Bone and Joint Flashcards

1
Q

malialignment of calcaneotalar-navicular complex

A

Talipes equinovarus (clubfoot)

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2
Q

normal foot that has been held in deformed position in utero and found to be flexible on examination

A

positional clubfoot

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3
Q

clubfoot is extremely common in patients with myelodysplasia and arthrogryphosis

A

Clubfoot

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4
Q

examination findings in infants with clubfoot

A

forefoot cavus and adductus

hindfoot varus and equinus

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5
Q

common radiographic finding in clubfoot

A

“parallelism” between lines drawn through axis of the talus and calcaneus on the lateral radiograph indicating hindfoot varus

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6
Q

pain over tibial tubercle in a growing child

A

Osgood-Schlatter disease

  • traction of the tibial tubercle growth plate and adjacent patellar tendon
  • self-limited in most patients and resolves with skeletal maturity
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7
Q

two groups of Developmental Dysplasia of Hip

A

typical

teratologic

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8
Q

occurs in otherwise normal patients or those with defined syndromes or genetic conditions

A

Typical DDH

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9
Q

have identifiable cause such as arthrogryposis or genetic syndrome and occur before birth

A

Teratologic DDH

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10
Q

what is Barlow maneuver

A

assess the potential dislocation of a nondisplaced hip in a neonate

  • examiner adducts the flexed hip and gently pushes the thigh posteriorly
  • (+) test: hip is felt to slide out of acetabulum
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11
Q

What is Ortolani maneuver?

A

examiner attempts to reduce a dislocated hip

  • examiner grasps the child’s thigh between thumb and index finger and with 4th and 5th fingers lifts the greater trochanter while simultaneously abducting the hip
  • (+) test: femoral head will slip into the socket with delicate chunk that is palpable not audible
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12
Q

shortening of the thigh is best appreciated by placing both hips in 90 degrees of flexion and comparing height of knees, looking for asymmetry in infants

A

Galeazzi sign

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13
Q

what is the modality of choice in DDH?

A

Ultrasonography

  • before appearance of femoral head ossific nucleus
  • early newborn period (0-4 weeks): PE preferred over UTZ
  • radiographs once femoral epiphysis ossifies
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14
Q

management of patients Barlow and Ortolani positive

A

Pavlik harness

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15
Q

most important complication of DDH

A

avascular necrosis of femoral epiphysis

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16
Q

hip disorder of unknown etiology that results from temporary interruption of the blood supply to the proximal femoral epiphysis –> osteronecrosis and femoral head deformity

A

Legg-Calve-Perthes Disease

17
Q

Stages of Legg-Calve-Perthes Disease

A
  1. initial: lasts months; synovitis, joint irritability and early necrosis of femoral head
    2 fragmentation: lasts 8 months; femoral epiphysis begin to collapse usually laterally and begins to extrude from acetabulum
  2. healing stage: lasts 4 years begins with new bone formation in the subchondral region
  3. residual stage: begins when entire head has reossified
18
Q

most common presenting sign of Legg-Calve-Perthes Disease

A

limp

*routine plain radiograph

19
Q

management of Legg-Calve-Perthes Disease

A

activity limitation, protected weight bearing, NSAIDs and physical therapy

*most common surgical containment procedure is varus osteotomy of proximal femur

20
Q

tilting head to the right or left side in combination of head to the opposite side

A

Torticollis

21
Q

most common etiology of Torticollis

A

congenital muscular torticollis

22
Q

treatment for congenital muscular torticollis

A

stretching, stimulation and positioning measures

23
Q

torticollis associated with GER

A

Sandifer syndrome

24
Q

result from strabismus (weakness of 4th cranial nerve) or superior oblique muscle palsy

A

Ocular torticollis

25
most common infecting organism in Osteomyelitis
Staphylococcus aureus
26
frequently affected bones in osteomyelitis
femur and tibia equally affected
27
imaging of choice in osteomyelitis
MRI is more sensitive than CT *Brodie abscess
28
In neonates with osteomyelitis, what is the treatment of choice?
Nafcillin or Oxacillin and broad spectrum cephalosporin such as Cefotaxime
29
gold standard agent for treating invasive MRSA infections of osteomyelitis
Vancomycin
30
parenteral treatment of osteomyelitis caused by Methicilin sensitive S. aureus
Cefazolin
31
minimal duration of antibiotics for osteomyelitis
21-28 days
32
most common cause of septic arthritis
Staphylococcus aureus
33
important cause of septic arthritis in neonates
Group B streptococcus
34
In neonates with septic arthritis, what is the treatment?
Nafcillin or oxacillin and broad spectrum cephalosporin Cefotaxime
35
most common genetic cause of osteoporosis
Osteogenesis imperfecta
36
triad of Osteogenesis imperfecta
fragile bones blue sclerae early deafness
37
most severe nonlethal form of Osteogenesis imperfecta
Osteogenesis imperfecta type III *results in significant physical disability
38
morbidity and mortality of Osteogenesis imperfecta
cardipulmonary
39
treatment for Osteogenesis imperfecta
Bisphosphonates decreases bone resorption by osteoclast | limit treatment duration to 2-3 years