Ortho/Rheumatology Flashcards
(27 cards)
What is a Nursemaid’s elbow
- Dislocation of radial head
How can you reduce a Nursemaid’s elbow
- supination and flexion with pressure over radial head
- hyperpronation with pressure over radial head
Define scoliosis
- lateral curvature of the spine > 10 degrees
How is scoliosis diagnosed?
- Adams forward bending test
- Cobb’s angle measured on AP/lateral films
Tx for scoliosis
- TLSO brace if curvature 20-40 degrees
- surgery if curvature > 40 degrees
What is Slipped Capital Femoral Epiphysis
- Slippage of femoral epiphysis off of femoral metaphysis “ice cream falling off of a cone” at the growth plate
- femoral head slips posterior and inferior
Slipped Capital Femoral Epiphysis is most common in what patient population
- african american obese males ages 10-16
Patients with Slipped Capital Femoral Epiphysis often present complaining of
- knee pain
- can present with a limp and external rotation
- restricted abduction and internal rotation
What are the greatest risk factors for developmental dysplasia of the hip
- first born
- female
- breech
- family history
Barlow maneuver
- Adduct the hip (bring knee to midline) while applying pressure on the knee, directing the force posteriorly
- Test is positive
What is the Ortolani maneuver
- Relocation of the dislocated hip caused by Barlow test
- Flex hips and knees to 90 degrees, apply pressure to greater trochanter and slowly abduct the hip
- Positive test is relocation of hip
What is Galeazzi maneuver
- Bend both knees and rest feet on table. Affected hip shorter in comparison
How is developmental dysplasia of the hip diagnosed
- clinical
- Dynamic stress US after 3-4 weeks of age
- Radiographs after 4-6 months of age
Management of developmental dysplasia of the hip
- Pavlik harness
- monitor is US monthly until 6 months of age -> then radiographs
What is Legg-calve-perthes disease
- idiopathic avascular osteonecrosis of femoral head in children due to ischemia of capital femoral epiphysis
Legg-calve-perthes disease most commonly presents in what type of patient population
- children 4-10 y.o.
- MC in boys
- Thin and extremely active
How does Legg-calve-perthes disease commonly present
- painless limping x weeks
- loss of abduction and internal rotation
Tx for Legg-calve-perthes disease
- abduction bracing: children > 5 y.o. Or significant loss of abduction
What is Osgood-Schlatter disease
- Inflammation and irritation of patellar tendon insertion of tibial tubercle
- presents with tenderness of tibial tubercle and enlargement or bony protrusion of tibial tubercle
- Pain flares around time of rapid growth
Management of Osgood-Schlatter disease
- Obtain lateral X-ray to rule out avulsion
- Rest, Ibuprofen, Quad exercises, Ice, chopat strap
Most common primary bone malignancy in children and adolescents
osteosarcoma
What is a osteosarcoma
- Primary malignant tumor characterized by production of osteoid or immature bone by malignant cells
- Growth spurt in metaphysis of rapidly growing bones, most commonly tibia or femur
What is ewings sarcoma
- malignancy of bone or soft tissue
- 2nd most common primary bone malignancy
Most common soft tissue malignancy seen in childhood
- rhabdomyosarcoma
- usually manifests as an expanding mass
