17: 4-year old female refusing to walk Flashcards
What cancer could cause bone pain and refusal to walk?
Leukemia
What’s the usual pathogen causing osteomyelitits?
Staph aureus
What could cause osteomyelitis in an unvaccinated kid?
Hib
When and following what does reactive arthritis normally occur?
2-4 weeks after a GI or GU infection?
What pediatric age group does reactive arthritis normally occur in?
Adolescents
What pediatric age group does septic arthritis normally occur in?
0-6 years
What condition might cause bacterial infection of a single, lower extremity joint, along with high fever?
Septic arthritis
What condition might present with acute onset of joint pain with possible low-grade fever, and occurs during or after a viral URI?
Transient synovitis
What condition might present with arthritis in 1+ joint for more than 6 weeks?
Juvenile idiopathic arthritis
What condition might present with a limp and impaired internal rotation, and looks like an ice cream scoop off a cone on XR?
Slipped capital femoral epiphysis
What condition commonly affects boys between age 4-10, involves avascular necrosis of the capital femoral epiphysis, and presents with chronic pain?
Legg-Calve-Perthes disease
What condition causes the femoral head to not be properly aligned with the acetabulum and is screened for with Ortolani and Barlow and is more common in females, breech deliveries, and family history of it?
Developmental dysplasia of the hip
Which is Ortolani and which is Barlow?
Ortolani=anterior force
Barlow=posterior force
“Bar back”
What disease starts with erythema migrans and arthritis which typically begins 4 weeks after the skin lesion?
Lyme disease
What are 5 predictors of septic arthritis of the hip?
- Fever
- Non-weight bearing
- ESR>40
- WBC>12
- Elevated CRP
What are 3 characteristics of synovial fluid in septic arthritis?
- Turbid appearance
- Increased WBCs
- Gm stain positive for bacteria
What are the 5 most common bacterial pathogens in septic arthritis?
- S. aureus
- Strep
- Hib
- N. gonorrhea
- Kingella kingae
What type of strep is in neonatal septic arthritis?
GBS
What type of strep is in infant and older child strep?
GAS and S. pneumo
What type of bacteria is the most common cause of septic arthritis in adolescents?
Neisseria gonorrhea
What age group does Kingella kingae cause septic arthritis in?
Children <4 years old
What’s the initial treatment of septic arthritis?
Broad IV abx
What’s the tx for transient synovitis?
Rest and ibuprofen
When does transient synovitis usually resolve?
3-10 days
Does transient synovitis predispose an individual to arthritis?
No
Can infections, leukemia, JIA, transient synovitis, and arthritis elevate ESR and CRP?
Yes
Is there a significant false positive rate in lyme test?
Yes, you gotta do two
