The Young Orthopod

The Young Orthopod Revision Quiz #04 We bring you the Fourth Revision Quiz! All the questions have been posted previously on our Facebook page @TheYoungOrthopod Which is not a feature of cervical syringomyelia: Hypertrophy of abductor pollicis brevis Burning sensation in arm Biceps reflex absent Extensor plantar Which of the following is not one of the trabecular patterns in the proximal femur? Greater trochanter group Lesser trochanter group Secondary compressive group Principle tensile group The most appropriate radiographic view to evaluate the acromioclavicular joint is? Serendipity view Zanca view Supraspinatus outlet view Garth view What is the predominant blood supply of femoral head? Lateral circumflex artery Obturator artery Medial circumflex artery Descending branch of lateral circumflex artery Gallows traction is most optimum for Fracture shaft femur > 2 years of age Fracture shaft femur < 2 years of age Fracture tibia Pelv

Chronic Recurrent Multifocal Osteomyelitis (CRMO)  affects predominantly children and adolescents, with a peak age of onset of 10 years  and a female preponderance. CRMO is characterized by recurrent inflammation at multiple skeletal sites , most commonly  involving the tibia, femur, clavicle, foot, or vertebral body and rarely the pelvis or rib cage. Associated inflammatory disorders , includes → Palmoplantar pustulosis → Chronic arthritis → Psoriasis → Inflammatory bowel disease → Pyoderma gangrenosum  → Sweet's syndrome, and  → Severe acne. Clinical Features → Multiple episodes of localized redness, pain, & swelling of insidious onset & spontaneous  regression . → Minimal functional impairment during the episodes. Pathophysiology The pathogenesis of this condition remains unexplained. Theories include an autoimmune process or an infecti

The Young Orthopod Revision Quiz #03 We bring you the Third Revision Quiz! All the question have been posted previously on our Facebook page @TheYoungOrthopod . All are true about menisci of knee joint except: Lateral meniscus covers more articular surface of tibia Lateral meniscus is more mobile Lateral meniscus is more prone to injury Lateral meniscus is semicircular Hawkin sign denotes? Retained vascularity Decrease vascularity Non-union Avascular necrosis Which of the following is a morphologically biphasic tumor? Rhabdomyosarcoma Synovial sarcoma Osteosarcoma Osteoblastoma Fairbank s triangle is seen in? Tibia vara Genu valgum Hip fracture Coxa vara CD markers of langerhans histiocytosis CD1a CD99 CD34 CD5 Adductor pollicis Nerve supply is: Ulnar Radial Median Sciatic Which of the following statements about changes in articular cartilage is not true? Water content increases in osteoarthritis. Water content decreases as part of

This video is the first in the "Osteology for Viva" series . Here we have discussed the Osteology pearls for clavicle, its parts, muscle and ligaments attachments, the fracture classification and few key points about the bone. This video is ideal for revising the osteology day before the exam. These are the minimum points that a student must practice before the viva exams. All the best :)

The Young Orthopod Revision Quiz #02 We bring you our second Revision Quiz! All the question have been posted previously on the Facebook page @TheYoungOrthopod . Like and follow us at Facebook for the Daily MCQ Challenge! The technical error that may lead to scapular notching after reverse total shoulder arthroplasty? Posterior placement of the glenoid component Superior placement of the glenoid component Inferior placement of the glenoid component
 Retroverted placement of the glenoid component Which of the following childhood tumours most frequently metastasizes to the bone? Neuroblastoma Ganglioneuroma Wilms tumor
 Ewing's sarcoma Islene’s disease is the osteochondritis of: 2nd Metacarpal 5th Metacarpal 2nd Metatarsal 
 5th Metatarsal In Henry's approach for proximal radius, the forearm is supinated to minimize injury to ______? Lateral antebrachial cutaneous nerve Posterior interosseous nerve Ulnar nerve Radial nerve To which of th

My patient Mr. X son of Mr. Y, 40 years old male, farmer by occupation, resident of Z, presented with the Chief Complaints of Pain in the lower back for 1 year Weakness of both lower limb for 1 year Loss of sensation in the right lower limb below groin for 6 months Difficulty in/ loss of control over passing urine & stools for 2 months Deformity of lower back for 2 months HOPI   (History of Presenting illness) - As stated by the patient/parents He was apparently asymptomatic 1 year back when he developed PAIN over lower back which was insidious in onset, gradually progressive, continuous/intermittent, mild to moderate in intensity, pricking/stabbing/shock type in nature, non-radiating, aggravated by weight bearing/activity/ coughing and sneezing , relieved by taking rest and oral medications. No diurnal or seasonal variation. Patient developed WEAKNESS   of the both lower limbs one year ba

