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Skeletal maturity is an important variable in the progression of idiopathic scoliosis. Figures A-E are radiographs showing varying stages of skeletal maturity. The patient represented by which Figure would be expected to have the highest risk of progression of an idiopathic scoliotic curve?
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The orthosis shown in Figure A is indicated for the treatment of the spinal deformity shown in which of the following radiographs?
Which of the following figures show an asterisk that correctly quantifies the amount of sagittal imbalance?
A 12-year-old female presents with a left thoracic rib prominence. Physical exam shows absent abdominal reflexes in the upper and lower quadrants on the left side, but present on the right. A PA standing radiograph is shown in Figure A. What is the next step in management?
Observation with repeat radiographs in 6 months
Bracing with a thoraco-lumbar-sacral orthosis
Magnetic resonance imaging (MRI)
Posterior spinal fusion with instrumentation
Anterior and posterior spinal fusion with instrumentation
A mother and her 16-year-old daughter present to your clinic because the daughter has noticed asymmetries in her back. She has no back pain and no neurologic symptoms. She is two years post-menarcheal. After a complete history and physical, you order PA thoracolumbar radiograph, which is seen in figure A. The cobb angle is 38 degrees. When discussing the natural history of the disease, you tell the family they should expect:
difficulty with vaginal child birth in the future.
decreased pulmonary function in the future
to undergo an MRI to rule out any underlying neurologic pathology, as this is an abnormal curve
an increased risk of chronic back pain over her lifetime
this curve magnitude has the highest curve progression rate without operative intervention
Which of the following methods of determining skeletal maturity correlates most closely with the curve acceleration phase for children with idiopathic scoliosis?
Lenke classification method
Greulich and Pyle method
A 13-year-old girl is referred to the orthopedic clinic for evaluation of scoliosis. She denies back pain and states she began her menses 3 months ago. On Adams forward bending, she measures 6 degrees. She has 5 of 5 motor strength in all muscles groups in her lower extremities and symmetric patellar and Achilles reflexes. A standing PA and lateral radiograph is shown in Figures A and B. All of the following should be performed as part of her evaluation EXCEPT:
Evaluation of leg lengths
Assessment of abdominal reflexes
Evaluation of waist asymmetry
Evaluation for café-au-lait spots
When compared to normal controls, adults with untreated idiopathic scoliosis and a Cobb angle of greater than 60 degree at the time of skeletal maturity have a higher rate of which of the following?
Acute and chronic back pain
Limitation in activities of daily living
Part 3 of 3This video explains posterior corrective surgery for adolescent idiop...
Part 2 of 3This video explains posterior corrective surgery for adolescent idiop...
Part 1 of 3This video explains posterior corrective surgery for adolescent idiop...
HPI - This 28 year-old gentleman with neglected scoliosis came to our outpatient clinic for the first time. He denies any pain, subjective weakness, or bowell and bladder symptoms. Cobb angle 67 degrees. We have no prior radiographs on record.
How would you treat this patient at this time?
HPI - A 22F patient presents with a prominent deformity of her spine.
She states that she has had idiopathic scoliosis since age 12, with no management (bracing or surgery) up to this point.
How would you manage this patient?