pediatric ortho part II Flashcards

1
Q

What is the H/P for physeal fractures?

A

pain, gross deformity, swelling, warmth, possible growth disturbance with limb inequality. xray will show premature closure of the pysis if there is a growth disturbance; otherwise, it is just a fracture

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2
Q

What is the most severe type of physeal fracture?

A

crush injury of physis

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3
Q

What is nursemaid’s elbow?

A

radial head subluxation that occurs via pulling and lifting on the hand. child presents with painful arm and won’t bend elbow

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4
Q

What is the tx for nursemaid’s elbow?

A

manual reduction via supination of the arm with flexion of the elbow from 0 to 90 degrees

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5
Q

What is the treatment for club foot?

A

serial casting of foot in correct position. may need surgery

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6
Q

What is the EMG seen with duchenne muscular dystrophy?

A

polyphasic potentials and increased fiber recruitment

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7
Q

What are the complications and tx for duchenne’s muscular dystrophy?

A

progressive cardiac issues, scoliosis, flexion contractures, respiratory compromise
give PT, steroids, pulm support, ACE-Is to decrease cardiac afterload

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8
Q

What is the most common cause of a bone tumor in adults?

A

metastatic disease. may present as pathologic fracture

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9
Q

What is the most common primary bone tumor?

A

osteosarcoma, common in male adolescents

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10
Q

What are risk factors for osteosarcoma?

A

paget disease of bone, p53 mutation, familial p53 mutation (Li-Fraumeni), familial retinoblastoma, radiation exposure, bone infarction

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11
Q

What are the radiographic findings of osteosarcoma?

A

x-ray shows bone lesion with a sunburst pattern and codman triangle (periosteal new bone formation at the diaphyseal end of the lesion)

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12
Q

What is the “next step” after an x-ray suggests osteosarcoma?

A

chest CT to look for mets. may want PET or MRI

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13
Q

What is Ewing sarcoma? what age is it most common in?

A

-highly malignant cartilage tumor in the diaphysis of long bones seen in kids 5-15

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14
Q

What are the key radiographic findings of ewing sarcoma?

A

-“onion skinning” bone lesion; destructive lesion with periosteal reaction

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15
Q

What is an osteochondroma? what age group? where does it occur

A
  • common benign tumor in the metaphysis of long bones; more common in patients less than 25, male > female
  • often in the low femur or upper tibia
  • bone is continuous with lesion
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16
Q

What is the treatment for an osteochondroma?

A

none unless it is causing soft tissue irritation, neurovascular compromise, or continuing growth, in which case you should recommend surgical excision
-rare (1%) transformation to chondrosarcoma