Cheung Part 7 Flashcards
what is scoliosis
lateral curvature greater than 10 degrees, often associated with rotational deformity
who is more likely to have scoliosis more than 20 degrees
females 7:1
what physical exam test is used for scoliosis
forward bend test
what tests are done for scoliosis
full length X-rays to measure vertebral angle
what is the treatment for scoliosis
brace if angle is greater than 30 degrees
surgery if angle is greater than 40-50degrees
what is club foot
idiopathic congenital foot deformity characterized by: plantar flexion of ankle adduction of heel high arch adduction of the forefoot
what physical exams are done in club foot
rule out neurological problems
what is the treatment of club foot
manipulation and casting immediately
surgery if still rigid at 3 years
what is Osgood Schlatter
overuse injury causing apophyseal injury at tibial tubercle
pain over tibial tubercle
what exam and test results are seen in Osgood Schlatter
pain over tibial tubercle
X-rays show fragmentation of tubercle
what is the treatment of Osgood Schlatter
NSAIDs
rest
PT
what is hip dysplasia
malformed hip socket and femoral head
associated with ligamentous laxity, left hip, female gender, breech presentation
what exams are done for hip dysplasia
Barlow and Ortolani exam (can hear hip clunk)
what tests can be helpful in hip dysplasia
ultrasound
what is the treatment of hip dysplasia
Pavlik harness to force relation of hip
casting and surgery in older kids
what is going on in the barlow test
dislocate hip by pushing it in and adducting
what is going on in the ortolans test
relocate hip by pulling it down and abducting
what is Perthes Disease
idiopathic osteonecrosis of femoral head
b/w 4-8 years old
what are the symptoms and exam findings in perches disease
limp and stiffness
decreased INTERNAL rotation and abduction
what are the test results in Perthes Disease
X-rays show sclerosis, coxa magna
MRI can help with diagnosis
what is the treatment for Perthes disease
ROM and bracing
what is a slipped capital femoral epiphysis
displacement of the femoral head through the physis usually during growth spurt
associated with obesity, males, sports, endocrine disrders
what workup must be done is there is bilateral slipped capital femoral epiphysis
endocrine workup
what are the symptoms and exam finding with slipped capital femoral epiphysis
pain with activity
loss of INTERNAL rotation with hip FLEXED
what tests are done for slipped capital femoral epiphysis
AP and lateral X-rays show slip
what is the treatment for slipped capital femoral epiphysis
surgical fixation in situ
what is the normal genu varum/valgum throughout life
start in varum at birth 10-15 deg
by 18 months straightens to 0
maximum valgum of 15deg at age 4
5-10 deg in adolescence
what are the symptoms and exam findings associated with genu varum/valgum
worried parents
measure the knee angle
what tests are done in for genu varum/valgum
weight bearing X-rays if outside normal
what is the treatment for genu varum/valgum
observation
bracing
occasional epiphyseal stapling
osteotomy
what is a tarsal coalition
abnormal connection between tarsal bones
what are the symptoms and exam findings in tarsal coalition
pain, limp, frequent ankle sprains
respricted hindfoot movment
what test are done to tarsal coalition
X-rays will show CALCANEA NAVICULAR coalition
CT scan can confirm
what is transient synovitis of the hip
sterile effusion of the hip causing pain
what are the symptoms and exam finding with transient synovitis of the hip
limp, refuses to walk, groin pain
history of viral infection elsewhere
limp, stiffness, afebrile
what tests are done in transient synovitis of the hip
X-rays show effusion
CBC, ESR, CRP are not elevated
joint aspirate less than 50,000
GETS BETTER WITH NSAIDS
what is the difference b/w transient synovitis of the hip and infectious arthritis
transient synovitis joint aspirate has less than 50,000WBC
infectious arthritis aspirate is more than 50,000 WBC
NSAIDS work for transient synovitis
infectious arthritis needs ABX
