Derm MSK Heme Flashcards
lateral curvature of the spine
scoliosis
When is scoliois treated
Cobb angle >20 degrees
annular ligament dislocated
nursemaid’s elbow
4 y/o F holding wrist with elbow pronated, no swelling or ecchymosis with hx of playing on monkey bars on playground
nursemaids elbow
tx nursemaids elbow
fully supinate then flex forearm vs hand shaking technique
14 y/o M with chronic intermittent pain over anterior aspect of knee. Participates in track during the fall and basketball in the winter. On exam there is soft tissue swelling over tubercle
dx
tx
Osgood-Schlatter’s disease
tx- rest, temporary activity avoidance, NSAIDS, ICE, PT , flexibility
14 y/o obese AAM with hip pain and associated limp
xray shows widineing of physis
SCFE
tx SCFE
immediate non-wt bearing
urgent ortho referral- ORIF
what is Legg- Calve Perthes Dis
idiopathic ischemia leads to avascular necrosis of the femoral head
Insidious onset of hip pain in limp in 7 y/o M. On exam hip has decreased internal rotation.
Xray shows small size ossific nucleus of the femoral head
dx
tx
Legg-Calve-Perthes Disease
Nonwt bearing, ortho consult
Oligoarticular JIA
<= 4 joints
often med to large joints
`uveitis
Polyarticular JIA
> =5 joints
large and small joints
~low grade fever, fatigue, rheumatoid nodules
more chronic and destructive
Systemic JIA
classically high fever 39-40C 1-2 times per day
90% rash when fever present
any # of joints affected
Enthesitis JIA
Males >10 MC LE joints
hallmark: inflamm of tendon insertions (tibial or heel)
TX JIA
1st line NSAIDs- naproxen, ibruprofen, meloxicam
2nd line- methotrexate low dose
RF for congenital hip dysplasia
Fhx, Breech presentation, F>M
W>AA Csection LGA
1st born status ligamentous laxity
What test detects a dislocated hip?
Ortolani- hips abducted- feel reducing back into acetabulum
What test detects unstable hips?
Barlow- adduction, “pistoning”
Tx congenital hip dysplasia
<6m- Pavlik harness
6-12m- manipulation and spica cast
1-2yrs- Open reduction
MC joint injury
inversion sprain of ankle
laterla ligament— primarily ATF
-anterior talofibular band
M with hx of gastroenteritis now with stomatitis and conjunctivitis. Right knee sore and swollen
dx
tx
aspiration sterile
Reactive Arthritis
TOC: NSAIDs
13y/o M with mass and pain in forearm. Xray shows a “sun ray” and triangle
Osteosarcoma
12 M with bone pain. xray demonstrating “onion peel”
Ewing sarcoma
a burn without pain is atleast what degree?
3rd
partial thickness burns are what degree?
2nd
Drugs commonly associated with TEN/SJS
Sulfa Alloprunol Tetracyclines Anticonvulsants NSAIDs
+PCN, cephalosporins, quinolones