Pestana- 2. Orthopedics Flashcards Preview

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Flashcards in Pestana- 2. Orthopedics Deck (157)
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1

When should developmental dysplasia of the hip be diagnosed?

ideally right after birth (it runs in families)

2

How do you diagnose developmental dysplasia of the hip?

-Children have uneven gluteal folds
-Can jerk the hip down and dislocate with a "click" and it returns to normal with a "snap"
-Use ultrasound (NOT x-ray)

3

How do you treat developmental dysplasia of the hip?

abduction splinting with Pavlik harness for around 6 months

4

What are the two ways that hip pathology in children may present?

hip pain or knee pain

5

What is Legg-Calve-Perthes disease?

avascular necrosis of the capital femoral epiphysis

6

When and how does Legg-Calve-Perthes disease usually present?

Around 6 years old with insidious limping (passive motion of hip is guarded when walking), decreased hip motion and hip/knee pain

7

How do you diagnose Legg-Calve-Perthes disease?

AP and lateral hip x-rays

8

How do you treat Legg-Calve-Perthes disease?

containing the femoral head within acetabulum by casting and crutches

9

What should you think if a 13 y/o boy presents with groin pain, limping, and when legs dangle while sitting, the sole of the foot on the affected side points toward the other foot?

slipped capital femoral epiphysis

10

What is the characteristic physical exam finding in slipped capital femoral epiphysis?

as hip is flexed, thigh goes into external rotation and cannot be rotated internally

11

How do you diagnose slipped capital femoral epiphysis?

x-ray (THIS IS AN ORTHOPEDIC EMERGENCY)

12

How do you treat slipped capital femoral epiphysis?

pinning the femoral head back in place

13

What should you suspect if a toddler has a febrile illness then holds the leg with the hip flexed (slight abduction and external rotation) and will not allow it to be moved?

septic hip

14

How do you diagnose septic hip?

aspiration of hip under general anesthesia

15

How do you treat septic hip?

if aspiration shows pus, do open drainage

16

What should you suspect if a young child has a febrile illness and it is followed by severe localized pain in a bone with no history of trauma?

acute hematogenous osteomyelitis

17

How do you diagnose acute hematogenous osteomyelitis?

MRI (x-rays will not show anything for a couple of weeks)

18

How do you treat acute hematogenous osteomyelitis?

antibiotics

19

What is genu varum?

bow legs

20

Up to what age is genu varum considered normal?

3

21

What should you think of if genu varum persists after age 3?

Blount disease

22

What is Blount disease?

disturbance of medial proximal tibial growth plate

23

What is genu valgus?

knock knee

24

When is genu valgus commonly seen?

between ages 4 and 8 (normal)

25

What should you suspect in a teenager with persistent pain right over the tibial tubercle that is aggravated by contraction of the quadriceps?

Osgood-Schlatter disease

26

What is Osgood-Schlatter disease?

osteochondrosis of the tibial tubercle

27

What does physical exam show in Osgood-Schlatter disease?

localized pain over the tibial tubercle and NO KNEE SWELLING

28

What is the definitive treatment for Osgood-Schlatter disease (if RICE does not work)?

extension or cylinder cast for 4-6 weeks

29

What is talipes equinovarus?

club foot

30

When does talipes equinovarus present?

birth