MS Path II

Older children who have been walking will respond well to conservative treatment.

The Pavlik harness may be worn from anywhere to 3-9 months eventually weaning its use to nighttime only.

Common management includes maintaining proper position with placement of the hip in a position of 100 degrees flexion.

The goal of the treatment is to ensure the stability of the femoral head in the acetabulum.

Affordability

Capable of producing contract and detail in soft tissue structures.

Broad availability

Wealth of useful information

Pain with active knee extension

Localized pain, swelling, tenderness over the tibial tuberosity

Pain with active hip flexion

Swelling

Fibula

Femur

Phalanges

Patella

Require high energy impact. May be suspicious of abuse if this injury occurs in infants less than a year old.

Restoring the length, alignment, and rotation are the primary treatment goals.

A spica cast is an option as a closed conservative treatment.

Closed treatment of femur fractures in children typically do not have many complications.

Pavlike Harness

Milwaukee Brace

Spica Cast

Ilizarov Appartus

Milwaukee Brace

Spica Cast

Botox

Ilizarov Apparatus

Legg-Calves Perthes Disease

Osgood-Schlatter Disease

Sever Disease

Slipped Capital Femoral Epiphysis

Congenital - convex curve to the left in the thoracic region

Idiopathic - convex curve to the right in the thoracic region

Idiopathic - convex curve to the left in the thoracic region

Congenital - convex curve to the right in the thoracic region

Hyaline

Type II

Type I

Articular

Coxa Vara

Swelling

Joint sepsis

Arthritis

Brain Pathology

Stress Fracture

Abdominal Injury

Traumatic Fracture

Distal Radius Fracture

Galeazzi Lesion

Kienböck's Disease

Monteggia Lesion

Subacromial + Coraco-claviulcar Space

Malalignment

AC Joint

Costal Cartilage

Monteggia Lesion

Kienböck's Disease

Galeazzi Lesion

Scheuermann's Disease

Posterior

Anterior

Medial

Lateral

Vertebral Bodies

Central Canal and Posterior Elements

Degenerative Changes

Alignment

Radial/Ulnar Shaft Fractures

Galeazzi Lesion

Kienböck's disease

Supracondylar Humerus Fracture

You should pay extra attention to the continuity along the posterior border of the vertebral bodies when observing the alignment.

Look for scoliosis, kyphosis, and lordosis when looking at the vertebral bodies.

The winking owl sign may be observed when looking for degenerative changes.

A Scotty Dog Fracture is best identified when looking at "everything else."

Femoral anteversion

Tibial Torsion

Femoral Torsion

Metatarsus Abductus

Distal femur - average 6 mm/year

Proximal tibia - average 10 mm/year

75% of lower extremity length

Tibial tubercle apophysis - premature growth arrest can lead to recurvatum

Coracoclavicular

Cord/Conus

Compression

Central Canal

Soft tissues will appear dark.

Cortical bone will appear light gray.

Cancellous bone with appear white.

All of the above are correct.

It is important to make sure the machine is clean and well-maintained to prevent machine error with use.

Old fractures tend to have sharp edges, where as new fractures tend to have more rounded edges.

You should get a minimum of 2 views per site from different angles.

Some complicated cases may require you getting comparison view of the other side to examine symmetry.

All the above are correct.

Atraumatic refers to multiple instability directions.

For 16 y.o. or older "active" individuals with a traumatic dislocation, reduction and immobilization is the common management.

Anterior is the most common dislocation direction.

No surgery (rotator cuff muscle strengthening instead) is the common management for atraumatic dislocations.

50, 50

40, 50

45, 45

90, 90

Healing capacity is very good.

Complications are uncommon.

Often occurs near the acromial end.

In many cases, treatment is not needed, even with a displaced fracture.

MRI

CT Scan

X-Ray

None of the Above

Scheuermann's Disease

Developmental Dysplasia of the Hip

Slipped Capital Femoral Epiphysis

The Limping Child

In adults, it is a radial shaft fracture with dislocation of the DRUJ (distal radioulnar joint injury)

In adults, it is a radial shaft fracture with the separation of the distal ulnar epiphysis.

In children, it is simply a fracture of the radial shaft.

Low incidence of growth arrest in children with the serration of distal ulnar epiphysis.

Kienböck's Disease - A radius that is shorter than the ulna

Galeazzi Lesion - A radius that is shorter than the ulna

Galeazzi Lesion - Limited vascular supply to the lunate.

Kienböck's Disease - Limited vascular supply to the lunate

X-rays are more affordable option.

Only X-rays expose the patients to ionizing radiation.

CT scans use the same 3 planes as MRI studies: axial, sagittal, and coronal plane.

CT allows for multiple plane views and three-dimensional images.

Type I, Type II, Type III

Partial Dislocation, Unstable dislocation, Complete Dislocation

Unstable Hip Dysplasia, Subluxation/Incomplete Dislocation, Complete Dislocation

Unstable hip dysplasia, Stable Hip Dysplasia, Idiopathic Hip Dysplasia

Malunion

Compartment Syndrome

Dislocation

Refracture

Good for pathology because lesions are usually water based

Fat appears gray.

Marrow appears bright.

Cortex appears dark.

Due to great healing and remodeling potentials, non-operative treatment/immobilization is commonly used.

Pinning is generally not recommended due to high complication rates.

Both A and B.

None of the above.

T1 and STIR

T2 and STIR

T1 weighted

T2 weighted

Scheuermann's Disease

Scoliosis

The Limping Child

LCPD

Lateral

Oblique

Anterior-Posterior

Y view

Elevated ESR/CRP

Recent Trauma

Unexplained weight gain

Cauda Equina Syndrome

Often use medial entry pins to avoid ulnar nerve injury.

Some varus/valgus with the re-alignment is OK.

Signs and symptoms include pink, pulseless extremity (brachial pulse)

Minimal rotation is important with the proper re-alignment of the body fragment.

MRI

X-Ray

CT Scan

None of the above.

Osgood-Schlatter Disease

Distal Patella Apophysitis

Sinding-Larsen-Johansson Syndrome

Both B and C.

Pediatric patients have a great healing capacity even when the fractures are displaced initially.

For pediatric fractures, correcting the angular deformity is more important than correcting the rotational deformity and fragment displacement.

The distal radius fracture is the most commonly fractured bone in children.

The type I Salter Harris fracture is the most common type at birth.

Neurologic injury

Nonunion

Compartment Syndrome

Malunion

Thick Adipose - White

Lung - Black

Cancellous Bone - Light Grey

Blood - Mid Grey

A non-displaced fracture usually results closed reduction and a cast above or below the elbow depending on the surgeon's preference.

Torus fractures are stable injuries and can be treated with a removable forearm splint.

The distal radius fracture is a Type I Salter-Harris Fracture.

The distal radial physeal is the part of the radius that is most vulnerable.

Sever Disease

Osgood-Schlatter Disease

Both A and B.

None of the above - A and B only occur shortly after a child begins a new activity.

Trauma

Overuse

Birth

All of the above.

High cost of equipment.

It is not the modality of choice when studying bone tissue.

A and B.

Does not involve ionizing radiation.

All of the above.