Module 4, General Orthopaedist Level

A four year old girl presented for evaluation of short stature. She was the healthy product of a normal pregnancy and delivery. Her height was 80 cm, below the third percentile for her age. Her lower extremities were having mild joint pain and stiffness, she had short stubby hands and feet along with a waddling gait. Limb epiphysis show delayed appearing centers of ossification, often demonstrating a fragmented appearance. Joint involvement is symmetric.

Question 4A

This is best described as an epiphyseal dysplastic process involving all bones.

Question 4B

You tell the family to expect that this girl will develop early degenerative joint disease in these joints.

Question 4C

Although this girl is so small, the family wants to know if she can be involved in sports when she starts school. You suggest that she should not be involved in any sports which place a high demand on her hips or knees.

Question 4D

This is an inherited autosomal dominant disorder.

Question 4E

A careful evaluation of the cervical spine is indicated before any surgery.

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