Postural problems

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7.2 (1.2)
Averil Tam
Flashcards by Averil Tam, updated more than 1 year ago
Averil Tam
Created by Averil Tam over 6 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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