TIM Ausink PEDS Flashcards by Edith Zaragoza

LCP Legg Calve Perthes

Causes avascular necrosis of the femoral head
Boys>girls ages 4-8 yr
PE: Limited Abduction
XR: AP+ Frog

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Tender berg sign

Positive when patient leans out to opposite side

Appears with short leg and odd gait

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Hip Dysplasia

Usually in infants 1st 4 months of life
Do Barlow ortolani and gallezati
Place in pavlick harness
May have medial knee pain

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Osteogenesis imperfecta typ1

Most subtle collagen disorder in children
Triad: blue sclera, angular kelitis
Brittle bone dz

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Neck tortoicollis

Mostly scm stressed

Can be rare vertebral abnml think this after pt does not work

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Blount Dz

One portion of proximal Tina stops growing and other portion keeps growing
Order XR
Obese early walkers and African American children
Type infantile and adolescent

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WHY ARE CHILDREN MORE PRONE TO INFECTION IN BONE

D/T high vascular ergo more room for infarction, bleeding, osteomyelitis risk increases.

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Clinodactyl

Finger bend out (pinky)

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Cyndactly

Club foot

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Diagnostic tool for Hip dysplasia is what?

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What other location may hip injuries present as ?

Medial knee pain

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Club foot components

Pathological with rigid foot
Tendon abnmlaity
Order serial casting and bracing
Check all other joints

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Three levels of Torsion include

1 femoral
2 tibial
3 metatarsal

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Slipped capital femoral epiphysis - SCIFY

Typically 
Boys 12-15 and Gorls 10-13
Obese children 
Limp and Hip pain with out trauma 
STOP WEIGHT BEARING REFER QUICKLY
XR: will show “ice cream slip off the cone” 
TX: Surgical pinning

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Idiopathic scoliosis and characteristics

No pain
Send to spine surgeon
Cobb angle greater than 50
XR: AP and lateral view

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Scheurmann Kyphosis

Thoraci kyphosis typically in teens

Refer to surgery

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Valgus signs

L shaped legs like riding horse

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Varus signs

Like an R out legs

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Children approach to FX

If it looks broken acts broken but the XR is nml Then treat it as its broken
Recheck XR in 10-14 days

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How do you care for a newborn clavicle fx?

Leave it be
Document both arms moving
Risk for brachial plexus injury

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What is most common fx in children

Spiral tibia fx

Child will not weight bear and be irritable

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Non accidental fx in child would be considered a red flag in what fx?

Study These Flashcards

Spiral femur fx

Suspicious fractures include

Study These Flashcards

Corner fractures 
Rib posterior 
Eternal 
Skull
Scapula fx
Order skeletal survey observe for multiple lesions at various healing times

Why do we worry about growth plate injuries in children ?

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This can delay or stop growth

Spine spondylosis

Seperation in vertebral pars Xr: has a Scottie dog appearance Order XR: lumbar film

Spine spodylythithesis

Restrict physical activity This is a spine slippage can cause foot drop Refer to PT ortho

Shoulder growth separation

Also called little league pitcher arm, gymnastics, volleyball This results in a seperation from growth place and shoulder Results in salter Harris 1 rx

Acute brachial plexus injury “stinger”

Caused by 2 moa: compression, direct blow and hyper extension of neck and shoulder SX: burning pain numbness down 1 arm resolves in minutes

Apophysis

Bony area where muscle and tendon attach. Can also looks very similar to fix but this runs parallel to the diaphysis not perpendicular like a fox

Epiphysis

End of bone involved in longitudinal growth

Knee osteochondritis

Pain felt at medial femoral condyle | Worse when climbing up stairs

What is the most common saltar Harris fx?

Type 2 A above

Type 1 saltar Harris fx

Straight across epipheseal plate

Type 2 saltar Harris fx

Above epiphiseal plate

Type 3 saltar Harris fx

Lower Than the epiphiseal plate

Saltar Harris type 4

Through the epiphiseal plate

Saltar Harris 5

Crushed epiphiseal plate

Buckle fx

D/t axial loading compression fx

Greentsick fx

Direct blow w angulation | Short term immobilization w/ viler splint 3-4 weeks

Osteomyelitis in children

Higher risk of infection due to open growth plates high vascular ivy Kids wiht heme issues are more at risk d/t low o2 carrying capacity- like sickle cell Room for more infarct and bleeding MC: femur And tibia bone

Osteomyelitis presentation

Hot joint toxic patient Elevated ESR, CRP, CBC Order: xr, mri, bone scan Give:v Iv abx until crp less than 50%

MC agent causing osteomyelitis in children

Staph Aures

Mc Osteomyelitis in 3–4 year olds

Kingealle kingae, salmonella

Septic arthritis

Unilateral pain in joint hot edematous joint Fever Source typically puncture wound, cellulitis Aspirate: gram stain culture cell count Iv abx Mc agents staph, strep, in teens Gonorrhea

Growing pains present as

Pain that is relieved in the AM

Most common source of joint infection

Blood

Mc bacteria causing osteomyelitis

Staph Aures

Malignant bony lesions include

Osteosarcoma | Ewing’s sarcoma

Osteosarcoma characteristics

Found in teens present with bone pain femur and tibia metaphysis

Ewing’s sarcoma

10- 20 years age range indicative of leukemia pathological fx of long bone To: chemo and radiation

Pathological suspicious

Bone pain wakes child at night Child limits activity Younger child

Reactive arthritis

``` Often follows after a URI With nml labs Afebrile Order viral panel, viral culture Send patient home rest pain management ```

SLE SYSTEMIC lupus errythematous

Malar butterfly rash Plus renal dz Order UA to see for protein spill

Juvenile idiopathic arthritis

Joint paint in 1 joint for more than 6 wks Autoimmune inflammation Non toxic appearing patient Will have uveitis and a rash Labs: Ana, anemia Send to: rheumatoid specialist, NSAIDs, steroids 85% goes away

TIM Ausink PEDS Flashcards

(54 cards)