1. General Principles & Basic Science MCQs

Dysplasia Epiphysealis Hemimelica (DEH) typically presents in a specific epidemiological group. Which demographic is overwhelmingly most commonly affected?

An MRI of a knee in a 5-year-old with suspected DEH is evaluated.

Which of the following findings on MRI definitively confirms DEH and differentiates it from synovial chondromatosis?

During the surgical excision of a DEH lesion causing a mechanical block in the knee, the surgeon must exercise extreme caution.

What specific anatomical structure is at the highest risk of iatrogenic damage that could lead to severe long-term joint dysfunction?

A 9-year-old girl presents with progressive proximal muscle weakness, an erythematous rash on her knuckles, and a purplish discoloration over her eyelids.

Which of the following is the most likely diagnosis?

An adult patient with a confirmed diagnosis of dermatomyositis complains of persistent hip pain. Radiographs reveal extensive subcutaneous and intramuscular calcifications.

This finding is known as:

Which of the following autoantibodies is most highly specific for dermatomyositis and is strongly associated with interstitial lung disease?

A 9-year-old girl with a history of proximal muscle weakness and a distinctive rash presents with hard, painful subcutaneous nodules around her elbows and knees. An X-ray is shown:

What is the pathophysiology underlying these radiographic findings?

The Woodward procedure is a common surgical treatment for Sprengel's deformity. Which of the following best describes the primary objective of this procedure?

A 7-year-old girl presents with proximal muscle weakness, an erythematous rash on her face, and violaceous papules over her metacarpophalangeal joints.

What is the eponym for the cutaneous sign over the knuckles?

A 9-year-old boy with a history of juvenile dermatomyositis presents with hard, painful nodules under the skin over his elbows and knees.

What is the primary composition of these deposits?

Sprengel's deformity represents a failure of the normal embryologic descent of the scapula. During normal development, the scapula descends from the cervical region to its final thoracic position between which weeks of gestation?

A 10-year-old girl with a history of juvenile dermatomyositis develops widespread, firm subcutaneous nodules around her elbows, knees, and pelvis. Some of these nodules have ulcerated and express a chalky white substance.

What is the primary mineral composition of these deposits?

Juvenile dermatomyositis is distinct from other inflammatory myopathies like polymyositis. What is the primary underlying immunopathogenic mechanism of muscle damage in juvenile dermatomyositis?

A 10-year-old girl with a history of profound fatigue and proximal muscle weakness is referred to orthopedics. Physical exam reveals erythematous, scaly papules over the metacarpophalangeal and interphalangeal joints.

What is the eponymous name of the pathognomonic skin finding described?

A surgeon is performing an anterolateral approach to the distal fibula for a complex pilon fracture extension. To safely expose the bone while minimizing denervation, the surgeon utilizes an internervous plane. This plane separates muscles innervated by which of the following nerve pairs?

When utilizing the standard anterolateral approach to the distal fibula for fracture fixation, the surgeon dissects through an internervous plane to minimize denervation of the surrounding musculature. This plane lies between which of the following muscle compartments?

A surgeon is performing an anterolateral approach to the distal fibula for fracture fixation. The deep dissection utilizes an internervous plane between the anterior and lateral compartments of the leg. Which of the following pairs of nerves innervates the muscles that define this internervous plane?

A 28-year-old male is undergoing open reduction and internal fixation of a displaced lateral malleolus fracture. The surgeon utilizes a standard longitudinal incision centered over the distal fibula. During the superficial dissection, a nerve is identified crossing the surgical field. To safely execute the internervous plane between the anterior and lateral compartments, which nerve must be meticulously protected, and what is its typical anatomical position relative to the fibula in this exposure?

A 58-year-old male with poorly controlled diabetes mellitus presents with a swollen, erythematous, and warm right foot. Radiographs reveal generalized osteopenia and joint subluxation at the midfoot. Which of the following MRI findings is most specific for diagnosing osteomyelitis over acute Charcot neuroarthropathy in this patient?

A 55-year-old male with long-standing diabetes presents with a non-healing neuropathic plantar ulcer beneath the first metatarsal head. He has bounding pedal pulses and profound peripheral sensory neuropathy. Which of the following is considered an absolute contraindication to treating this ulcer with a Total Contact Cast (TCC)?