Page 50 South African Orthopaedic Journal 
http://journal.saoa.org.za

SAOJ
SOUTH AFRICAN ORTHOPAEDIC JOURNAL

CPD QUESTIONNAIRE. MARCH 2020 VOL 19 NO 1

Femoral lengthening in children (Horn A, Sipilä M)

1. In this study, the most common diagnosis resulting in leg 
length discrepancy was:

a. Post-infectious growth arrest A

b. Post-traumatic growth arrest B

c. Hemihypertrophy C

d. Congenital short femur D

e. Achondroplasia E

2. Fifty per cent of patients in this study sustained a fracture 
either through or adjacent to the regenerate bone. Which 
factor was not associated with an increased rate of fracture?

a. Healing index A

b. Underlying diagnosis of congenital short femur B

c. Level of the osteotomy C

d. Percentage length gained D

e. Absolute length gained E

3. Regarding the mean healing index (HI) in this cohort of 
patients: 

a. The HI was comparable to other published series A

b. There was a significant association between the HI and the 
amount of length obtained

B

c. An increased HI was associated with a higher rate of deep pin-
site infection

C

d. The HI was increased in patients with congenital shortening of 
the femur

D

e. A decreased HI was not associated with an increase in fracture 
rate

E

An epidemiology of paediatric cervical spine injuries at the 
Red Cross War Memorial Children’s Hospital over a ten-year 
period (Noconjo L, Horn A)

4. The following are the characteristics of paediatric cervical 
spine anatomy except:

a. Increased ligamentous laxity A

b. Wedge-shaped vertebral bodies B

c. Cervical lordosis   C

d. Pseudo-subluxation  D

e. Horizontal orientation of the facet joint E

5. In this study, the most common cause of injury was:

a. Physical abuse A

b. Motor vehicle accident (MVA)  B

c. Recreation and sports C

d. Drowning D

e. Gun shot E

6. Children under 8 years of age sustained most cervical 
spine injuries at:

a. C1–C4   A

b. C1–C2 B

c. C3–C4 C

d. C2–C7 D

e. C5–C7 E

18F-FDG PET/CT as a modality for the evaluation of persisting 
raised infective markers in patients with spinal tuberculosis 
(Davis JH, Burger MC, Pienaar G, Lamberts RP)

7. A positive Gene Xpert test on tissue from a site with 
increased activity on a 18F-FDG PET/CT scan could fit with:

a. The presence of tuberculosis bacterial DNA in a healed TB 
lesion

A

b. A myeloproliferative condition B

c. An alternate type of granulomatous infection C

d. A metastatic lesion D

e. All of the above E

8. The only way to confirm the diagnosis of ongoing spinal 
tuberculosis infection after initial chemotherapy, is with:

a. Persistent raised ESR>100 A

b. A positive 18F-FDH PET/CT scan B

c. A positive Gene Xpert test C

d. Histology showing a predominant leucocyte infiltrate D

e. Histology showing granulomatous inflammation E

9. The incidence of multi-drug resistant TB (MDR-TB) of 
the spine, as reported in this study and other supporting 
Western Cape-based studies, falls in the following range:

a. 1–5% A

b. 5–15% B

c. 15–25% C

d. 1–3% D

e. 5–25% E

The accuracy of pre-operative digital templating in total hip 
arthroplasty performed in a low-volume, resource-constrained 
orthopaedic unit (Wiese KR, Kock FW, Blake CA, Franken T, 
Jordaan JD)

10. The goals of total hip arthroplasty include:

a. Restoration of normal hip biomechanics only A

b. Pain relief only B

c. Pain relief, total correction of leg length discrepancy and no 
improvement in function

C

d. Pain relief, restoration of normal hip biomechanics and 
improvement in function

D

e. None of the above E



Page 52 South African Orthopaedic Journal 
http://journal.saoa.org.za

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11. In the templating process, as described by Bono, step 2 
consists of:

a. Determining if a leg length discrepancy is present A

b. Determining the pelvis axis B

c. Determining the centre of rotation of the hip joint C

d. Determining the size of the femoral stem component D

e. None of the above E

12. Katz et al. define a high-volume arthroplasty unit as the 
following:

a. More than 500 cases annually A

b. More than 1 000 cases annually B

c. More than 250 cases annually C

d. More than 100 cases annually D

e. None of the above E

Surgical anatomy of the sciatic nerve and its relationship 
to the piriformis muscle with a description of a rare variant 
(Asmall T, Gunston G, Venter R, Henry BM, Keet K)

13. What is the nerve root origin of the sciatic nerve?

a. L4, L5, S1, S2, S3 A

b. L5, S1, S2, S3, S4 B

c. S1, S2, S3, S4, S5 C

d. L3, L4, L5, S1, S2 D

e. L2, L3, L4, L5, S1 E

14. In which region of the lower limb does the sciatic nerve 
most commonly bifurcate into the common fibular and tibial 
nerves?

a. Gluteal A

b. Superior third of thigh B

c. Inferior third of thigh C

d. Popliteal D

e. Middle third of thigh E

Intramedullary nailing of tibial non-unions using the 
suprapatellar approach: a case series (Botma N, Graham S, 
Held M, Laubscher M)

15. The advantages of the suprapatellar nail above the 
infrapatellar nail include the following except: 

a. Easier and improved tibial alignment A

b. Improved post-operative knee range of motion B

c. A decrease in the incidence of post-operative sepsis C

d. A decrease in the incidence of anterior knee pain D

e. Enabling a straight working channel for reamers in knee 
extension

E

16. The surgical technique is this study included:

a. Reamed intramedullary nail using the suprapatellar approach A

b. Insertion of blocking (Poller) screws if needed B

c. Fibula osteotomy if fibula united C

d. Fracture site compression (controlled compression) D

e. All of the above E

17. What was the union rate in this study?

a. 100% A
b. 95% B
c. 90% C
d. 80% D
e. 60% E
Bursal synovial chondromatosis overlying a solitary 
osteochondroma of the distal femur: a case report (Tanwar Y, 
Potgieter M, Oosthuizen M, Schubert P, Ferreira N)

18. Which of the following might indicate malignant transfor-
mation of an osteochondroma?

a. Acute onset of pain following direct trauma to a pedunculated 
osteochondroma A

b. Increase in size during puberty B
c. Pain following physical exertion, like playing soccer C
d. Presentation with multiple osteochondromas D
e. Progressive enlargement after skeletal maturity E

19. Osteochondromas represent true neoplastic lesions because:
a. Both sporadic and hereditary forms are encountered A
b. They have potential for malignant transformation B
c. They have the potential to grow during skeletal growth C
d. They may be irritated by overlying structures D
e. They show underlying genetic abnormalities E

20. Osteochondromas have been shown to have underlying 
genetic abnormalities in which of the following genes?

a. C-MYC and C-FOS A
b. EWSR1 and FLI1 B
c. EXT-1 and EXT-2 C
d. HER2/neu and MDM2 D
e. TP53 and RB1 E

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