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  • Question 1 - A 30-year-old patient presents with complaints of recurrent bloody diarrhoea and symptoms of...

    Correct

    • A 30-year-old patient presents with complaints of recurrent bloody diarrhoea and symptoms of iritis. On examination, there is a painful nodular erythematous eruption on the shin and anal tags are observed. What diagnostic test would you recommend to confirm the diagnosis?

      Your Answer: Colonoscopy

      Explanation:

      Inflammatory Bowel Disease with Crohn’s Disease Suggestion

      The patient’s symptoms and physical examination suggest inflammatory bowel disease, with anal skin tags indicating a possible diagnosis of Crohn’s disease. Other symptoms consistent with this diagnosis include iritis and a skin rash that may be erythema nodosum. To confirm the diagnosis, a colonoscopy with biopsies would be the initial investigation. While serum ACE levels can aid in diagnosis, they are often elevated in conditions other than sarcoidosis.

      Overall, the patient’s symptoms and physical examination point towards inflammatory bowel disease, with Crohn’s disease as a possible subtype. Further testing is necessary to confirm the diagnosis and rule out other conditions.

    • This question is part of the following fields:

      • Rheumatology
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  • Question 2 - A 50-year old heavy drinker visits his GP complaining of swelling and pain...

    Correct

    • A 50-year old heavy drinker visits his GP complaining of swelling and pain in his left knee. He reports experiencing a similar excruciating pain in his right big toe two years ago, for which he was prescribed allopurinol. What is the patient's diagnosis?

      Your Answer: Gout

      Explanation:

      Common Bone and Joint Conditions

      Gout is a condition where uric acid builds up in a joint, causing sudden and intense pain, swelling, and redness. It often affects the big toe and can be triggered by alcohol. Men are more likely to develop gout, and it can also affect other joints such as the ankle, knee, and elbow. The presence of uric acid crystals, known as tophi, can confirm the diagnosis. Allopurinol can be used to prevent future attacks.

      Osgood-Schlatter disease is caused by tension on the patella tendon, leading to a fracture and symptoms such as pain and swelling over the tibial tubercle.

      Osteoporosis is a condition where the bone mineral density is reduced, increasing the risk of fractures, especially in the spine, hip, and wrist. It is most common in women after menopause due to a decrease in estrogen levels.

      Osteosarcoma is a type of bone cancer that can be associated with Paget’s disease of bone. It causes pain, especially at night, and increases the risk of fractures.

      Rheumatoid arthritis is an autoimmune disorder that commonly affects the small joints in the hands. Inflammatory markers will be elevated, and some cases may have a positive rheumatoid factor.

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      • Rheumatology
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  • Question 3 - A 6-year-old boy presents to the clinic after experiencing his seventh fracture. Upon...

    Incorrect

    • A 6-year-old boy presents to the clinic after experiencing his seventh fracture. Upon examination, his x-rays reveal dense bones with multiple cortical layers. He also has a mild normocytic anemia and low platelets, but his sclera appear white. What is the probable diagnosis?

      Your Answer: Acute lymphocytic leukaemia

      Correct Answer: Osteopetrosis

      Explanation:

      Osteopetrosis and its Distinction from Other Bone Disorders

      Osteopetrosis is a congenital condition that affects bone reabsorption, leading to the appearance of a ‘bone within a bone’ from multiple cortical layers. Despite the increased density, bones become brittle and prone to fracture, and there is no room for the marrow to grow, causing bone marrow failure and peripheral cytopenias. Additionally, bones expand and frequently cause neural compression symptoms.

      When diagnosing osteopetrosis, it is important to exclude non-accidental injury (NAI) due to the repeated bone injury, but NAI alone cannot account for the x-ray findings or the blood counts. However, a diagnosis of osteopetrosis does not rule out the possibility of NAI co-existing with the condition.

      Other bone disorders, such as acute lymphocytic leukemia and aplastic anemia, may present with peripheral cytopenias but not the x-ray appearances or multiple fractures. On the other hand, osteogenesis imperfecta (OI) is a congenital condition of brittle bones susceptible to multiple fractures due to a mutation in type I collagen. The most common form, type I OI, is inherited as an autosomal dominant condition and is associated with blue sclerae and neural deafness from bone overgrowth. X-rays show reduced bone density with cortical disorganization.

      In summary, the distinct features of osteopetrosis and its differentiation from other bone disorders is crucial in making an accurate diagnosis and providing appropriate treatment.

