Peds Ortho Flashcards
(40 cards)
1
Q
Talipes equinovarus- Eti
A
- Clubfoot deformity
- 1:1000 births
- Congenital fixed foot deformity
- Idiopathic, neuro, other syndromes
2
Q
Talipes equinovarus- Sx
A
- Plantar flexion with varus deformity
3
Q
Talipes equinovarus- Dx
A
Clinical
4
Q
Talipes equinovarus- Tx
A
- Plaster casting to surgery, if severe
- Refer to ortho
5
Q
Genu varum- Eti
A
- Bowleg
- Normal from 0-2 yrs
- Seek tx if pain, unilateral
6
Q
Genu valgum- Eti
A
- Knock-kneed
- Normal from 2-8 yrs
- Seek tx if pain, unilateral
7
Q
Congenital dysplasia of hip- Eti
A
- Dislocated: 1: 1000
- Dislocatable: 1:1000
- Subluxable: 9:1000
8
Q
Congenital dysplasia of hip- Risk
A
- Fam hx
- Breech position
- Female 2-3x
- Risk factors are additive
9
Q
Congenital dysplasia of hip- Dx
A
- Hip ABduction
- Asymmetry
10
Q
Congenital dysplasia of hip- Tx
A
- Maintain hip in reduced position, reverses if tx early on
- Prolonged traction, casting and surgical repair if > 18 months
11
Q
Scoliosis- Eti
A
> 10 degree curvature measured by Cobb angle
- 3D deformity: curvature, kyphosis, lordosis and rotation of axial plane
- Idiopathic most common
- 9-10 yo female
12
Q
Scoliosis- Tx
A
- Observation 40 degrees
- Determine based on risk of progression and cobb angle
13
Q
Scoliosis- Sx
A
- Asymptomatic and painless
- Discrepancy in shoulder ht, scapulae, waist line and arm distance
14
Q
Scoliosis- Dx
A
- Adams forward bend test
- Rib & muscle prominence
- Looking at rotation only
- Standing x-rays- measure Cobb angle for severity
- Eval skeletal maturity- Risser sign
15
Q
Scoliosis- Tx
A
- Observation 40 degrees
- Determine based on risk of progression & cobb angle
16
Q
Torticollis- Eti
A
- Fibrosis & shortening of SCM
- Traumatic birth or positioning
- 20% also have hip dysplasia
17
Q
Torticollis- Sx
A
- Head tilt to affect side with rotation of chin
- Swelling/ mass in SCM
- Limited lateral bending away from affected side
18
Q
Torticollis- Tx
A
PT & stretching
19
Q
Legg-calve-perthes- Eto
A
- Unknown etiology
- 4-11 yo male
- Small for age, delayed skeletal maturation
- Unilateral
- Painless, limp & fatigue
20
Q
Slipped capital femoral epiphysis- Eti
A
- Separation of proximal femoral epiphysis through growth plate
- Displaced medially and posterior
- During growth spurt: 10-17 male, 8-15 female
- Obese
21
Q
Slipped capital femoral epiphysis- Sx
A
- Progressive pain and limp
- Referred pain to thigh, knee or groin
- Bilateral involvement within 2 years
22
Q
Slipped capital femoral epiphysis- Dx
A
- Xray: Klein’s line- doesn’t intersect formal head
- Affected limp positioned in external rotation, shorter
- Gait externally rotates
- Loss of internal rotation
23
Q
Slipped capital femoral epiphysis- Tx
A
- Surgery- fixation of femoral head
- Leads to avascular necrosis
24
Q
Legg-calve-perthes- Eto
A
- Unknown etiology
- 4-11 yo male
- Small for age, delayed skeletal maturation
- Unilateral
- Painless, limp and fatigue
25
Legg-calve-perthes- Sx
- Impairment to blood supply leads to avasc. necrosis,spontaneously regenerates
- Limp
- Pain &; limitation of internal rotation
- Flexion contracture of involved hip
26
Legg-calve-perthes- Dx
- X-ray- late: failure of development of femoral head
27
Septic arthritis- Eti
- Infection of synovium
- S. aureus most common, N gonorrhea in adolescence
- First 2 yrs of life
28
Septic arthritis- Sx
- Ill appearing child with fever
| - Local swelling, effusion, pain, erythema & warmth
29
Septic arthritis- Dx
- Joint aspiration for gram stain
- X-ray to RO occult fx
- Bone scan RO osteomyelitis
30
Septic arthritis- Tx
- IV abx x 2-4 wks
| - I and D if abscess suspected
31
Nursemaids elbow- Eti
- Most common elbow injury in children
- Sudden traction on extended arm
- 1 - 4 YO
32
Nursemaids elbow- Sx
- Sudden pain that subsides
- Pain increases with arm movement
- Holds elbow flexed and pronated
- Refusal to move/ bend
- Tenderness over radial head
- Normal x-ray
33
Nursemaids elbow- Tx
- Reduction by extension, supination then flexion, feel clunk
- Relief almost immediately
34
Tibial torsion- Eti
- Toeing in
- Rotation of leg between knee and ankle
- Should be neutral by 16 mo.
- Self limited and self resolves
35
Femoral anteversion
- Toeing in beyond age 2-3 due to internal rotation of hip
| - Tx with active external rotation exercises
36
Juvenile Rheumatoid arthritis- Eti
- Chronic arthritis in 1+ joint x 6 wks
| - Autoimmune
37
Juvenile Rheumatoid arthritis- Sx
- Arthritis: pain, swelling, warmth, AM stiffness and decreased ROM
- Systemic manifestations: fever, rash, uveitis, serositis, anemia & fatigue
38
Juvenile Rheumatoid arthritis- Eti
- Chronic arthritis in 1+ joint x 6 wks
- Autoimmune
- Oligoarticular most common
39
Juvenile Rheumatoid arthritis- Dx
- Elevated inflammation markers- CRP, WBC, ESR
| - Xray- degeneration, increased joint space, soft tissue swelling
40
Juvenile Rheumatoid arthritis- Tx
- NSAIDs
- Methotrexate
- Triamcinalone injections
