EM musculoskeletal Flashcards
When the hip is involved in infectious arthritis, the affected leg is usually kept in the most comfortable position. The pain may be perceived at a site distal to the actual infection. _____ can confirm joint effusion and is a useful guide for diagnostic arthrocentesis.
An ultrasound study. Elevations in peripheral WBC and C reactive protein are common, but they are non-specific. Radionuclide scans have limited value in diagnosis making but may indicate coexisting osseous infection. Plain radiographs are not helpful in the diagnosis of infectious arthritis.
is an osteochondrosis seen commonly in the older child entering the pubescent growth spurt, is a common cause of heel pain. Mechanical stress and excessive tension on the growing calcaneal apophysis is considered the mechanism of injury.
Sever disease. This stress causes microfractures and sets up inflammation and a subsequent healing response. Symptoms wax, wane, and tend to subside as the skeleton reaches maturity.
____ typically presents in obese or rapidly growing adolescent males, usually between the ages of twelve and fifteen. It may occur from an upward blow through the femoral shaft, but is generally not associated with any significant trauma. Radiographic findings include widening of the epiphyseal plate in the pre slip condition, and frank slippage of the femoral neck in relation the capital epiphysis.
Slipped capital femoral epiphysis (SCFE)
Pain in the right groin area, a 2-week history of limp, and limited abduction of the right hip in an afebrile 5-year-old boy is consistent with _____. It occurs primarily among boys aged 3 to 10 years and it often presents clinically following a minor fall or accident. It is noted initially as a ‘painless limp’ that worsens over time.
Legg-Calve-Perthes disease (LCPD). The diagnosis is obtained by an anteroposterior and frog-leg radiograph of the pelvis. Generally, management of patients who have LCPD consists of maintaining the femoral head within the acetabulum using surgical and/or nonsurgical methods until the femoral head has reossified.
____ is an autosomal dominant condition that can include arthropathy and epiphyseal dysplasia. Associated ocular problems include myopathia, open-angle glaucoma, cataracts, and retinal disorders.
Stickler syndrome. Children who have this syndrome also frequently have cardiac defects or craniofacial findings consistent with the Pierre-Robin sequence.
the incremental muscle response on rapid repetitive stimulation, are characteristic to the disease caused by the toxin of ______. It can occur at any age during childhood, but the mechanism is varying. Infants under 1 year of age can ingest the spores, which survive in the gut and produce toxins (floppy baby syndrome). In older age groups, the toxin is ingested with improperly prepared or stored food.
clostridium botulinum (botulism)
Classic findings of _____ include insidious onset of proximal muscle weakness; stiff, sore and/or indurated muscles; respiratory difficulty, nasal regurgitation, nasal voice, and/or aspiration due to involvement of palatorespiratory muscles; skin lesions, which are typically violaceous erythema on upper eyelids; a butterfly malar facial rash; and atrophic, scaly, erythema on the extensor surfaces of joints.
dermatomyositis
_____ refers to a group of diseases that have the following 4 criteria: (1) it is a primary myopathy; (2) it is hereditary; (3) it follows a progressive course; (4) degeneration and death of the muscle fibers occur.
Muscular dystrophy. Dermatomyositis is a nonhereditary myopathy. Although this patient has muscular weakness, the lack of family history and the presence of the characteristic rash lead one to the diagnosis of dermatomyositis.
