1. General Principles & Basic Science MCQs

A newborn is noted to have deep circumferential skin creases around the distal right lower extremity with distal limb edema, as well as acrosyndactyly of the toes. What is the recommended surgical management for the deep constriction bands to prevent distal ischemia?

A 2-year-old boy is evaluated for genu varum. Standing radiographs demonstrate a metaphyseal-diaphyseal angle (Drennan angle) of 18 degrees on the right tibia. What is the most likely diagnosis?

A 2-year-old boy presents with a 3-day history of fever, irritability, and refusal to bear weight on his right leg. MRI reveals a subperiosteal abscess of the proximal femoral metaphysis with extension into the hip joint. What is the most likely mechanism of joint involvement?

A 4-year-old boy presents with right hip pain, a temperature of 38.6 C (101.5 F), refusal to bear weight, an ESR of 45 mm/hr, and a WBC count of 13,000/mm3. According to the Kocher criteria, what is the predictive probability that this child has septic arthritis of the hip?

A 4-year-old boy presents with right hip pain, a temperature of 38.8°C (101.8°F), inability to bear weight, and a WBC count of 14,000/mm3. ESR is 55 mm/hr. According to the Kocher criteria, what is the approximate probability that this child has septic arthritis rather than transient synovitis?

A 14-month-old girl presents with refusal to bear weight on her right leg. She is afebrile with normal inflammatory markers. MRI shows early osteomyelitis in the distal tibial metaphysis. Given her age, what fastidious organism should be highly suspected, and how can its culture yield be optimized?

A 3-year-old obese girl presents with unilateral genu varum. Radiographs reveal a metaphyseal-diaphyseal (Drennan) angle of 20 degrees. What is the diagnosis and best initial treatment?

A 3-year-old girl refuses to bear weight on her right leg for 2 days. Her temperature is 38.8 C, ESR is 50 mm/hr, and peripheral WBC is 14,000. Ultrasound confirms a hip effusion. According to the Kocher criteria, what is the probability of septic arthritis?

When attempting to differentiate transient synovitis from septic arthritis of the pediatric hip, which laboratory value has been shown to be the strongest independent multivariate predictor for septic arthritis?

During a direct anterior approach for total hip arthroplasty, which nerve is at greatest risk of iatrogenic injury during the superficial dissection between the sartorius and tensor fasciae latae?

Aseptic loosening due to wear-particle induced osteolysis remains a long-term complication of total hip arthroplasty. At the cellular level, which of the following is the primary direct mediator of osteoclast activation and subsequent bone resorption in this cascade?

According to the latest guidelines from the American Academy of Orthopaedic Surgeons (AAOS) and the American Association of Hip and Knee Surgeons (AAHKS), what is the recommended pharmacological strategy for routine venous thromboembolism (VTE) prophylaxis in a standard-risk patient undergoing primary THA?

A 28-year-old professional hockey player presents with gradual onset of anterior groin pain exacerbated by hip flexion and internal rotation.

A cross-table lateral radiograph reveals a prominent bump at the anterolateral head-neck junction. Which of the following intra-articular damage patterns is most characteristic of this specific morphology?

During an anterior approach (Smith-Petersen) to the hip for total hip arthroplasty, the surgeon develops the internervous plane between the sartorius and the tensor fasciae latae. Which of the following structures is at greatest risk of injury during the superficial dissection of this approach?

A 40-year-old man sustains a transverse acetabular fracture with significant posterior wall comminution. Which of the following surgical approaches provides the optimal visualization for direct reduction and fixation of the primary displaced components in this fracture pattern?

During hip arthroscopy, excessive traction or prolonged operative time in the supine position most commonly causes neurapraxia to which of the following nerves?

Which of the following best describes the true internervous plane utilized during the direct anterior approach to the hip?

A patient complains of an inability to dorsiflex their foot immediately following a revision THA performed via a posterior approach. The operative report notes that the leg was lengthened by 3.5 cm to achieve stability. Which specific neural structure is most likely injured?

A surgeon is performing a primary total hip arthroplasty using the direct anterior approach. To access the hip joint, the superficial surgical dissection utilizes an internervous plane between which two muscles?