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Flashcards in peds Deck (39):
1

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

2

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

3

Dx of scoliosis requires a curve > ____ degrees, of which curve to the ____are most common.

> 10 degrees....right

4

at what age can you dx adolescent idiopathic scoliosis?

10

5

tx of adolescent idiopathic scoliosis:

1) observe for curve < 20
2) brace for curve 20 - 45
3) spinal fusion for > 45

6

risk factors for hip dysplasia

first born female, breech presentation, with FHx and OLIGOHYDRAMNIOS

7

What maneuver reveals a clunk when posterior force is placed on the hips in adduction?

Barlow

8

What maneuver reveals a palpable clunk when hip is abducted, returning femoral head into the acetabulum?

Ortolani (a reduction technique)

9

This test measures height of baby's knees if they are on their back with knees up, discrepancy indicates posterior femur displacement

Galeazzi test

10

what imaging do you use for dx of hip dysplasia?

US

11

First line tx for hip dysplasia if reducable?

Pavlik Harness x 6 weeks (non-reducable = sx)

12

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

13

How do you tx septic arthritis of the hip?

SURGICAL IRRIGATION, debridement and decompression, IV abx

14

Septic hip caused by what pathogens?

Neonates--GBS, staph
1 mo-3 yrs--staph, strep, strep
3-13 yrs--staph, strep, h.flu
>13 yrs--staph, GC

15

Young child with knee pain, limping, leg stiffness, Trendelenburg gait, LLD, normal knee PE

think HIP! Perthes Dz

16

What is perthes dz?

idiopathic osteonecrosis of hip

17

Who gets Perthe's?

males b/t 5-7 years, ADHD risk

18

What are poor prognostic indicators for Perthe's patients?

1) bone age > 8 years
2) LROM
3) females
4) loss of femoral head sphericity

19

tx of perthe's?

restrict activity for bone age < 8 years....Sx for older (takes 12 mo for re-ossification)

20

Can Perthe's affect both hips at the same time

no

21

obese kids (males) are at risk for:

SCFE (slipped capital femoral epiphysis)

22

How often does SCFE/ice cream happen in both hips?

17-50%

23

What are some additional risk factors for development of SCFE?

radiation, metabolic disorder

24

tx for SCFE?

stop bearing wt!! Ortho RFL for Sx (risk for AVN)

25

3 causes of in-toeing

Turning in of
1) femur
2) tibia
3) feet

26

W position, often resolves with age:

Excessive femoral anteversion

27

C-shaped foot

metatarsus adductus

28

causes for Genu Varum:

rickett's, skeletal dysplasia, blounts dz

29

causes for Genu Valgum:

rickett's, skeletal dysplasia, physeal injury, tumor

30

clubfoot nmeumonic:

CAVE
Cavus = high arch
Adductus = C-shape
Varus = inturned heel
Equinus = hoof

31

tx of clubfoot:

serial casting x 5 years

32

These problems come from rapid bone growth, soft tissues cannot keep up

apophyseal issues

33

apophyseal issue w/ tibial tubercle

Osgood schlatter

34

apophyseal issue with calcaneus

Sever's dz

35

Subluxation of radial head from traction or roation

nursemaid's elbow

36

Tx of nursemaid?

1) pressure on radial head
2) traction on wrist
3) supination

37

SCM contraction a/w intrauterine compartment syndrome

congenital muscular torticolis

38

What condition necessitates ortho RFL?

SCFE

39

What is the most likely problem in kids with knee pain?

hip path