Module 5, General Medical Level

This girl was the product of 42 week gestation without complications. Her birth weight was 7 lbs (3.2 kg), length 18-1/2" (47 cm). At birth she was found to have bilateral clubfeet, bilateral dislocaton of the hips. Casts were applied to the feet and hips for the first 13 months of life. The developmental milestones were delayed. She pulled up and walked without help at 20 months.

Question 5A

The delay in walking can attributed to the cast treatment of the feet and hips.

Question 5B

Bilateral club feet and dislocated hips often occur together with no other problems.

Question 5C

Spine x-rays are obtained and are normal. An MRI should be obtained.

Question 5D

On physical examination the knees appeared to have hyper-laxity. Normal hyper-laxity is associated with multiple joint dislocations.

Question 5E

When hyper-laxity is noted on examination of the knee a further evaluation of the cervical spine should also be performed.

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