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      • Rheumatology
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  • Question 4 - A 50-year-old man visits his doctor complaining of intense pain in his hip...

    Incorrect

    • A 50-year-old man visits his doctor complaining of intense pain in his hip and a tingling feeling down his right leg. He suspects that he may be suffering from rheumatoid arthritis. The doctor conducts several blood tests, all of which come back normal except for an elevated plasma alkaline phosphatase level. Based on this information, what is the most probable diagnosis?

      Your Answer: Systemic Lupus Erythematosus (SLE)

      Correct Answer: Paget’s disease of bone

      Explanation:

      Common Bone Disorders and Their Symptoms

      Paget’s disease is a chronic bone disorder that causes continuous enlargement and deformation of bones, leading to weakness, bone pain, fractures, and arthritis deformities. The symptoms vary depending on the location of bone deformity. Diagnosis of Paget’s disease involves a bone x-ray and measurement of plasma alkaline phosphatase levels, which are usually elevated, while plasma calcium, phosphate, and aminotransferase levels are normal. Treatment includes bisphosphonates, a proper diet, and exercise. Surgery may be necessary if bone deformity or fractures are present.

      Gout is another bone disorder caused by a buildup of uric acid in a joint, resulting in sudden, burning pain, swelling, and redness in the joint. This condition is more common in men, and the pain is usually felt in the first metatarsal head.

      Osgood-Schlatter disease is caused by tension at the patella tendon, leading to an avulsion fracture that causes pain and swelling over the tibial tubercle.

      Rheumatoid arthritis (RA) is an autoimmune disorder that commonly affects the small joints in both hands. Inflammatory markers are elevated, and some cases may have a positive rheumatoid factor.

      Systemic lupus erythematosus (SLE) affects multiple systems and is diagnosed using the ACR classification criteria.

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      • Rheumatology
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  • Question 5 - A patient is diagnosed with mitral stenosis due to a history of rheumatic...

    Incorrect

    • A patient is diagnosed with mitral stenosis due to a history of rheumatic fever during childhood. What is included in Jones' major criteria for rheumatic fever?

      Your Answer: Fever

      Correct Answer: Erythema marginatum

      Explanation:

      Rheumatic Fever and Jones’ Criteria

      Rheumatic fever is a rare immunological complication that can occur after an infection with Streptococcus pyogenes. This condition is not commonly seen in developed countries due to the availability of antibiotics. Jones’ criteria are used to diagnose rheumatic fever and are divided into major and minor criteria. The major criteria include pancarditis, Sydenham’s chorea, erythema marginatum, subcutaneous nodules, and polyarthritis. The minor criteria include fever, arthralgia, raised ESR/CRP, prolonged PR interval, and previous rheumatic fever.

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      • Rheumatology
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  • Question 6 - An 8-year-old girl comes to the doctor complaining of leg pains. She cries...

    Incorrect

    • An 8-year-old girl comes to the doctor complaining of leg pains. She cries at night and her mother has to massage the painful areas to soothe her. Upon examination, there are no visible abnormalities. What is the probable diagnosis?

      Your Answer:

      Correct Answer: Idiopathic pains

      Explanation:

      Idiopathic Limb Pains in Children

      Idiopathic limb pains, also known as growing pains, are a common occurrence in children between the ages of 3 and 9. These pains typically occur in the lower limbs and can be quickly settled with comforting. It is important to note that these pains are not associated with any abnormalities found during examination and the child should be growing normally.

      However, it is important to distinguish idiopathic limb pains from other conditions that may cause similar symptoms. Acute lymphoblastic leukaemia, for example, may cause limb pain due to bone marrow infiltration. Children with this condition may also exhibit signs of bone marrow failure and be systemically unwell.

      Langerhans histiocytosis is another condition that can cause painful bone lesions. This proliferative disorder of antigen presenting cells may be localised or systemic and can be difficult to diagnose. The systemic form of the condition may also present with a widespread eczematous rash and fevers.

      Non-accidental injury may also present with recurrent pains, but evidence of an injury would be expected. Primary bone malignancy is more common in teenage years and typically presents with unremitting pain, growth failure, weight loss, or pathological fractures.

      In summary, while idiopathic limb pains are relatively easy to settle and associated with a normal examination, it is important to consider other potential conditions that may cause similar symptoms. Proper diagnosis and treatment can help ensure the best possible outcome for the child.

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      • Rheumatology
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  • Question 7 - A 27-year-old male presents with lower back pain and painful feet that feel...

