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Exam 2 Skin block > Pediatrics orthopaedics > Flashcards

Pediatrics orthopaedics Flashcards

(63 cards)

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1
Q

Scoliosis: Description

A

lateral curvature greater than 10 deg, often associated with rotational deformity. M:F = 1:1 of curves less than 20, but girls are 7 times more likely to progress

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2
Q

Scoliosis: Sx

A

no pain. Ill fitting clothes

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3
Q

Scoliosis: Exam

A

forward bend test. Scoliometer.

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4
Q

Scoliosis Tests

A

Full length x rays measure vertebral angle

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5
Q

Scoliosis: tx

A

brace if angle > 30. surgery if > 40-50

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6
Q

Club foot Description

A

idiopathic congenital foot deformity, characterized by plantar flexion of ankle; adduction of the heel; high arch; adduction of the fore foot

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7
Q

Club foot: sx

A

none

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8
Q

Club foot: tests

A

none

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9
Q

Club foot TX

A

manipuation and casting immediately. surgery if still rigid at 3 years

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10
Q

Osgood schlatter: description

A

overuse injury causing apophyseal injury at tibial tubercule

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11
Q

Osgood schlatter: sx

A

pain over tibial tuberculev

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12
Q

Osgood schlatter: exam

A

pain over tibial tubercle

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13
Q

Osgood schlatter: tests

A

xrays show gramentation of tubercle

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14
Q

Osgood schlatter: tx

A

NSAIDS, rest, PT

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15
Q

hip dysplasia: description

A

malformed hip socket and femoral head, asscoiated with ligamentous laxity, left hip, female gender, breech presentation. Xray will show dislocation.

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16
Q

hip dysplasia: SX

A

limp

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17
Q

hip dysplasia: Exam

A

barlow and ortolani exam. Dislocation test then relocate it.

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18
Q

hip dysplasia: tests

A

ultrasound can help with difficult cases

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19
Q

hip dysplasia: tx

A

pavlik harness to force relocation of hip. mimic ortalani maneuver

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20
Q

perthes disease: description

A

idiopathic osteonecrosis of femoral head, between 4-8 years old

Good blood supply to lateral side can help with good prognosis. Femoral head is medial crcumflex and pulvinar artery.

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21
Q

perthes disease: sx

A

limp and stiffness

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22
Q

perthes disease: exam

A

decreased internal rotation and abduction

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23
Q

perthes disease: tests

A

x rays show sclerosis, coxa magna. MRI can help with diagnosis

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24
Q

perthes disease: tx

A

ROM and bracing. No good treatment

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25
SLipped capital femoral epiphysis: description
displacement of the femoral head through the physis usually during growth spurt, associated with obesity, maes, sports, endocrine disorders
26
SLipped capital femoral epiphysis: SX
pain with activity
27
SLipped capital femoral epiphysis: exam
loss of internal rotation with hip flexed
28
SLipped capital femoral epiphysis: tests
AP and lateral X rays show slip. Workup for endocrine abnormality if bilateral
29
SLipped capital femoral epiphysis: tx
surgical fixation in situ pin it and let it heal
30
Genu varum/valgum: description
normally the knee starts at birth in varum 10-15 deg, and by 18 months straightes out to 0. Maximum valgum of 15 degree at age 4, then 5-10 deg in adolescence
31
Genu varum/valgum: SX
worried parents
32
Genu varum/valgum: exam
measure knee angle
33
Genu varum/valgum: tests
weight bearing x rays if outside normal
34
Genu varum/valgum: tx
observation, bracing, occasional epiphyseal stapling osteotomy
35
tarsal coalition: description
abonrmal connection between tarsal bones
36
tarsal coalition: SX
pain, limp, frequent, ankle sprain
37
tarsal coalition: exam
restricted hindfoot movement
38
tarsal coalition: tests
x rays will show calcaneal navicular coaltion. CT scan can confirm
39
tarsal coalition: TX
casting then surgery if needed.
40
transient synovitis of the hip: description
sterile effusions of the hip causing pain.
41
transient synovitis of the hip: SX
limp, refuses to walk, groin pain. History of viral infection elsewhere.
42
transient synovitis of the hip: exam
limp, stiffness, afebrile
43
transient synovitis of the hip: tests
x rays effusion. CBC, esr, crp are not elevated. Joint aspirate < 50000 WBC. Gets better with NSAIDS
44
transient synovitis of the hip: TX
Supportive care
45
Supracondylar humerus fracture description
affects 2-12 years old, most common elbow fracture
46
Supracondylar humerus fracture: SX
fall of trampoline, elbow deformity, pain
47
Supracondylar humerus fracture exam
neurovascular exam important
48
Supracondylar humerus fracture tests
x rays show supracondylar fracture, positive posterior sail sign
49
Supracondylar humerus fracture tx
casting vs surgical reduction
50
Rickets: description
error in Vit D metabolism causes failure of mineralization Large hypertrophic zone.
51
Rickets: SX
pain in legs
52
Rickets: exam
bowed lgs
53
Rickets: xray
looser lines (osteoid seam). Widened growth plates
54
Rickets: labs
low normal serum Ca, phos low
55
Rickets: tx
nutritional supplementation. treat for underlying cause (meds)
56
Non-accidental trauma incidence:
42/10000 children were victims of abuse or neglect 15-20% presents with fractures humerus is the most common bone then femur
57
Non-accidental trauma: risk factors
low income, first born, premature, stepchildren, handicapped, single parent, drug use, unemployed parents, abused parents fractures in non amulatory children
58
Non-accidental trauma: injuries to be aware of
posterior rib fractures spiral fractures metaphyseal corner fractures Spiral fractures. Rib fractures (shaking baby syndrome) Corner fracture: distal fracture. Bucket fracture. Salter harris classification of growth factors: Damage of growth plate.
59
Non-accidental trauma : TX
contact CPS rule out other causes (OI, caffey's disease, leukemia, accidental trauma) treat fracture
60
Acute joint effusion
mono articular oligoarticular systemic sx: JIA, lyme, septic. Ophtalmology consult. Sometimes painless
61
Cerebral palsy
permanent non progressive brain injury in the peripartum period upper motor neurons affected with spasticity hemiplegia; diplegia keeping mobile is key be suspicious for cerebral palsy in a paitnet with delayed motor development, history of prematurity, prolonged NICU stay, toe walking
62
Achondroplasia
disproportionate short stature FGFR3 mutation autosomal dominant hypertrophic zone in growth plate is narrow problems involve the spine
63
Marfan syndrome
defect in collagen 1 from osteoblast fibrillin mutation hyper mobile thumb. really long fingers and narrow bone. SX: tx no treatment

Exam 2 Skin block (22 decks)

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