Adolescent Sports Ortho

Question 1

OCD Staging
Intact articular cartilage surface with no fluid, but high signal in subchondral bone on MRI, managed with conservative care (PT and no impact for 3-6 months)

Answer 1

Stage I

Question 2

OCD Staging
Intact articular cartilage with high signal in subchondral bone on MRI requiring immediate surgical intervention for optimal long term outcome
Full breach with synovial fluid leaking, inflammation

Answer 2

Stage III

Question 3

OCD Staging
Articular cartilage breached/defect with high signal in subchondral bone on MRI managed with conservative care (PT and no impact for 3-6 months)
Fluid present and necrotic bony tissue, small breach

Answer 3

Stage II

Question 4

OCD Staging
Articular cartilage defect that is a loose fragment in the joint, requiring immediate surgery for fixation
Migration of fragment, loose body

Answer 4

Stage IV

Question 5

30-50% of sports related pediatric injuries are d/t

Answer 5

overuse, not allowing tissue recovery time relative to amount of activity and ongoing development which requires more sleep and nutrition

Question 6

Patho-anatomy abnormalities are common and nonconcering in adults, but in adolescents …

Answer 6

MRI should be normal

Question 7

Adolescent LBP predictors

Answer 7

Pain beliefs
Mental health
Somatic complaints
Anxiety/stress response
Female > male

Question 8

Not predictive of LBP (myths)

Answer 8

Scoliosis
Posture
Joint hypermobility
Back/core muscle strength endurance
Carrying school bag

Question 9

Why does apophysitis happen?

Answer 9

Centers of ossification are located around major tendon attachment to bones and open at varying ages to provide contour to developing bones. These centers are weakest links at specific ages and can be irritated by repetitive stress, traction stress, and inadequate healing time.

Question 10

Most fuse again by 17, with exclusios

Answer 10

ASIS and Ischial Tuberosity

Question 11

apophysitis of patellar tendon attachment to tibial tuberosity

Answer 11

Tibial Tuberosity Apophysitis (Osgood-Schlatter)

Mimics patellar tendinopathy, PFPS, Fat pad syndrome

Question 12

apophysitis of patella 9 - 12 years

Answer 12

Patellar apophysitis
Mimis: infrapetellar fat pad syndrome, patellar tendonopathy, PFPS, plica syndrome

Question 13

Sinding Larson Johansson Syndrome

Answer 13

Patellar Apophysitis

Question 14

Osgood Schlatter Disease

Answer 14

Tibial Tuberosity Apophysitis

Question 15

Sever’s Disease

Answer 15

Calcaneus

Question 16

Little Leaguer’s Elbow

Answer 16

Medial epicondyle of humers

Question 17

Iselin’s Disease

Answer 17

Base of 5th met

Question 18

Little Leaguer’s shoulder

Answer 18

Humeral physis