    Incorrect

    • A 27-year-old male presents with lower back pain and painful feet that feel like walking on pebbles. He has been generally healthy, but he recently returned from a trip to Corfu where he had a diarrheal illness. He admits to infrequently taking ecstasy but takes no other medication. On examination, he has limited movement and pain in the sacroiliac joints and soreness in the soles of his feet upon deep palpation. What is the most probable diagnosis?

      Your Answer:

      Correct Answer: Reactive arthritis

      Explanation:

      After a diarrhoeal illness, the patient may be at risk of developing reactive arthritis, which is a possible diagnosis for both sacroiliitis and plantar fasciitis. However, it is less likely to be related to inflammatory bowel disease (IBD) if there is only one acute episode of diarrhoea.

      Sacroiliitis is a condition that affects the sacroiliac joint, which is located at the base of the spine where it connects to the pelvis. It causes inflammation and pain in the lower back, buttocks, and legs. Plantar fasciitis, on the other hand, is a condition that affects the plantar fascia, a thick band of tissue that runs along the bottom of the foot. It causes pain and stiffness in the heel and arch of the foot.

    • This question is part of the following fields:

      • Rheumatology
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  • Question 8 - A 57-year-old female patient complains of morning stiffness, persistent low grade fever, and...

    Incorrect

    • A 57-year-old female patient complains of morning stiffness, persistent low grade fever, and symmetrical joint pain for several months. During examination, you observe that the metacarpophalangeal and proximal interphalangeal joints are affected with four nodules on the digits of her hand. The inflamed joints lead you to suspect a polyarthropathy disease.

      What is the most specific serological marker for rheumatoid arthritis?

      Your Answer:

      Correct Answer: Anti-cyclic citrullinated peptide antibodies

      Explanation:

      Serological Markers for Autoimmune Diseases

      Rheumatoid factor is present in a majority of patients with rheumatoid arthritis, but it is not specific to the disease. On the other hand, anti-CCP antibodies are highly specific for rheumatoid arthritis, with a specificity of 98%. Anti-Jo antibodies are found in patients with dermatomyositis, while anti-Ro antibodies are associated with Sjögren’s syndrome. Lastly, anti-mitochondrial antibodies are found in patients with primary biliary cirrhosis. These serological markers can aid in the diagnosis and management of autoimmune diseases. It is important to note that while these markers can be helpful, they should not be used in isolation and should always be interpreted in the context of the patient’s clinical presentation and other diagnostic tests.

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      • Rheumatology
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  • Question 9 - A 10-year-old girl comes to the clinic with a painful left ankle following...

    Incorrect

    • A 10-year-old girl comes to the clinic with a painful left ankle following a fall. An x-ray reveals a fracture that runs through the tibial growth plate and metaphysis. What Salter-Harris fracture classification does this injury fall under?

      Your Answer:

      Correct Answer: II

      Explanation:

      Type II Salter-Harris Fractures

      The Salter-Harris classification system is a way to categorize fractures that involve the growth plate or physis. These types of fractures are common in children and teenagers whose growth plates are still open. Type II Salter-Harris fractures are the most common, accounting for 75% of all growth plate fractures. This type of fracture involves a defect that runs through the growth plate and then the metaphysis.

      To put it simply, a Type II Salter-Harris fracture occurs when a bone breaks through the growth plate and into the surrounding bone tissue. This type of fracture is often caused by a sudden impact or trauma to the affected area. It is important to diagnose and treat Type II fractures promptly to prevent any long-term complications, such as growth abnormalities or joint problems.

      In summary, Type II Salter-Harris fractures are a common type of growth plate fracture that involves a defect running through the growth plate and then the metaphysis. These fractures can have long-term consequences if not treated properly, making prompt diagnosis and treatment essential.

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      • Rheumatology
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  • Question 10 - A couple in their mid-40s with no known genetic disorders in their family...

    Incorrect

    • A couple in their mid-40s with no known genetic disorders in their family have a baby boy who exhibits asymmetrical growth. The child's head and torso are proportionate, but his arms and legs are significantly shorter than average, and his fingers are all the same length. What is the mode of inheritance for this condition?

