Exam 2 - Pediatric ortho diagnoses

Question 1

What is nursemaid’s elbow?

Answer 1

There is displacement of the annular ligament between radius and ulna

• From swinging child by arms or pull on kids arm to get them to go with you

Question 2

How would the child present if they have nursemaid’s elbow?

Answer 2

Non painful at first, but will begin to endorse pain after awhile

• Won’t let anyone move their arm
• Don’t want to use their affected arm
• Might hold in flexed position (won’t let anyone pull elbow down)

Question 3

Physical exam findings with nursemaid’s elbow

Answer 3

• Tenderness to palpation at radial head
• Resistance with supination

Question 4

Slipped capital femoral epiphyses management

Answer 4

Non weight bearing

• More common in overweight males

Question 5

What is Legg Calve-Perthes?

Answer 5

Avascular necrosis of the head of femur

Question 6

How would a child present if they have Legg Calve-Perthes?

Answer 6

• Presents with hip pain
• Seen with trendelenburg sign

Question 7

What commonly causes osteomyelitis in children?

Answer 7

Break in skin where pathogens can enter and end up infecting the bone

Question 8

What is congenital vertical talus?

Answer 8

Extreme flat foot

Question 9

What is talipes equinovarus?

Answer 9

Clubfoot

Question 10

What is metatarsus adductus?

Answer 10

Top of foot points inward

Question 11

What is calcaneovalgus foot?

Answer 11

Foot is in extreme dorsiflexion

Question 12

Causes of leg limp in children

Answer 12

• Leg length inequality
• Development dysplasia of hip
• SCFE
• Etc.

Question 13

Antalgic gait

Answer 13

Shortened stance due to pain in extremity or spine

Question 14

Trendelenburg gait

Answer 14

Abductor lurches, so there is shifting of the trunk and shoulders to effected side

• From hip cause

Question 15

Equinus gait

Answer 15

Instead of heel striking the foot first, the front of the food strikes first

• Causes: contracture of heel, leg length discrepancy

Question 16

Circumduction gait

Answer 16

Leg swings out

• Cause: leg is longer, spasticity

Question 17

Common sites of overuse injury in pediatrics

Answer 17

Little League shoulder

• Proximal humeral epiphysiolysis
• Varus overload of elbow

Question 18

Overuse injury management

Answer 18

Rest (children are skeletally immature)

Question 19

What causes Osgood-Schlatter disease?

Answer 19

Seen in knees of children who underwent rapid growth over months

• Swelling and pain over tibial tubercle

Question 20

Osgood-Schlatter management

Answer 20

Typically goes away on its own in 12-18 months (when they stop growing)

• NSAIDs

Question 21

What is patellofemoral syndrome? How would you manage this?

Answer 21

Anterior knee pain

• NSAIDs
• Rest
• Quadricep strengthening