Pediatric Hip MCQs

An 8-year-old boy presents with bilateral slipped capital femoral epiphyses. His height is in the 5th percentile and his weight is in the 90th percentile. Which of the following laboratory studies is most critical in evaluating the underlying etiology of his condition?

In the treatment of developmental dysplasia of the hip with a Pavlik harness or spica cast, maintaining the hip in excessive abduction significantly increases the risk of which of the following complications?

Prophylactic pinning of the contralateral hip is most strongly indicated in which of the following patients presenting with a unilateral slipped capital femoral epiphysis?

A 4-week-old female infant is undergoing treatment for developmental dysplasia of the hip (DDH) with a Pavlik harness. During a follow-up visit, the mother reports that the infant is no longer actively extending her knee on the affected side. Examination confirms absent active knee extension, though patellar reflexes are intact. What is the most appropriate next step in management?

When evaluating coronal ultrasound images for developmental dysplasia of the hip (DDH) in a 6-week-old infant, the alpha angle is routinely measured. Which anatomic structure serves as the primary landmark for determining this angle?

A 12-year-old boy presents with an acute on chronic slipped capital femoral epiphysis (SCFE) of the left hip. Under which of the following circumstances is prophylactic in-situ pinning of the contralateral, asymptomatic hip most strongly indicated?

A 13-year-old boy with a BMI of 35 presents with a 2-day history of severe right hip pain and absolute inability to bear weight, even with crutches. According to the Loder classification, what is his approximate risk of developing avascular necrosis (AVN) following treatment?

A 14-year-old boy is evaluated 6 months after an uncomplicated in-situ percutaneous pinning for a stable SCFE. He now reports worsening hip pain and demonstrates a global loss of range of motion in the affected hip. Joint space narrowing is evident on radiographs. What is the most likely etiology?

A 6-month-old girl has been treated with a Pavlik harness for 4 weeks due to a completely dislocated left hip (Developmental Dysplasia of the Hip). Serial ultrasounds demonstrate that the hip remains persistently dislocated despite confirmed appropriate strap tension and compliance. What is the most appropriate next step in management?

A 12-year-old boy presents with a unilateral stable Slipped Capital Femoral Epiphysis (SCFE) of the left hip. Which of the following patient factors is the strongest absolute indication for prophylactic in situ pinning of the asymptomatic right hip?

A 2-year-old girl is brought to the clinic for a painless limp. She has a positive Trendelenburg gait. Radiographs show a dislocated right hip with a false acetabulum and hypoplastic femoral nucleus. Which of the following is the most appropriate treatment for this late-presenting developmental dysplasia of the hip (DDH)?

A 13-year-old girl with a high BMI presents to the emergency department with acute right hip pain after a minor slip. She cannot bear weight on the right leg, even with the assistance of crutches. Radiographs confirm a slipped capital femoral epiphysis. Compared to a stable slip, this patient is at significantly higher risk for which of the following complications?

During an open reduction for developmental dysplasia of the hip (DDH) via an anterior approach, several structures are identified that may block concentric reduction. Which of the following is considered an EXTRA-articular obstacle to reduction?

An 11-year-old overweight boy complains of left knee pain. Knee radiographs are unremarkable. An AP pelvis radiograph is obtained.

A line drawn along the superior margin of the left femoral neck fails to intersect any portion of the femoral epiphysis. What is the name of this radiographic line?

Which of the following surgical techniques is the most widely accepted standard to minimize the risk of complications when treating a typical stable Slipped Capital Femoral Epiphysis (SCFE)?

A 4-week-old female is placed in a Pavlik harness for developmental dysplasia of the hip (DDH). Two weeks later, the parents report that the child has stopped kicking her right leg. On exam, there is an absent quadriceps reflex and no active knee extension. What is the most appropriate next step in management?

A 13-year-old obese male presents with 2 days of severe left hip pain and an inability to bear weight after a minor fall. Radiographs show a severe slipped capital femoral epiphysis (SCFE). He is treated with an urgent gentle closed reduction and pinning. Which of the following is the most significant risk associated with this specific presentation and intervention?

An 18-month-old female presents with a waddling gait. Radiographs reveal a dislocated left hip with an acetabular index of 40 degrees. During the planned open reduction, which structure is considered the most inferior block to concentric reduction of the femoral head into the true acetabulum?

A 9-year-old boy presents with a unilateral stable slipped capital femoral epiphysis (SCFE). His height is in the 10th percentile and weight in the 90th percentile. Based on his age and body habitus, which of the following screening tests is most appropriate?

A 6-month-old male with DDH undergoes a closed reduction and spica casting. A post-reduction MRI is obtained to confirm reduction. To minimize the risk of avascular necrosis (AVN), the hip must NOT be immobilized in which of the following excessive positions?