      Your Answer:

      Correct Answer: Autosomal dominant

      Explanation:

      Achondroplasia: A Congenital Condition Causing Impaired Bone Growth

      Achondroplasia is a congenital condition that affects bone growth, resulting in short arms and legs, fingers and toes of equal length, increased lumbar lordosis, and normal intellect and life expectancy. Although it is an autosomal dominant condition, most cases occur without a family history. The underlying defect is a mutation in fibroblast growth factor receptor 3 (FGFR3), which is responsible for membranous bone growth. However, 80% of all cases are sporadic mutations, with the most common cause being a de novo mutation. The risk of a de novo mutation is increased due to the age of the father.

      Increased paternal age promotes single gene mutations, while increased maternal age promotes non-dysjunction and chromosomal abnormalities. Despite the impaired bone growth, affected patients have normal-sized heads and trunks due to normal membranous bone growth. Achondroplasia is a congenital condition that can be diagnosed through genetic testing and managed through various treatments, including limb-lengthening surgeries and physical therapy.

    • This question is part of the following fields:

      • Rheumatology
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  • Question 11 - A 5-year-old girl from an underprivileged family comes in with a waddling gait....

    Incorrect

    • A 5-year-old girl from an underprivileged family comes in with a waddling gait. She displays signs of a proximal myopathy and positional deformity in her lower limbs. Upon examination, x-rays reveal a widened growth plate with cupping of the metaphysis. What is the probable diagnosis?

      Your Answer:

      Correct Answer: Vitamin D deficiency

      Explanation:

      Rickets and Other Growth-Related Disorders

      Rickets is a condition that results from a deficiency in vitamin D, which is essential for the mineralization of osteoid. This process primarily occurs at the growth plate, or physis, and in vitamin D deficiency, the growth plate widens, and the metaphysis appears cupped and frayed. The bones become softer than usual, and the lower limbs may develop a bow-legged deformity. In addition to affecting bone health, vitamin D deficiency can also lead to hypocalcemia, which causes muscle spasms and changes in bowel habits.

      Growth hormone deficiency, on the other hand, causes growth failure and an immature doll-like facies. Hyperthyroidism tends to occur in teenage girls and presents with weight loss, heat intolerance, and diarrhea. Hypothyroidism, on the other hand, presents with failure to grow, disproportionate weight gain, tiredness, and cold intolerance.

      It is important to understand these growth-related disorders and their symptoms to ensure proper diagnosis and treatment. By recognizing the characteristic changes on x-ray in rickets, for example, healthcare professionals can identify and address vitamin D deficiency early on. Similarly, the symptoms of other disorders can help healthcare professionals provide appropriate care and support to those affected.

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      • Rheumatology
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  • Question 12 - A 14-year-old boy with juvenile idiopathic arthritis is visiting the eye clinic for...

    Incorrect

    • A 14-year-old boy with juvenile idiopathic arthritis is visiting the eye clinic for a screening.

      What is the purpose of his visit and what complication is he being screened for?

      Your Answer:

      Correct Answer: Chronic anterior uveitis

      Explanation:

      Complications of Juvenile Idiopathic Arthritis

      Patients with Juvenile Idiopathic Arthritis (JIA) are regularly screened for chronic anterior uveitis, which can lead to scarring and blindness if left untreated. However, this condition may be asymptomatic in some cases, making annual screening using a slit-lamp essential.

      One of the long-term complications of JIA is the development of flexion contractures of joints due to persistent joint inflammation. This occurs because pain is partly related to increased intra-articular pressure, which is at its lowest when joints are held at 30-50 degrees.

      While corticosteroids may be used to manage joint inflammation, they are used sparingly in children due to the risk of cataract development. Conjunctivitis is not typically associated with JIA, but reactive arthritis. Keratitis, on the other hand, tends to be an infective process caused by bacteria or viruses.

      Lastly, pterygium is an overgrowth of the conjunctiva towards the iris and is often seen in individuals exposed to windy or dusty conditions, such as surfers.

      In summary, JIA can lead to various complications, including chronic anterior uveitis, joint contractures, and cataract development. Regular screening and management are crucial to prevent long-term damage.

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      • Rheumatology
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  • Question 13 - A 70-year-old male complains of increasing pain and swelling in his left knee...

    Incorrect

    • A 70-year-old male complains of increasing pain and swelling in his left knee over the past three days. He has a medical history of hypertension and takes bendroflumethiazide and lisinopril. Upon examination, his left knee is swollen, red, and tender, and he experiences limited mobility due to the pain. What is the most suitable test to perform for this patient?

