MSK part 2 Flashcards
What is another name for Developmental Dysplasia of the hip?
Congenital hip dislocation
What causes Developmental Dysplasia of the Hip?
Excessive hip flexion in utero (breech) causes lax posterior hip capsule musculature which can result in posterior dislocation of the femoral head
What can you observe that may point towards a diagnosis of Developmental Dysplasia of the Hip?
With the hips and knees flexed, the dislocated side will have a lower knee
– Also asymmetric inguinal skin folds
– Also limited abduction
If you see an infant with asymmetric inguinal skin folds or limited leg abduction, what should you be concerned for?
Developmental Dysplasia of the Hip
What 2 maneuvers can help assess for Developmental Dysplasia of the Hip?
Barlow
Ortolani
Describe the Barlow Maneuver
With posterior pressure, adducting the hip causes the femoral head to dislocate
= Audible clunk
Describe the Ortolani Maneuver
With anterior pressure, abducting the hip reduces the femoral head back into the acetabulum with a soft click
Without treatment, what 2 conditions may result from Developmental Dysplasia of the Hip?
Joint contracture
AVN of the femoral head
What is the treatment for Developmental Dysplasia of the hip for < 6 months, 6-15 months, > 15 months?
< 6 months = Splint to maintain F/Abd
6-15 months = Spica cast
> 15 months = Open reduction + Spica cast
At what ages is Legg-Calve-Perthes Disease common in boys?
4-10 years old
What is Legg-Calve-Perthes Disease?
AVN of the femoral head
What are the signs of Legg-Calve-Perthes Disease?
PainLESS limp
Thigh atrophy
Impaired Abduction/IR
Legg-Calves-Perthes Disease - unilateral or bilateral?
Unilateral
What will an XR show with Legg-Calve-Perthes Disease?
Normal or flattened femoral head
If full ROM is present with Legg-Calve-Perthes Disease, what is the treatment?
Observation
If there is decreased ROM present with Legg-Calve-Perthes Disease, what is the treatment?
Bracing or Osteotomy
If a young boy presents with a painless limp, what should you suspect?
Legg-Calve-Perthes Disease
What 2 motions are impaired with SCFE and Legg-Calve-Perthes Disease?
Abduction and IR
SCFE
Slipped Capital Femoral Epiphysis
At what ages is SCFE common in boys? Another risk factor?
OBESE 10-16 year olds
What is SCFE?
Displacement of the femoral head (epiphysis) from the femoral neck through the growth plate
The femoral head remains in the joint capsule with SCFE, but where does it displace?
Medial and Inferior
What else may be present in the obese boys that have SCFE?
Endocrinopathies
What are the signs of SCFE?
PainFUL limp
Inability to bear weight
Impaired Abduction/IR
How will patients hold their leg with SCFE?
ER
SCFE - unilateral or bilateral?
May be bilateral
Painful limp in a teenage boy, what should you suspect?
SCFE
What is the treatment of SCFE?
Surgical fixation and non-weight bearing
What is the child with untreated SCFE at risk for?
AVN and OA
What defines Scoliosis?
Lateral curvature of the spine > 10 degrees
Treatment for scoliosis curve < 20?
Observation
Treatment for Scoliosis curve 20-49 degrees?
Bracing
Treatment for Scoliosis curve > 50 degrees?
Surgery
If Scoliosis is severe enough, what may be a complication?
Restrictive lung disease