The Young Orthopod Revision Quiz #1 We bring you our first Revision Quiz! All the question have been posted previously on the Facebook page @TheYoungOrthopod. Like and follow us at Facebook for the Daily MCQ Challenge! Which of the following is not a major criteria for the diagnosis of fat embolism? Axillary or sub-conjunctival petechiae Hypoxemia Retinal Emboli CNS depression Which of the following is a low grade chondrosarcoma? Secondary chondrosarcoma Dedifferentiated chondrosarcoma Clear cell chondrosarcoma Mesenchymal chondrosarcoma Filum terminale internum ends at which spinal level? L1 S2 S5 Coccyx Holdsworth classification of thoracolumbar spine fracture is based on how many columns of spine? Two Three Four Five Idiopathic scoliosis is most commonly? Dextroscoliosis of thoracic spine Levoscoliosis of thoracic spine Dextroscoliosis of lumbar spine Levoscoliosis of lumbar spine Tibial collateral ligament is formed by? Adductor magn

Kienbock's disease is Osteonecrosis Of The Lunate . By a mechanism that still is not entirely understood, the blood flow to the lunate bone of the wrist is compromised to such an extent that osteonecrosis ensues and collapse and fragmentation of the  bone occurs over time . The end result can be degenerative arthritis of the radio-carpal joint and pain .  Pathogenesis Various predisposing factors exist. About 75% of patients have a shorter ulna compared to the radius, as  measured at the wrist ( Ulnar Negative Variance ). The slope of the distal radius articular surface is found   to be more horizontal . Approximately 25% of lunate are thought to have a single vessel blood supply. Repetitive micro-fracture of the bone or a single fracture have been suggested as the cause of  osteonecrosis of the lunate. Incidence More common in Males that females. It occurs more frequently between the ages of 15 and 40 years and in the dominant wrist

This video describes the basics of osteotomy that are essential for deciding the management of various deformities in the clinics and also important as a student's point of view for exams and to understand the concept behind various osteotomies. References - Principles of deformity correction: Dror Paley.

Juvenile Rheumatoid Arthritis (JRA)  or  Juvenile Idiopathic Arthritis (JIA)  is a type of arthritis that causes joint inflammation and stiffness for more than six weeks in a child aged 16 or younger. Juvenile rheumatoid arthritis differs significantly from the adult form. The diagnosis of juvenile rheumatoid arthritis usually is made by exclusion .  Diagnostic Criteria For Classification Of Juvenile Rheumatoid Arthritis Age of onset younger than 16 years Arthritis in one or more joints defined as swelling or effusion or by the presence of two or more  of the following signs— limitation of motion, tenderness or pain on motion, and increased heat. Duration of disease 6 weeks to 3 months Exclusion of other rheumatic diseases Rheumatoid factor is positive in less than 25% of patients. → After patients pass the age of 8 years , laboratory tests show an increasingly higher percentage of positi

An osteoclast is a type of bone cell that resorbs bone tissue . This function is critical in the maintenance and repair of compact bones in the mammalian skeleton. Kolliker discovered osteoclasts in 1873 . An osteoclast is a large multinucleated cell and human osteoclasts on bone typically have five  nuclei and are about 15 0-200 μm in diameter. In bone, osteoclasts are found in pits in the bone surface, which are called resorption bays, or  Howship's Lacunae. Osteoclasts are characterized by a cytoplasm with a homogeneous, "foamy" appearance. This appearance is due to a high concentration of vesicles and vacuoles. These vacuoles include lysosomes filled with acid phophatase. This permits characterization of Osteoclasts by their staining for high expression of tartrate resistant acid phosphatase (TRAP) and cathepsin K . Osteoclast rough endoplasmic reticulum is sparse, and the Golgi complex is extensive. Osteoclasts, large irre

The pelvic support osteotomy is a useful surgical procedure for the salvage of damaged hips of patients in whom arthrodesis or hip arthroplasty are not appropriate. ✫ The surgery is a double-level osteotomy of the femur : (a) The more proximal valgus-extension osteotomy is performed with the femur in maximum  adduction and at a level where the femoral shaft is seen to abut the pelvis. (b) The second, more distal , osteotomy restores the orientation of the knee and ankle joint lines in the coronal plane and also provides a focus for femoral lengthening if warranted. ✫The proximal osteotomy lateralizes and distally displaces the greater trochanter and in doing so  increases the action of the abductor muscles . ✫To this is added the elimination of any further adduction between femur and pelvis which then prevents pelvic drop during the single stance phase of gait. ✫ A successful pelvic support osteotomy Reduces limp through abolish