MSK and Orthopaedics Prometric Style Questions – 50 Cases with Answers

What this deck covers

MSK and Orthopaedics — Prometric Style Questions, Set 1 in 50 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 50 cases, in order

1. A breech baby with a family history
2. One leg looks shorter
3. How the harness works
4. A poor result after treatment
5. In or out at the newborn check
6. A limp for four months
7. Knee pain with a normal knee
8. A limp after a cold
9. Normal film, persistent limp
10. Shaping the head as it heals
11. Feet turned in at birth
12. Front of the foot turns in
13. Bow legs in a toddler
14. Walking with toes turned in
15. One leg bowing more
16. A baby with a tilted head
17. A new head tilt at seven
18. A flat spot on the head
19. A break across the physis
20. A bone that bent and cracked
21. A crack after a difficult birth
22. Refusing to walk after a trip
23. A story that does not fit
24. Why image the whole skeleton
25. Two fractures in a year
26. Short limbs at birth
27. Bones too dense on the film
28. Starting infusions for brittle bones
29. Fever with a painful thigh
30. A newborn who will not move a leg
31. Bone pain in sickle cell disease
32. Sterile bone lesions in many places
33. A mild limp with negative cultures
34. Uneven shoulders at school
35. A curve with warning signs
36. Back pain that wakes him
37. A gymnast with back pain
38. A rounded back that will not straighten
39. A painful lump below the knee
40. Sore heels after football
41. A knee that locks
42. Shin pain in a runner
43. A twisted ankle on the pitch
44. Back to rugby after a knock
45. A swollen elbow after a fall
46. An arm that will not be used
47. A twisting break in a toddler
48. Flat feet at four
49. A break while being lifted
50. A waddle at three years

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: No action, since the examination is normal, Recurrent dislocation of the hip, Slipped upper femoral epiphysis, Long-term corticosteroid to reduce the inflammation, Radiographs of both legs and a vitamin D level, Urgent ultrasound to exclude a malignant neck mass, Failure of the fracture to unite at all, Osteomyelitis of the tibia in an early phase, Inflicted injury from physical abuse, Correction of the underlying collagen defect, Salmonella species, Physiotherapy and exercises to correct the curve, Lumbar disc prolapse with nerve root irritation, Achilles tendon rupture from repeated microtrauma.

Clinical pearls from this deck

• Two risk factors and a normal examination still means a scan. The examination is what you image around, not what you rely on.
• The newborn tests stop working at three months. After that, look at abduction and at the level of the knees.
• The socket is shaped by the head sitting in it. That is why the harness allows movement rather than preventing it.
• The worst outcome in this condition is caused by its treatment. That is why gentle is not a courtesy here, it is the technique.
• Ortolani puts it in. One letter is all it takes to stop confusing the two for good.
• Examine the hip in every child with knee pain. The hip refers pain to the knee, and the knee never refers pain to the hip.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all MSK and Orthopaedics case decks · pediatric reference values.