childhood conditions 2 Flashcards
infx (discitis, osteomyelitis)
tumor in SC or column
trauma
-ddx for back pain in this age group
Pre-puberty
idiopathic: scheuermann's dz tumor in sc or column trauma inherited Ddx for back pain in this age group
puberty
warning signs for back pain in kids <4yo functional deficiency lasting >4w and 4 more:
antalgic posture
neurological abnormalities
limited ROM
with fever
before MRI was available, 30% of all peds cord injuries with pos neuro findings were called:
SCIWORA
spinal cord injury witho out radiographic abn
best test for discitis, paired with s/s, hx of infx
bone scan
enuresis is not dx until this age
5yo
areas to check for enuresis
S2
LE, pelvis, lumbar, cervical
-myofascial release, nutrition
MC type of genetic obesity
prader willi syndrome
-chrom abn
MC hemolytic anemia, can cause preterm, spontaneous abortion, LBP, stillbirth, perinatal mortality
sickle cell anemia
must do this if childhood HA is: acute, worst/thunderclap, chronic and progressive, neuro sx, abn eye movements, hemiparesis, ataxia, abn reflexes, NF, heart, vomits on awakening
imaging
sudden/severe HA lasting up to 60 sec, possible sign of subarachnoid hemorrhage, trauma, stroke
thunderclap HA
-check T12 only
childhood migraine criteria
5+ lasting 1-48h
- have at least 2 of: bilat/unilat, pulsating, mod-sev, exac by routine activities
- accomp by at least 1: n/v, photo/phonophobia
CT autoimmune dz with polyarticular joint inflam, req davis series due to inc ADI, transverse lig instability
RA
three types of JRA
____: 5-10yo, 10%
____: 2yo, 40-60%
____: 1-3yo, 30-40%
systemic
pauciarticular
polyarticular
adult with “old” JRA
JCA
spine infx that causes rapid disc space loss, without osteophytes, DDD, pre-vert ST swelling
spondylitis
ddx: mets (preserved disc space)
4 seronegative spondyloarthropathies
(Rh-, HLA B27 +) Mc older
AS (MC)
PA
reiter’s
enteropathic arthritis
MC seroneg spondyloarthrop, and its DDX
cant see cant pee cant dance with me
AS
ddx: OCI
- can’t adjust bamboo spine, maybe inc ADI
wedging of 5* or more of 3 vert (T7, 8, 9)
sceuermann’s dz
female triad
osteoporosis
ED
amenorrhea
pn at prox lat humerus, xray shows epiph widening, fragmentation, sclerosis
little league shoulder
irritation/inflam/degen of shoulder tissues
impingement
sulcus sign, hill sachs, bankart lesion on xray all indicate
shoulder dislocation
extensor carpi radialis brevis indicated in
lateral epicondylitis
ulnar collateral ligament indicated in
-tommy john surgery
medial epicondylitis
ant disloc of radial head
ulnar fx
Together known as
Monteggia Frx
FOOSH can cause
scaphoid fx/disloc
bennett’s fx is a broken:
thumb
ulnar collat lig of MCP 1 jt
skier’s thumb
-FOOSH with abd thumb
AVN of met head 2
freiberg
AVN of navicular
kohler
heel pn, often in soccer
sever dz
boxer’s/barroom fx
metacarpal 4/5 fx
shin splints aka
medial tibial stress syndrome
pars defect/frx w/o anterior slippage, 90% L5, MC white males
scottie dog
spondylolysis
MC type of spndylolisthesis
isthmic
spondys I II III IV V
dysplastic *5* isthmic *MC* traumatic degenerative *L4* pathologic
MC type of salter harris frx, thurston hollon sign
above epiphys plate
type 2 (A)
salter harris phys frx straight across the epiphs plate
type 1 (S)
older children, salter harris frx, starts thru GP and goes beLow
type 3 (L)
salter harris goves starts above GP and exits Thru joint cartilage
type 4 (T)
growth plate crushed in salter harris frx, most concerning prognosis (ERasure of gp)
type 5 (ER)
4 stages of AVN
avascular -> ____ -> repair -> _____
revascularization
deformity
subchondral bone collapse on xray is seen in ____ sign and the healing phase with osteoblastic activity in a fuzzy mushy appearance is ___ sign
crescent
snow cap
PLASTICRAGS acronym for avn(?)
Pancreatitis/preg LCP, lupus Alcoholism/atherosclerosis Steroids Trauma Idiopathic/infx Caisson/collagen dz RA/radiation Amyloid Gaucher dz Sickle cell anemia
segmental AVN presents with clicking, locking, limited ROM, swelling, pn on ROM, floaters
OCD
MCC of BP in athletic teenages
facet tropism
_____ is assoc with klippel feil and arnold chiari malform, scap winging
sprengel’s deformity
MCC of death in children
accidents