      Your Answer:

      Correct Answer: Joint aspiration

      Explanation:

      Differential Diagnosis of Monoarthropathy

      Monoarthropathy can have various causes, and one of the possibilities is septic arthritis. To rule out this condition, joint aspiration is necessary, and the sample should be sent for microscopy and culture to detect the presence of crystals and organisms. Polymorphs and organisms are expected in septic arthritis, while negatively birefringent crystals are typical for gout, and positively birefringent crystals are seen in pseudogout. FBC and ESR are not useful for diagnosis, and although an x-ray may show osteoarthritis changes, it is not the primary investigation.

      Bendroflumethiazide can increase urate levels and trigger acute gout, but urate concentrations may remain normal during an acute gout attack. Therefore, it is essential to consider all possible causes of monoarthropathy and perform the appropriate tests to make an accurate diagnosis.

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      • Rheumatology
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  • Question 14 - A 58-year-old female patient with chronic rheumatoid arthritis visits her GP complaining of...

    Incorrect

    • A 58-year-old female patient with chronic rheumatoid arthritis visits her GP complaining of symptoms related to keratoconjunctivitis sicca. What is a straightforward test that can be performed to confirm this diagnosis?

      Your Answer:

      Correct Answer: Schirmer's test

      Explanation:

      Secondary Sjögren’s Syndrome in Rheumatological Patients

      It is not uncommon for patients with rheumatological disease to develop secondary Sjögren’s syndrome, which is also known as keratoconjunctivitis sicca. This condition is characterized by a reduction in secretions, particularly in the salivary and lacrimal glands. One of the diagnostic tests used to identify this condition is the Schirmer’s test. This test is a simple procedure that measures the production of tears in the eyes. During the test, a strip of paper is placed under the eyelid of the patient, and after five minutes, the amount of moistness on the paper is measured. If the moistness is less than 5 mm, it is suggestive of Sjögren’s syndrome.

      Overall, secondary Sjögren’s syndrome is a common condition that can occur in patients with rheumatological disease. The Schirmer’s test is a simple and effective way to diagnose this condition, and it can help healthcare professionals provide appropriate treatment to patients.

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      • Rheumatology
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  • Question 15 - A 16-year-old girl visits a rheumatologist with complaints of occasional joint pain. Despite...

    Incorrect

    • A 16-year-old girl visits a rheumatologist with complaints of occasional joint pain. Despite the absence of clinical synovitis, she has a Beighton score of 9 and is in good health. What is the most suitable course of action for her management?

      Your Answer:

      Correct Answer: Physiotherapy

      Explanation:

      Joint Pain in Children and Hypermobility Syndrome

      Joint pain in children can have various causes, including hypermobility syndrome. This condition is characterized by increased flexibility, as opposed to hereditary connective tissue disorders. The Beighton score is a method used to assess hypermobility, which involves ten tests. A score of 9 indicates high flexibility and suggests susceptibility to hypermobility syndrome. Although there is no intrinsic joint disease or clinical synovitis, joint pain can be experienced. Physiotherapy can help strengthen the soft tissues supporting joints and reduce pain.

      In mild juvenile idiopathic arthritis (JIA), which may present similarly to hypermobility syndrome, ibuprofen is the first line of management. However, if joints show clinical synovitis, methotrexate may be considered for severe JIA. It is important to reassure the child and parents that the pain is not sinister, but it is not the optimal management for this condition. Genetic conditions causing hypermobility, such as Ehlers-Danlos and Marfan syndrome, may require referral for genetic counseling, but there are no other features of these syndromes present in hypermobility syndrome.

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      • Rheumatology
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  • Question 16 - A 12-year-old boy comes to his GP complaining of a limp. He has...

    Incorrect

    • A 12-year-old boy comes to his GP complaining of a limp. He has a swollen right knee with clinical synovitis but no effusion. He is growing normally and has been generally healthy, except for experiencing diarrhoea and vomiting last week. There are no signs of joint issues in his other joints.

      What condition is most likely causing his symptoms?

      Your Answer:

      Correct Answer: Reactive arthritis

      Explanation:

      Reactive Arthritis in Children

      Reactive arthritis is the most common form of arthritis in children and is often associated with recent illness. In this case, the child presents with large-joint oligoarthritis following gastroenteritis. While it may also be associated with genitourinary infection, treating the infection does not alter the course of the joint disease. The child should be given analgesia and observed for arthritis elsewhere.

      Although this may be a new presentation of enteropathic arthritis or JIA, the child’s lack of chronic disease symptoms reduces the likelihood of these diagnoses. Gout is extremely rare in children, except for in rare metabolic conditions. Septic arthritis must also be considered, but the child is likely to be systemically unwell with features of infection.

