Atlantoaxial Instability

Question 1

What is Atlantoaxial (AA) instability?

Answer 1

excessive mobility of C1 on C2 which can lead to subluxation and spinal cord injury

Question 2

What disorders are associated with Atlantoaxial (AA) instability?

Answer 2

Down syndrome and RA

Question 3

How do you diagnose Atlantoaxial (AA) instability?

Answer 3

Lateral x-ray films with flexion and extension

Question 4

What precaution should be taken with Atlantoaxial (AA) instability?

Answer 4

Risk of injury with intubation

Question 5

How do you treat Atlantoaxial (AA) instability?

Answer 5

Surgical Fusion

Question 6

What is Osgood-Schlatter Disease (Tibial Tuberosity Avulsion: Traction Apophysitis)?

Answer 6

Anterior knee pain often b/L of tibial tuberosities in adolescent children who are athletic and undergoing a growth spurt

Question 7

What is the cause of Osgood-Schlatter Disease (Tibial Tuberosity Avulsion: Traction Apophysitis)?

Answer 7

Repetitive stress o f Quads tendon pulling on the tibial tuberosities during rapid growth spurts

Question 8

What makes pain in Osgood-Schlatter Disease (Tibial Tuberosity Avulsion: Traction Apophysitis) worse?

Answer 8

Sports with jumping, running and kneeling

Question 9

What relieves the pain in Osgood-Schlatter Disease (Tibial Tuberosity Avulsion: Traction Apophysitis)?

Answer 9

Rest

Question 10

How do you diagnose Osgood-Schlatter Disease (Tibial Tuberosity Avulsion: Traction Apophysitis)?

Answer 10

Clinical: Pain with palpation over tibial tuberosities and reproduced with resisted knee extension

Question 11

How do you treat Osgood-Schlatter Disease (Tibial Tuberosity Avulsion: Traction Apophysitis)?

Answer 11

Conservative: symptoms resolve when bones completely ossify (Takes up to 18 months)

NSAIDs to relieve pain
Patellar strap to distribute force around the insertion of patellar tendon

Question 12

What is Nursemaid’s Elbow (Radial Head Subluxation)?

Answer 12

typically in children ages 1-5 due to traction on forearm: commonly when child is swung by the arms of yanked by the arm

Question 13

What occurs in a Nursemaid’s Elbow (Radial Head Subluxation)?

Answer 13

Radial head slips outside the annular ligament and gets stuck leading to Pain and limited ROM

Question 14

How do you diagnose Nursemaid’s Elbow (Radial Head Subluxation)?

Answer 14

Clinical: arm is held still in the pronated position and is mildly tender

No obvious deformity or erythema

Question 15

How do you treat Nursemaid’s Elbow (Radial Head Subluxation)?

Answer 15

Physical maneuvers: Hyperpronate and/or supination with hyperflexion while continuously applying force over the radial head