Scoliosis, developmental dysplasia of the hip, and Legg-Calve-Perthes disease with their presentation and management tested on USMLE Step 1.
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- What pediatric hip condition involves abnormal development of the acetabulum, leading to instability or dislocation of the hip?
- Developmental dysplasia of the hip (DDH)
- What exam maneuver detects a dislocatable hip in an infant by adducting a flexed hip while applying posterior pressure?
- The Barlow test
- What exam maneuver relocates a dislocated hip in an infant by abducting the flexed hip?
- The Ortolani test
- What imaging modality is preferred for evaluating developmental dysplasia of the hip in infants younger than 6 months?
- Ultrasound
- What is the first-line treatment for developmental dysplasia of the hip diagnosed in early infancy?
- A Pavlik harness
- What idiopathic pediatric condition involves avascular necrosis of the femoral head, typically in children ages 4 to 8?
- Legg-Calve-Perthes disease
- What is the classic presentation of Legg-Calve-Perthes disease?
- Insidious onset of hip or groin pain and a limp, often with limited internal rotation and abduction
- What imaging finding confirms Legg-Calve-Perthes disease?
- Femoral head flattening, fragmentation, and sclerosis on hip radiographs
- What condition involves displacement of the proximal femoral epiphysis through the growth plate, typically in obese adolescents?
- Slipped capital femoral epiphysis (SCFE)
- What is the classic age and body habitus associated with slipped capital femoral epiphysis?
- Obese adolescents, typically ages 10 to 16
- What is the classic presentation of slipped capital femoral epiphysis?
- Hip, groin, thigh, or knee pain with an antalgic gait and limited internal rotation of the hip
- What is the standard treatment for slipped capital femoral epiphysis?
- Surgical in situ screw fixation to stabilize the femoral head
- What term describes a lateral curvature of the spine, often idiopathic, detected during adolescent growth spurts?
- Scoliosis
- What screening test detects scoliosis by having the patient bend forward at the waist?
- The Adams forward bend test
- What is the most common type of scoliosis in adolescents?
- Idiopathic scoliosis
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