4. Pediatrics MCQs

A 22-year-old collegiate athlete presents with chronic anterior groin pain exacerbated by hip flexion and internal rotation. A Dunn view radiograph of the hip demonstrates an alpha angle of 65 degrees. This radiographic finding is most consistent with which of the following pathomorphologies?

A 25-year-old professional hockey player presents with gradual onset of anterior hip pain exacerbated by hip flexion and internal rotation. Radiographs reveal an alpha angle of 68 degrees and a prominent bump at the anterolateral femoral head-neck junction. What is the most likely diagnosis?

A 6-week-old female is being treated with a Pavlik harness for developmental dysplasia of the hip. After 2 weeks, her parents note that she is no longer actively kicking or extending the knee on the treated side. What is the most appropriate next step in management?

A 35-year-old woman with a history of untreated developmental dysplasia of the hip (DDH) is planned for a THA. Preoperative planning reveals a Crowe Type IV dysplasia. Which of the following surgical techniques is most likely required to successfully reconstruct this hip and avoid sciatic nerve palsy?

A 12-year-old boy with hypothyroidism and a BMI of 35 presents with an unstable slipped capital femoral epiphysis (SCFE) of the left hip. Radiographs show a moderate slip. Which of the following factors is the strongest indication for prophylactic in situ pinning of the contralateral right hip?

A 12-year-old boy with a BMI in the 98th percentile is diagnosed with a severe, slipped capital femoral epiphysis (SCFE) of the left hip. Radiographs of the right hip are normal. According to current evidence, which of the following is the strongest indication for prophylactic in situ pinning of his contralateral asymptomatic right hip?

A 6-week-old female infant is treated with a Pavlik harness for developmental dysplasia of the hip. At the 3-week follow-up, ultrasound shows the hip remains dislocated. What is the most appropriate next step in management?

A 13-year-old obese boy presents with a mild slipped capital femoral epiphysis (SCFE) of the left hip. When is prophylactic pinning of the contralateral, asymptomatic hip most strongly indicated?

Which of the following is considered a 'head-at-risk' sign in Legg-Calve-Perthes disease?

A 45-year-old woman with a history of bilateral developmental dysplasia of the hip (Crowe type IV) is undergoing THA. Preoperative planning indicates the native femoral head is migrated 5 centimeters proximally. Which of the following surgical strategies is most appropriate to restore normal biomechanics while minimizing complications?

An 8-year-old boy presents with a displaced extension-type supracondylar humerus fracture. The hand is pink but the radial pulse is absent before and after closed reduction and percutaneous pinning. The hand remains warm and well-perfused. What is the most appropriate next step?

A

14-year-old girl is evaluated for scoliosis. Radiographs reveal a right thoracic curve of 42 degrees. Her Risser stage is 0 and she is premenarchal. What is the most appropriate next step in management?

A 12-year-old premenarchal female presents with a right thoracic curve measuring 48 degrees on a standing PA radiograph. She is Risser 0 and has a Sanders skeletal maturity stage of 2. What is the most appropriate management?

A 12-year-old girl is diagnosed with adolescent idiopathic scoliosis. She is premenarcheal with a Risser stage of 0. Standing radiographs reveal a right thoracic curve of 35 degrees. What is the most appropriate next step in management?

A 13-year-old premenarchal girl (Risser 0) is diagnosed with adolescent idiopathic scoliosis. Her right thoracic curve measures 34 degrees. What is the most appropriate next step in management?

A 13-year-old premenarcheal female presents with a right thoracic prominence. Radiographs reveal an adolescent idiopathic scoliosis (AIS) curve of 32 degrees. Her Risser stage is 1. What is the most appropriate management?

A 14-year-old girl is diagnosed with Adolescent Idiopathic Scoliosis. Upright radiographs demonstrate a main thoracic curve of 55 degrees and a lumbar curve of 35 degrees. On lateral bending films, the thoracic curve corrects to 40 degrees, and the lumbar curve corrects to 30 degrees. According to the Lenke classification system, what type of curve pattern does she have?

In the surgical planning for Adolescent Idiopathic Scoliosis using the Lenke classification, which curve type is defined specifically as a 'Double Major' curve?

In the Lenke classification of Adolescent Idiopathic Scoliosis, a structural curve is determined by side-bending radiographs. Which of the following defines a structural proximal thoracic curve?

A 14-year-old female with adolescent idiopathic scoliosis (AIS) has a standing PA radiograph demonstrating a main thoracic curve of 55 degrees and a lumbar curve of 35 degrees. On supine side-bending radiographs, the lumbar curve corrects to 15 degrees. What is her Lenke curve type, and what is the standard surgical strategy?