Ch 10 - Peds: Bone and Joint Diseases Flashcards

1
Q

What are treatments for club foot?

A

Physical therapy
Bracing
Serial casting
50% require surgical correction

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2
Q

What is bowleg?

A

Genu varum

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3
Q

What is Blount’s disease?

A

Tibia Vara d/t ABN function of the medial portion of the proximal tibial growth plate and results in bowing in the proximal tibia

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4
Q

What is the MCC of bowing in young children?

A

Blount’s disease

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5
Q

Who is Blount’s disease MC seen in?

A

Obese children who walk at 9 to 10 months
African Americans
Suspected in children with bowing >2yo

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6
Q

What is the treatment of Blount’s disease?

A

Osteotomy of the proximal tibia and

fibula

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7
Q

Describe the Galeazzi (Allis) Test.

A

Flex hip and knees bilaterally, looking at the level of the knees and low knee indicates that hip dysplasia

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8
Q

What is the olive sign?

A

Soft, nontender enlargement of the SCM within the first 6 weeks and subsides within 4 to 6 months of age

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9
Q

What is seen on exam in Congenital Torticollis?

A

Flattening of the ipsilateral face
Contralateral occipital flattening
Orbital asymmetry (plagiocephaly)
Ipsilateral hip dysplasia

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10
Q

What is the MCC of Congenital Torticollis?

A

Fibrosis of the SCM

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11
Q

Describe right torticollis.

A

Head is tilted to the right shoulder with the chin rotated to the left.

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12
Q

What are treatments of congenital toricollis?

A
  1. Stretch SCM 15-29x/day
  2. Position head to encourage ipsilateral superior gaze to strengthen muscles
  3. Put mobile on right side of the crib in right torticolis
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13
Q

Describe Nursemaid’s elbow.

A

Radial head and neck are displaced distal to the annular ligament d/t longitudinal pull or sudden traction applied to the upper extremity

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14
Q

What is the treatment for Nursemaid’s elbow?

A

Reduction usually is achieved by supination and extension of the forearm

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15
Q

What is Little Leaguer’s elbow?

A

Repetitive traction stress on the apophysis of the medial epicondylar ossification center of the humerus from repetitive valgus stress

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16
Q

What is Osgood-Schlatter’s Disease (OSD)?

A

Traction apophysitis of the anterior tibial turbercle typically seen in active adolescent boys>girls

17
Q

What is the most common cause of limping and pain in the hip of children?

A

Transient (toxic) synovitis of the hip

18
Q

What is Legg-Calvé-Perthes disease?

A

AVN of the proximal femur d/t rapid growth in relation to blood supply

19
Q

What is onset of Legg-Calvé-Perthes disease?

A

4-10yo

Boys> girls (4:1)

20
Q

What is the clinical presentation of Legg-Calvé-Perthes disease?

A

Pain in groin and radiates anterior/medial thigh toward knee
Dec internal rotation, extension, and abduction

21
Q

What is the treatment of Legg-Calvé-Perthes disease?

A

Abduction brace
Retain spherical shape of the femoral head
Continue WB with the femur in abducted position so that the head is well contained by the acetabulum
Surgical: varus osteotomy

22
Q

What is Slipped capital femoral epiphysis (SCFE)?

A

Separation of proximal femoral epiphysis through the growth plate

23
Q

What is the onset of Slipped capital femoral epiphysis (SCFE)?

A

9 to 15 years
Boys > girls
Blacks > whites

24
Q

What is the clinical presentation of Slipped capital femoral epiphysis (SCFE)?

A

Dec internal rotation, abduction
Affected leg in external rotation
Endomorphic habitus

25
Q

What is the treatment of Slipped capital femoral epiphysis (SCFE)?

A

Surgical pinning

26
Q

What is the cause of 80% of scoliosis?

A

Idiopathic

27
Q

What is the curve pattern in infantile scoliosis?

A

Left thoracolumbar

28
Q

What is the curve pattern in juvenile scoliosis?

A

Right thoracic or double curve

29
Q

What is the curve pattern in adolescent scoliosis?

A

Right thoracic 1

Right thoracic/left lumbar 2

30
Q

What is the treatment of idiopathic scoliosis?

A

1–20°: Observation
20–40°: Brace
>40°: Surgery

31
Q

What is the treatment of neuromuscular scoliosis?

A

1–20°: Observation

20–40°: Surgery

32
Q

What is the treatment of scoliosis in CP?

A

1–20°: Observation

>40°: Surgery, may wait until 60° in some cases

33
Q

What is Scheuermann’s disease?

A

≥3 consecutive thoracic vertebrae are wedged >5°

34
Q

What is the MCC of Spondylolisthesis in children?

A

Dysplastic and isthmic types

Occur MC at L5–S1 and then at L4–L5

35
Q

What is isthmic spondylolisthesis?

A

Vertebral body slippage d/t spondylolysis from fx of the pars interarticularis

36
Q

What is dysplastic spondylolisthesis?

A

Congenital malformation of the facet joints at the lumbosacral junction with pars elongation or attenuation