MSK Flashcards
Cartilage doesn’t show on imaging, so there may be a fracture if it doesn’t show up on X-ray. Splint pain. If there is pain, splint it, and then try re-imaging a few weeks later and you may see some ossification.
Children can have growth plate fractures where muscle and tendon attaches to bone. Things like swimming, throwing balls, golfing, etc where adults would just get muscle/tendon sprain can cause damage to that insertion growth plate - possibly avulsion.
Children age 8-14 start having transition to more hardened bone, and so therefore slow down with the ability to self-repair bones and may need more interventions in treating/reducing fractures
Metatarsus abductus vs club foot
The first you are able to straighten out manually, and the other needs corrective casting/surgery.
If there is a sacral dimple or tuft of hair, doesn’t necessarily mean a spinal abnormality, but if you’re really concerned, then you can have an ultrasound. Look for developmental delays or any leakage.
What are 3 anatomical abnormalities that can cause in-toe walking
Metatarsus abductus (ankle)
Internal Tibial Torsion (ITT) (shin/knee)
EFA Excessive Femoral Antiversion (hip)
What is Galeazzi sign?
Asymmetry in gluteal folds, skin folds or leg length differences. Can indicate a unilateral DDH problem.
If there is any bruising, swelling or point tenderness, then it is ____ a nursemaids elbow. Only physical exam finding will be _______
NOT
Pain with movement of elbow, or unable to move elbow.
Growing pain risk factors:
Hyper mobility, flat feet, low vit D, emotional factors and social stressors
Growing pains are characterized as
Pain in bilateral LEs, behind knee (no other joints), thigh or calf. Intermittent, >3mo, may awaken them at night. Between 4-8yo, not associated with an injury, no morning stiffness, no limp and PE will be normal. Dx of exclusion.
What is oschgood schlatter?
Tibial apophysitis. Inflammation of the tibial tubercule growth plate due to constant tension on the tibialpatellar tendon.
Treatment for apophysitis:
Rest from exacerbating activity, ice, elevate, NSAIDS. Patellar band, heel cups.
NO crutches or immobilization.
Refer to ortho/PT if not helped with conservative treatment.
T/F: all toddlers and young children have flat feet. They develop an arch during the 1st decade of life.
True.
Difference between “flexible” and “rigid” flat feet.
Flexible - arch is formed when not weight bearing. Usually asymptomatic, but may be symptomatic
Rigid - no arch when not weight bearing. Usually symptomatic.
Red flags for pediatrics back pain
Red flags: history of major trauma, numbness/tingling down extremities, shooting pains down extremities, changes in sensation in the saddle distribution, urinary retention, bowel/bladder accidents, headaches related to pain, seizures
Ongoing fever with recent infection, concerns for brittle bones, history of cancer, recent unexpected weight loss, concern for kidney infection, pain elsewhere, other systemic problems?
