that is transmitted by which of the following modes of inheritance?
A 12-year-old boy reports limping and chronic knee pain that is now inhibiting his ability to participate in sports. Clinical examination and radiographs of the knee are normal. Additional evaluation should include:
In children with moderate to severe osteogenesis imperfecta (OI), intravenous pamidronate therapy has been shown to increase the thickness of cortical bone. This occurs primarily as a consequence of:
Split posterior tibial tendon transfer is used in the treatment of children with cerebral palsy. Which of the following patients is considered the most appropriate candidate for this procedure?
A 3-year-old child has bilateral genu varum and short stature. Radiographs show physeal widening and generalized osteopenia. The femora and tibiae show anterolateral bowing. Laboratory studies show low normal serum calcium values, significantly decreased serum phosphate levels, and normal parathyroid hormone (PTH), alkaline phosphatase, and vitamin-D levels. These findings are consistent with:
During the early swing phase of the normal gait cycle, what lower extremity muscle is primarily contracting?
A 6-month-old child is seen in the emergency department with a spiral fracture of the tibia. The parents are vague about the etiology of the injury. There is no family history of a bone disease. In addition to casting of the fracture, initial management should include:
The rate of complications after in situ pinning of a chronic slipped capital femoral epiphysis is highest with placement of the screw in what quadrant of the femoral head?
A full-term newborn has webbing at the knees, rigid clubfeet, a Buddha-like posture of the lower extremities, and no voluntary or involuntary muscle action at and below the knees. Radiographs of the spine and pelvis reveal an absence of the lumbar spine and sacrum. What maternal condition is associated with this diagnosis?
A 3-year-old child has refused to walk for the past 2 days. Examination in the emergency department reveals a temperature of 102.2 degrees F (39 degrees C) and limited range of motion of the left hip. An AP pelvic radiograph is normal. Laboratory studies show a WBC count of 9,000/mmP3P, an erythrocyte sedimentation rate (ESR) of 65 mm/h, and a C-reactive protein level of 10.5 mg/L (normal < 0.4). What is the next most appropriate step in management?
The Figure below shows the radiograph of an otherwise healthy Caucasian 5-year-old boy who has a painless limp. What is the best treatment option?
What acetabular procedure for developmental dysplasia of the hip does not require a concentric reduction of the femoral head in the acetabulum?
A 5-year-old boy has had pain in the right foot for the past month. Examination reveals tenderness and mild swelling in the region of the tarsal navicular. Radiographs are shown in the Figure below. Management should consist of:
A 9-year-old child sustained a fracture-dislocation of C-5 and C-6 with a complete spinal cord injury. What is the likelihood that scoliosis will develop during the remaining years of his growth?
The Figures below show the radiograph and MRI scan of an otherwise normal 3-month-old infant who has a spinal deformity. MRI reveals no intraspinal anomalies. What is the next step in management?
A 22-month-old girl has cerebral palsy. Which of the following findings is a good prognostic indicator of the child’s ability to walk in the future?
The Figure below shows the oblique radiograph of an 11-year-old boy who has a mild left flatfoot deformity. Examination reveals that subtalar motion is limited and painful. Despite casting for 6 weeks, the patient reports foot pain that limits participation in sport activities. A CT scan shows no subtalar joint abnormalities. Management should now include:
