CRACKCast E176 – Musculoskeletal Disorders

CRACKCast & Physicians as Humans on CanadiEM

Core questions

1. What are the indications for orthopedic surgery for clavicle fracture?
2. List 5 Xray features of supracondylar fracture
3. Describe the Gartland Classification for Extension-type supracondylar fractures
4. List specific complications of a supracondylar fracture.
5. Describe the sequence of ossification around the elbow.
6. What is Baumann’s Angle? (shownotes)
   1. Monteggia fracture-dislocation
   2. Toddler’s fracture
   3. Nursemaid’s elbow.
7. Describe the radiographic findings and management of:
8. Describe the Ortolani and Barlow maneuvers. (shownotes)
9. List 3 physical exam findings consistent with DDH.
10. List 10 causes of hip pain in children
11. Provide a differential diagnosis of limp in the toddler, school-aged child and adolescent.
12. How would you differentiate between transient synovitis and septic arthritis in a child with hip pain?
13. What is the most common location for septic arthritis in a child?
14. What is the prognosis for transient synovitis?
15. What is the most common cause of septic arthritis?
    1. Age < 2 months
    2. 2 months – 5 yrs
    3. 5 yrs – 12 yrs
    4. > 12 yrs
    5. Prosthetic joint
    6. Sickle cell disease
    7. Immunocompromised
16. What are the important pathogens of septic arthritis in the following groups:
17. Describe three mechanisms for the development of septic arthritis in children.
18. Regarding synovial fluid analysis, which tests should be ordered. How are the results interpreted?
19. Describe the management of a child with septic arthritis? What the indications for operative debridement?
20. What are the potential complications of septic arthritis?
21. Describe the pathophysiology of Legg-Perthes disease; how does slipped capital femoral epiphysis (SCFE) occur?
22. Describe the common clinical presentation of SCFE + LCPD
23. Describe 2 radiographic findings consistent with SCFE + LCPD
24. How is SCFE classified? How is this classification used to determine management? (shownotes)
25. What is the risk of bilateral SCFE? (shownotes)
26. What are the potential complications of SCFE? (shownotes)
27. What is a juvenile Tilleaux fracture? How does it occur?
28. What is a triplanar fracture?
29. List seven red flags for pediatric back pain.
30. What is spondylolysis? What is spondylolisthesis? How is it managed?
31. List 4 common apophyseal injuries in children.

Wisecracks:

1. List 6 specific xray findings / fractures consistent with non-accidental injury (shownotes)
2. What is a corner / bucket handle fracture?
3. What are the investigations in a complete skeletal survey (shownotes)
4. List 4 conditions with similar presentation to child abuse (shownotes)
5. List causes of pathologic fractures in children.
6. What is the utility of blood culture, ESR and CRP in a child with suspected septic arthritis of the hip?
7. What the mechanism of a lateral elbow condyle fracture and how are they managed? (shownotes)
8. What is the mechanism of a medial elbow condyle fracture and how are they managed? (shownotes)

What is the most common pediatric fracture?