Module 73, General Medical Level

A 10 year old male was born at term without post natal problems. His walking was delayed until 2 years and 6 months of age. Medical treatment to this time has been observation with several short episodes of physical therapy aimed at stretching contracture at the knees. He is in grade five, doing well academically and lives on a farm where he is able to do most age appropriate farm tasks. At this time the family complains that he is walking more with his knees flexed and his knees rub together. He has recently seen a physical therapist who requests a prescription for inhibitive casting for the hamstring contractures.

Question 73A

These are typical problems for individuals with diplegic patern cerebral palsy and inhibitive casting is a common and effective way the address hamstring contractures in this situation.

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Question 73B

The use of long leg knee braces is probably needed to correct these knee problems.

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Question 73C

With the above history you would expect that this boy has problems writing and you would ask him about this.

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Question 73D

You would also ask about his bowel and bladder function because these may need to be tested.

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Question 73E

Upon questioning the family they can not recall that this child has had a hip x-ray ever, therefore you would order a hip x-ray.

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