MSK Flashcards
What is slipped capital femoral epiphysis?
Femoral head slips posterior & inferior at the growth plate
Who is slipped capital femoral epiphysis MC in?
7-16 yo
Obese
African American
Males during growth spurt
What are clinical manifestations of slipped capital femoral epiphysis?
High, thigh, or knee pain w/ limp
External rotation of affected leg
How do you treat slipped capital femoral epiphysis?
Non-weight bearing w/ crutches –> ORIF
What is legg-calve-perthes disease?
Idiopathic avascular osteonecrosis of the femoral head in children
Who is legg-calve-perthes disease MC in?
Children 4-10 yo
4x MC in boys
What are clinical manifestations of legg-calve-perthes disease?
Painless limping x weeks (worse w/ continued activity esp. at the end of the day)
Intermittent hip, thigh, knee, or groin pain
Loss of abduction & internal rotation
How do you diagnose legg-calve-perthes?
Hip radiograph
- Early: increased density of femoral head, widening of cartilage space
- Advanced: deformity, crescent sign*
How do you treat legg-calve-perthes?
Obs
Activity restriction w/ ortho follow up
PT
Pelvic osteotomy
What is osgood-schlatter disease?
Osteochondritis of the patellar tendon @ tibial tuberosity from overuse
What is the MC cause of chronic knee pain in young, active adolescents?
Osgood-schlatter disease
Who is osgood-schlatter disease MC in?
Males
10-15yo
Athletes w/ growth spurts
What are the clinical manifestations of osgood-schlatter disease?
Activity-related knee pain/swelling
Painful lump below knee
Tenderness to anterior tibial tubercle
How do you diagnose osgood-schlatter disease?
Radiograph:
- prominence or heterotopic ossification at the tibial tuberosity
How do you treat osgood-schlatter disease?
RICE, NSAIDs, quadriceps stretching
If refractory –> surgery
What is ankylosing spondylitis?
Chronic inflammatory arthropathy of the axial skeleton and sacroiliac joints w/ progressive stiffness
Who is ankylosing spondylitis MC in?
Young males 15-30 yo
What are clinical manifestations of ankylosing spondylitis?
Chronic low back pain, morning stiffness w/ decreased ROM (stiffness decreases w/ exercise/activity)
May radiate to thighs
Peripheral arthritis: sacrolitis (bilateral), kyphosis
How do you diagnose ankylosing spondylitis?
Increased ESR, + HLA-B27
Bamboo spine on xray = squaring of the vertebral bodies
How do you treat ankylosing spondylitis?
NSAIDs, rest, PT
TNF-alpha inhibitor (infliximab), Steroids
