Transient Synovitis and the Limping Child – Board-Style Questions

What this deck covers

transient synovitis and the limping child in 18 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 paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. Watching him walk
2. One manoeuvre
3. No cold at all
4. How long will it go on
5. It has come back
6. He points at his knee
7. Still on his feet
8. Home with a plan
9. What to give
10. Both legs at night
11. Why come back
12. More than a sore hip
13. Take the socks off
14. Do we need a needle
15. Stiff first thing
16. Back to class
17. Will the joint suffer
18. Who gets it

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: A toe-walking gait, in which the heel never reaches the floor, Gentle inward rolling of the leg, the most sensitive hip test, A throat infection must be documented before the label can be used, It will not settle until a course of antibiotics has been given, Recurrence happens in a minority and does not mean the diagnosis was wrong, The knee joint is inflamed even though it looks and feels entirely normal, Walking excludes infection completely and ends the assessment here, Review in three months in the general orthopaedic outpatient clinic, Regular ibuprofen for a few days shortens the time to walking freely, One-sided night pain with local bone tenderness and a limp during the day, Antibiotics are started at six weeks if any limp is still present, Absence of fever, which makes serious disease very unlikely here, Inspect the sole of the foot, where a splinter or verruca often hides, Every child with an irritable hip should have the joint sampled to be certain.

Clinical pearls from this deck

• An antalgic gait signals pain rather than weakness.
• Log roll the leg: the hip gives itself away first.
• No preceding cold does not overturn an irritable hip.
• An irritable hip is over within a fortnight.
• One in seven has a second irritable hip episode.
• Knee pain with a normal knee: examine 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.