      In summary, reactive arthritis is the most likely diagnosis in this case of paediatric arthritis following recent illness. It is important to monitor the child’s symptoms and consider other potential diagnoses if necessary.

    • This question is part of the following fields:

      • Rheumatology
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  • Question 17 - What type of juvenile arthritis is most frequently seen? ...

    Incorrect

    • What type of juvenile arthritis is most frequently seen?

      Your Answer:

      Correct Answer: Antinuclear antibody positive oligoarthritis

      Explanation:

      Juvenile Idiopathic Arthritis (JIA) and its Characteristics

      Juvenile Idiopathic Arthritis (JIA) is a condition characterized by persistent joint swelling in children under 16 years of age without any known cause. It is not the same as rheumatoid arthritis, as only 5% of JIA cases are rheumatoid factor positive polyarthritis. Instead, 60% of JIA cases are ANA+ oligoarthritis. Children with JIA may also experience systemic symptoms, such as chronic anterior uveitis, which requires regular screening. Chronic inflammation can lead to secondary amyloidosis, while poor growth, anorexia, and anaemia are common due to chronic disease and steroid therapy.

      Overall, JIA is a complex condition that can have a significant impact on a child’s health and wellbeing. It is important for healthcare professionals to be aware of the various characteristics of JIA and to provide appropriate care and support to affected children and their families.

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      • Rheumatology
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  • Question 18 - A 50-year-old male complains of stiffness and joint pains in his hands and...

    Incorrect

    • A 50-year-old male complains of stiffness and joint pains in his hands and feet for the past month, which is worse in the morning. He has no significant medical history and is not taking any medication. Upon examination, there is some mild swelling in the proximal interphalangeal joints of both hands, metacarpo-phalangeal joints, and wrist. No other abnormalities are detected. What would be the most suitable investigation for this patient?

      Your Answer:

      Correct Answer: Rheumatoid factor

      Explanation:

      Rheumatoid Factor and Diagnostic Markers for Rheumatoid Arthritis

      The clinical scenario presented is a common manifestation of rheumatoid arthritis, with a positive rheumatoid factor found in approximately 70% of cases. This factor is an IgM antibody directed against IgG, and while false positives can occur, its presence is highly supportive of the diagnosis and carries prognostic significance. In addition to rheumatoid factor, non-specific markers of inflammation such as erythrocyte sedimentation rate (ESR) and C reactive protein (CRP) are expected to be elevated in patients with rheumatoid arthritis. These diagnostic markers can aid in the diagnosis and management of the disease. Proper interpretation and utilization of these markers can lead to earlier diagnosis and better outcomes for patients with rheumatoid arthritis.

    • This question is part of the following fields:

      • Rheumatology
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  • Question 19 - A previously healthy 8-year-old girl comes to the GP with a recent onset...

    Incorrect

    • A previously healthy 8-year-old girl comes to the GP with a recent onset limp. She experiences tenderness in her right leg during all hip movements. Blood tests reveal no abnormalities. An MRI scan shows an irregular femoral head. What is the probable underlying diagnosis?

      Your Answer:

      Correct Answer: Legg-Calve-Perthes disease

      Explanation:

      Idiopathic Osteonecrosis of the Femoral Head in Children

      Idiopathic osteonecrosis of the femoral head, also known as Perthes disease, is a condition that primarily affects boys between the ages of 5 and 11. It is characterized by pain in the hip during movement and difficulty bearing weight. Unlike septic arthritis, the child is not systemically unwell. The cause of Perthes disease is unknown, although trauma may sometimes be a contributing factor.

      Examination findings can help localize the pathology to the hip, and irregularities in the femoral head may be visible on x-ray. However, MRI is the preferred imaging modality. Treatment options depend on the extent of the affected area. If less than 50% of the head is affected, bed rest and analgesia may be sufficient. If more than 50% is affected, surgery may be necessary.

      Other conditions that can cause a limping child include caisson disease, septic arthritis, sickle cell disease, and slipped upper femoral epiphysis (SUFE). However, each of these conditions has distinct characteristics that can help differentiate them from Perthes disease. For example, caisson disease is associated with nitrogen decompression sickness after diving, while SUFE tends to occur in teenagers and involves a fracture through the growth plate with a displaced femoral head.

    • This question is part of the following fields:

      • Rheumatology
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SESSION STATS - PERFORMANCE PER SPECIALTY

Rheumatology (2/5) 40%
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