Flashcards in peds Deck (39):
Your young patient c/o deep nagging pain in the LLE. You are worried about a sarcoma. What characteristics are true for Osteosarcoma?
sunburst pattern, attacks the metaphysis, has a lacy pattern on histology
Your young patient c/o deep nagging pain in the LLE. You are worried about a sarcoma. What characteristics are true for Ewing's sarcoma?
attacks the diaphysis and pelvis. Has small round cell tumors on histology
Dx of scoliosis requires a curve > ____ degrees, of which curve to the ____are most common.
> 10 degrees....right
at what age can you dx adolescent idiopathic scoliosis?
tx of adolescent idiopathic scoliosis:
1) observe for curve < 20
2) brace for curve 20 - 45
3) spinal fusion for > 45
risk factors for hip dysplasia
first born female, breech presentation, with FHx and OLIGOHYDRAMNIOS
What maneuver reveals a clunk when posterior force is placed on the hips in adduction?
What maneuver reveals a palpable clunk when hip is abducted, returning femoral head into the acetabulum?
Ortolani (a reduction technique)
This test measures height of baby's knees if they are on their back with knees up, discrepancy indicates posterior femur displacement
what imaging do you use for dx of hip dysplasia?
First line tx for hip dysplasia if reducable?
Pavlik Harness x 6 weeks (non-reducable = sx)
12 month old seems to have pain in the leg. Holding hip out like butterfly. May have fever. What is high on DDx?
Septic hip joint
How do you tx septic arthritis of the hip?
SURGICAL IRRIGATION, debridement and decompression, IV abx
Septic hip caused by what pathogens?
1 mo-3 yrs--staph, strep, strep
3-13 yrs--staph, strep, h.flu
>13 yrs--staph, GC
Young child with knee pain, limping, leg stiffness, Trendelenburg gait, LLD, normal knee PE
think HIP! Perthes Dz
What is perthes dz?
idiopathic osteonecrosis of hip
Who gets Perthe's?
males b/t 5-7 years, ADHD risk
What are poor prognostic indicators for Perthe's patients?
1) bone age > 8 years
4) loss of femoral head sphericity
tx of perthe's?
restrict activity for bone age < 8 years....Sx for older (takes 12 mo for re-ossification)
Can Perthe's affect both hips at the same time
obese kids (males) are at risk for:
SCFE (slipped capital femoral epiphysis)
How often does SCFE/ice cream happen in both hips?
What are some additional risk factors for development of SCFE?
radiation, metabolic disorder
tx for SCFE?
stop bearing wt!! Ortho RFL for Sx (risk for AVN)
3 causes of in-toeing
Turning in of
W position, often resolves with age:
Excessive femoral anteversion
causes for Genu Varum:
rickett's, skeletal dysplasia, blounts dz
causes for Genu Valgum:
rickett's, skeletal dysplasia, physeal injury, tumor
Cavus = high arch
Adductus = C-shape
Varus = inturned heel
Equinus = hoof
tx of clubfoot:
serial casting x 5 years
These problems come from rapid bone growth, soft tissues cannot keep up
apophyseal issue w/ tibial tubercle
apophyseal issue with calcaneus
Subluxation of radial head from traction or roation
Tx of nursemaid?
1) pressure on radial head
2) traction on wrist
SCM contraction a/w intrauterine compartment syndrome
congenital muscular torticolis
What condition necessitates ortho RFL?