Cheung Part 8 Flashcards
what is the most common elbow fracture
supracondylar fracture of the humerus
supracondylar humerus fracture affects who and what symptoms are seen
2-12 year olds
fall off trampoline, elbow deformity, pain
what exam and tests are important when dealing with a supracondylar humerus fracture
neurovascular exam important
X-rays show supracondylar fracture
postive posterior SAIL SIGN
what are the symptom and exam results seen in rickets
pain in legs
bowed legs
what is seen on an X-ray of rickets
looser lines (osteoid seam) widened growth plates
what lab results are seen in rickets
low normal serum Ca
Phos is low
what is the treatment of rickets
nutritional supplementation
treat underlying cause
the hypertrophic zone in rickets is what size
large
the sun produces what in the vitamin D pathway
7-dehydrocholesterol
7-dehydrocholesterol becomes what in the vitamin D pathway
cholecalciferol (vitamin D3)
what happens to cholecalciferol (vitamin D3) in the liver
becomes 25-hydroxyvitamin D3
what happens to 25-hydroxyvitamin D3 in the kidney
1,25-dihydroxyvitamin D3
as one goes from epiphysis to metaphysis in the growth plate what happens
germinal zone (nearest epiphysis) proliferative zone zone of maturation hypertrophic zone bone (metaphysis)
what is the most common bone broken in non-accidental trauma
humerus (then femur)
metaphyseal corner fractures are commonly seen in what
child abuse
what are risk factors for child abuse
low income first born premature stepchildren handicapped single parent drug use unemployed parents abused parents
what types of injury should one suspect child abuse
spiral fractures
posterior rib fractures
metaphyseal corner fractures
what is the Salter Harris classification of bone fractures
type I: through growth plate
type II: growth plate and metaphysis
type III: growth plate and articular epiphysis
type IV: growth plate meta and epiphysis
type V: crush injury damaging growth plate
what is acute joint effusion
monoarticular or oligoarticular
systemic symptoms: JIA, Lyme, Septic
Sometimes painless
what is cerebral palsy
permanent, non-progressive brain injury in permpartum period
what is seen in cerebral pals
upper motor neurons issue with spasticity
hemiplegia
diplegia
when should one be suspicious of cerebral palsy
patient with delayed motor development
history of prematurity
prolonged NICU stay
toe walking
the hypertrophic zone in growth place of achondroplasia is what
narrow
musculoskeletal issues in achondroplasia typically arise where
spine
marfan syndrome is due to what
fibrillin mutation
defect in collagen I osteoblasts
what is seen in marfan syndrome
caved chest
really long fingers and narrow bones
hypermobile thumb
what is the treatment for osteogenesis imperfecta
bisphosphonates
surgery
what are the symptoms of osteogenesis imperfecta
blue sclerae macrocephaly hearing loss poor dentition kyphoscoliosis fracture growth retardation
