Musculoskeletal Flashcards
Genu varum
African American
Not rickets
Overweight (adolescent)
Medial Metaphyseal angulation (breaking)
Blount’s disease
Fracture through physis
Separation of epiphysis and metaphysis
Management
Salter Harris type 1 fracture
Cast x 2-3 weeks
Fracture through physis and metaphysis
Management
Salter Harris type 2
Closed reduction casting x 3-6 weeks
Fracture physis and epiphysis
Management
Salter Harris type 3
ORIF
Fracture though physis, metaphysis, epiphysis
Management
Salter Harris type 4
ORIF
Growth plate fracture
Crush injury
Microvascular compromise
Salter Harris type 5
FOOSH
fracture on one side of bone and not on other side
Greenstick fracture
Mutation in COL1A1 and COL1A2
Fractures
Blue/gray sclera
Triangular face
Macrocephaly
Large anterior fontanelle
Pectus excavatum or carinatum
Osteogenesis imperfecta
Osteogenesis imperfecta
Most common type
Autosomal dominant
Preschool
Hearing loss
Type 1
Osteogenesis imperfecta
Most severe
Lethal. Stillborn
Germinal
Mosaicism
Multiple fractures (“bag of bones”)
Type 2
Osteogenesis imperfecta
Progressive deforming type
Fractures
Wormian bones
Codfish vertebrae
Type 3
Osteogenesis imperfecta
White sclera
Type 4
Osteogenesis imperfecta
Progressive calcification
No blue sclera
Type 5
Mass in sternocleidomastoid muscle
Head tilted
Congenital torticollis
Associated with developmental dysplasia of the hip
Fusion of cervical vertebrae
Short neck
Low Occipital hairline
Scoliosis
Spina bifida
Renal problems
Sprengel deformity
Deafness
Klippel-Feil syndrome
Failure of scapula to descend to normal position during fetal development
Sprengel deformity
Risk factors for developmental dysplasia of hip
Female (#1)
Breech positioning
Family history in first degree relative
Improper swaddling methods
Diagnosing developmental dysplasia of hip
< 3 mo - ortalani/barlow
> 3 mo - limitations in hip abduction
< 4 mo (> 6wk) - US
> 4 mo - Xray (frog leg)
Treatment for developmental dysplasia of hip
Pavlik harness
Weakness/tenderness to muscle
Elevated CK
Recent URI
Viral myositis
Recent URI
Hip
Hip pain or limp
Normal ESR
Transient synovitis
Fever
Won’t walk or move extremity
Leukocytosis
Elevated ESR
Increased joint space on Xray
Warm, red, swollen joint
Positive gram stain
Septic arthritis
Treatment for septic Arthitis
Joint aspiration
IV antibiotics
Most common bacteria for septic arthritis
Staph aureus
Septic arthritis
Sickle cell
Salmonella
Cefotaxime
Osteomyelitis
Sickle cell
Salmonella
Osteomyelitis
Nail
Pseudomonas
Avascular necrosis of femoral head
Hip pain
Limping
4-10 yo
One femoral head smaller than other
Legg-Calve- Perthes disease
Hip/knee pain
Limp
Leg extended and externally rotated
Male. Obese
Slipped capital femoral epiphysis
Pain below patella
Athletic adolescent
Excessive activity
Pain with knee extension against resistance
Osgood-Schlatter disease
(Tibial tuberosity apophysitis)
Osgood-Schlatter disease
Heel
Sever’s syndrome
(Calcaneal apophysitis)
Fluid-filled cysts
Not precancerous
Asymptomatic
Diagnosed as pathological fracture
Simple (unicameral) bone cyst
Painful bone cyst
Associated with underlying tumor
Can cause nerve compression if on vertebra
Aneurysmal bone cyst
Hypermobile
Poor wound healing
Easy bruisability
Ehlers-Danlos syndrome
Management for idiopathic scoliosis if
A) Curvature < 25 deg
B)Curvature 25-40 deg + > 2 yr of growth still expected
C) curvature > 40 def
A) Observation
B) Bracing
C) Surgery
Fixed kyphosis
Puberty
Distended abdomen
Scheuermann disease
Pulled by the arm
Not using arm
Arm held close to body
Elbow flexed
Forearm pronated
Nursemaid’s elbow
3 causes of intoeing
Metatarsus adductus in infancy
Tibial torsion in toddlerhood
Femoral anteversion in early childhood
Broad-based mass originating from surface of bone
Projective away from joint
Osteochondroma
Observation only
Scoliosis management
< 20 deg - normal activity
25-45 deg - bracing
> 45 deg - spinal fusion or rod
Mature peripheral ossification with a distinct margin surrounding a radiolucent center of immature osteoid and primitive mesenchymal tissue.
Heterotopic ossification
