Page 72 South African Orthopaedic Journal 
http://journal.saoa.org.za

SAOJ
SOUTH AFRICAN ORTHOPAEDIC JOURNAL. 

CPD QUESTIONNAIRE. AUGUST 2019 VOL 18 NO 3

Complications following acute severe haematogenous 
osteomyelitis of the long bones in children (Horn A, Wever S, 
Hoffman EB)

1. In a recent study on osteoarticular infections in children, 
which causative organism was associated with co-infection 
with HIV?

a. Pseudomonas aeruginosa A

b. Klebsiella pneumonia B

c. Streptococcus pneumonia C

d. Staphylococcus epidermidis D

e. Staphylococcus aureus E

2. Which of the following factors are commonly associated 
with the development of complications following acute 
haematogenous osteomyelitis?

a. Raised ESR at presentation A

b. Male sex B

c. History of trauma C

d. Raised CRP at presentation D

e. Raised temperature at presentation E

3. In this study, there was an association between:

a. Delay in presentation and the development of complications A

b. The development of complications and a prolonged hospital stay B

c. The need for repeat surgery during the index admission and 
duration of antibiotic treatment

C

d. Raised CRP at presentation and the development of a 
pathological fracture

D

e. Infection with MRSA and the development of complications E

4. The main radiological finding in this study was that:

a. Bony changes in more than 45% of the diaphysis on X-rays 
taken at 6 weeks were significantly associated with the 
development of complications

A

b. Bony changes in more than 66.1% of the diaphysis on X-rays 
taken at 6 weeks were significantly associated with the 
development of complications

B

c. X-rays taken at presentation are usually normal C

d. MRI should be performed in all cases of suspected osteomyelitis D

e. X-rays taken at presentation usually show early periosteal 
reaction which is associated with the development of 
complications

E

Profile of patients with Blount’s disease at an academic hospital 
(Mehtar M, Ramguthy Y, Firth GB)

5. The deformities of Blount’s disease develop secondary to 
relative inhibition of the:

a. Posterolateral aspect of the proximal tibial growth plate A

b. Anteromedial aspect of the proximal tibial growth plate B

c. Posterior aspect of the proximal tibial growth plate C

d. Posteromedial aspect of the proximal tibial growth plate D

e. Anterolateral aspect of the proximal tibial growth plate E

6. Regarding the classification of Blount’s disease as 
described by Thompson and Carter, which statement is 
correct?

a. Juvenile Blount’s onset is after the age of 10 years A

b. Adolescent Blount’s onset is after the age of 15 years B

c. Juvenile Blount’s onset is at age 4 to 10 years C

d. Infantile Blount’s occurs under the age of 5 years D

e. Infantile Blount’s occurs under the age of 3 years E

7. In our study, the percentage of patients with Blount’s 
disease classified as obese was:

a. Highest in the infantile group A

b. Highest in the adolescent group B

c. Highest in the juvenile group C

d. Equal in all the groups D

e. Lowest in the juvenile group E

8. According to the series of Blount’s patients at Chris Hani 
Baragwanath Academic Hospital:

a. Unilateral involvement occurred more frequently compared to 
bilateral disease

A

b. There is an increased occurrence of obesity in female children 
with Blount’s

B

c. The majority of patients in the adolescent group were female C

d. Blount’s disease is associated with an early walking age D

e. Blount’s disease is not associated with an early walking age E

Cross-screw technique for the modified Lapidus procedure 
using headless compression screws (Mayet Z, Ferrao PNF, 
Saragas NP)

9. Choose the incorrect statement regarding the modified 
Lapidus procedure:

a. The Lapidus procedure is used to treat hallux valgus A

b. It is a powerful procedure B

c. Correction is possible in two planes C

d. Correction is possible in three planes D

e. It has a long lever arm for correction E



Page 74 South African Orthopaedic Journal 
http://journal.saoa.org.za

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10. In the preparation of the joint for the modified Lapidus 
fusion:

a. The plantar side of the joint should be neglected A

b. Joint surfaces are never fenestrated B

c. The intercuneiform joint should always be included C

d. The medial cuneiform articular surface is resected perpendicular 
to the long axis of the second metatarsal 

D

e. All of the above E

11. Fixation options for the modified Lapidus procedure does 
not include:

a. Solid 3.5 mm AO screws A

b. Chromic sutures B

c. Cannulated screws C

d. A lag screw with a plate D

e. Headless compression screws E

12. Regarding complications of the Lapidus procedure, select 
the correct answer:

a. Attention to detail and meticulous surgical technique minimises 
complications

A

b. Non-union is a minor complication B

c. Transfer metatarsalgia is not a concern C

d. The distal metatarsal articular angle is not affected D

e. None of the above E

Unrepaired rotator cuff tears following acromioplasty  
(Chivers D, Lambrechts A, Vrettos B, Dachs R, Roche S)

13. Melis et al.’s research into the progression of fatty infiltration 
and atrophy in tears of supraspinatus stated that:

a. Traumatic tears do not progress to fatty atrophy and infiltration A

b. Traumatic tears progress faster than atraumatic tears B

c. Muscle atrophy was present in all tear types at 6 years C

d. Tears progressed to stage 2 fatty infiltration at 6 years D

e. Traumatic tears can heal without intervention E

14. The aetiology of atraumatic rotator cuff tears:

a. Is only due to intrinsic causes A

b. Is mainly due to genetic influence B

c. Is attributed to genetic, intrinsic and extrinsic causes C

d. Is such that acromial morphology does not play a role D

e. Is such that acromial morphology is the only extrinsic cause E

15. Evidence to support intrinsic theories for rotator cuff tears 
include:

a. Bursal-sided tears are more common than articular-sided tears A

b. Cuff tears and acromial degeneration both progress with age B

c. Open acromioplasty prevents cuff tear progression C

d. There is a zone of hypovascularity and hypoxia which results in 
cuff degeneration D

e. Acromial morphology is directly related to cuff tear progression E

16. In the rotator cable theory as described by Burkhart:

a. Three distinct areas with different load characteristics are 
described A

b. The rotator cable is relatively thicker and supports more load B

c. There is progressive thickening of the crescent area with age C

d. Kim et al. have not been able to support Burkhart’s theory D

e. Degenerative tears occur in a more anterior position E

Anthropometric differences in the tibial tuberosity to trochlear 
groove measurement in an African population (Rankin M, 
Mohideen MAH)

17. The tibial tuberosity trochlear groove (TTTG) measurement 
is clinically relevant for which diagnosis?

a. Osteoarthritis A

b. Anterior cruciate ligament laxity B

c. Patella instability C

d. Medial co-lateral laxity D

e. Blount’s disease E

18. The TTTG measurement predominantly utilised with which 
imaging modality?

a. Ultrasonography A

b. X-ray B

c. CT scan C

d. MRI D

e. Radionuclide scan E

19. Regarding the TTTG measurement:

a. TTTG measurement decreases at terminal extension due to the 
‘screw-home’ mechanism A

b. TTTG measurement increases at terminal extension due to the 
‘femoral roll-back’ mechanism B

c. TTTG measurement decreases at terminal extension due to the 
‘femoral roll-back’ mechanism C

d. TTTG measurement increases at terminal extension due to the 
‘screw-home’ mechanism D

e. TTTG measurement is unaffected by range of motion of the 
knee E

20. According to current literature, a medialising osteotomy of 
the tibial tuberosity should be considered when the TTTG is:

a. >20 mm A

b. >15 mm B

c. >12 mm C

d. <20 mm D

e. Not a consideration E

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