Musculoskeletal and Orthopaedics – Exam Review Set 3

What this deck covers

Musculoskeletal and Orthopaedics – Exam Review Set 3 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 paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 50 cases, in order

1. It slipped, then it returned
2. His father has read about surgery
3. Clunking since he could walk
4. Swollen inside the hour
5. Six months, and rest made it worse
6. The arch that never came back
7. A lump where the shoe rubs
8. It runs in the family, they said
9. Short, curved, and too tight
10. The sole bulged downwards
11. Will it come out again
12. A hollow, and a changed voice
13. Eighteen hours a week
14. A burning arm, then nothing
15. A sharp point, gone white
16. He will not bend forward
17. A dull ache and clean bloods
18. Three courses, and it keeps returning
19. The joints all moved freely
20. Seven months, and still moving
21. His mother asked what it does
22. An operation that cannot be undone
23. Fading a little each time
24. She leans, and props on one arm
25. The dose that works puts him to sleep
26. Eighteen months, and still bent
27. Resting it until it feels right
28. Back on the trampoline next day
29. A hard lump six weeks on
30. Two years old, and a broken thigh
31. Pulled up out of the blocks
32. Two weeks off, then back by stages
33. A hurdler who cannot sit down
34. The ache, and then a crack
35. A groin strain that took a flake
36. Three toes, and a dimpled shin
37. The foot that reaches the other calf
38. One side sits higher, and stops
39. The hand that will not turn up
40. A shin against the thigh at birth
41. Walking on the outside of the foot
42. Pain under the ball of the foot
43. A thrower who is only nine
44. Rounded, and told to sit up
45. Fifty degrees, and still growing
46. Sent to the wrong clinic
47. Turned out, and no longer bearing
48. One side done, and then?
49. Eighteen months, and never checked
50. A fifth, then a half

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: A torn meniscus from the twisting injury, Bleeding from a fractured patella, An extra bone at the inner side of the midfoot, A rigid foot that curves the wrong way, An undisplaced fracture of the scaphoid bone, Transient synovitis of the hip, In the hip joint, with pain referred to the thigh, Lengthening the tight tendons in both legs, Inject more muscles at each session instead, An underlying bone cyst weakening that site, The chronic soreness has flared again after the jump, The shortening is in the thigh, above the knee, Immediate operation to reduce the knee, The absence of swelling around the joint.

Clinical pearls from this deck

• She has described the diagnosis without naming it. Something went sideways and came back when she straightened.
• Operate on the second one, not the first. Most knees never do it again.
• Clicking in a child is usually nothing. Clicking that has always been there, with a knee that will not straighten, is not.
• Time the swelling. Inside two hours is blood; overnight is a sprain.
• Rest is what she has already tried. The treatment is load, and telling her it is safe to apply it.
• Ask him to stand on tiptoe. An arch that appears is normal; an arch that does not is a diagnosis.

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 musculoskeletal and orthopaedics case decks · pediatric reference values.