Musculoskeletal Flashcards
Inflammation of the tibial tubercle as a result of repetitive stressors in patients with immature skeletal development.
Osgood-Schlatter Disease
Peak ages for Osgood-Schlatter disease? What is this disease associated with?
11-14
rapid growth spurt
Where is pain located in Osgood-Schlatter disease?
Tibial tubercle
Management of OSD?
Limiting activity
Self-limiting inflammation of the hip, most likely due to a viral or immune cause
Toxic Synovitis
What ages are most affected for toxic synovitis? Who’s affected more, males or females?
Ages 2 - 6
males
Signs of toxic synovitis includes a ______ limp, _____ involvement
Painful limp
Unilateral involvement
What do Xrays and joint fluid aspiration show with toxic synovitis?
NORMAL
When should hospitalization be considered with toxic synovitis?
high fever or septic arthritis is considered
Aseptic or avascular necrosis of the femoral head
Legg-Calve Perthes disease
Onset of limp is ______ in legg-calve-perthes disease and there is pain in the _____.
insidious
knee
In Legg-Calve-Perthes, there is limited ______ ______ ______ and abduction of the hip joint.
passive internal rotation
What is the goal of treatment for LCPD?
To restore range of motion while maintaining femoral head within acetabulum
In LCPD, observation is warranted if the child is less than __ years old, and there is involvement of less than ___ of the femoral head and full ROM is preserved.
6 years old
1/2 of the femoral head
Aggressive treatment is needed in LCPD when more than ___ of the femoral head is involved and the child is older than __.
1/2 of the femoral head
6 years old
Spontaneous dislocation of the femoral head (capital epiphysis) both downward and backward relative to the femoral neck and secondary to disruption of the epiphyseal plate.
Slipped Capital Femoral Epiphysis (SCFE)
Incidence of SCFE is greater among ____ adolescents with _____ lifestyles.
Obese
Sedentary
Where is pain located with SCFE? Where is the pain referred to (2)
Groin
Knee or thigh
In SCFE, you may observe limb _______, resulting from proximal displacement of metaphysis.
shortening
Lateral. bowing of the tibia, often due to joint laxity
Genu Varum (bowleg)
Genu Varum is a normal variant until age ___.
2
When should Genu Varum patients be referred to ortho?
If continued after 2 years of age
Knees are abnormally close and ankle space is increased
Genu Valgum
Genu Valgum typically evolves to normal alignment by age __
7 years
In Genu Valgum, distance between medial malleoli is more than ___ inches.
3 inches
Lateral curvature of the spine that is idiopathic and most common in adolescence.
Scoliosis
Occurs more often in ____ with an 8:1 ratio
Females
In scoliosis, there is ______ of shoulders, ribs, hips, and waistline
Asymmetry
What test can you do to view asymmetry in scoliosis?
Adam’s Forward Bend Test
Lab/diagnostic test for Scoliosis?
XRay
Observation in scoliosis is warranted if less than ____ degree curvature. Refer if greater to this degree of curvature.
25 degrees
Progressive genetic disorder beginning in the lower extremities progressing to the upper extremities and torso
Muscular Dystrophy (Duchenne)
What is the most common inherited neuromuscular disease in children?
Muscular dystrophy
Average age of diagnosis for muscular dystrophy is __ to __ years
3 to 5 years
What is it called when the child “walks” hands up legs to attain standing position when getting up?
Gower’s maneuver
Wheelchair dependence is often seen by age ___ in MD.
12 years
Death from what complication is common in MD?
cardiopulmonary failure
What lab test is markedly increased in affected males?
Creatine Kinase (CK)
Stretching and/or tearing of the ligaments around the ankle, typically involving the lateral ligament complex and is the most common sport injury:
Ankle sprain
Ankle injuries are graded __ to __
1 to 3
Stretching but no tearing of ligament and no joint instability. There is minimal edema with full ROM
Stage 1 ankle injury
Partial (incomplete) tear of ligament; some joint instability but definite end-point to laxity, ROM is limited
Stage 2 ankle injury
Complete ligamentous tearing; joint unstable with no definite endpoint with ligamentous stressing, severe pain, significant edema, profound ecchymoses, no weight bearing or ROM
Stage 3 ankle injury
Radiographs are indicated according to what?
Ottawa Ankle Rule
Ottawa Ankle Rule: There is pain near the _____ AND _____ ______ is present OR the patient is unable to bear weight for at least __ steps at the time of injury
malleoli
bone tenderness
4 steps
Unique to pediatric patients of varying ages, this fracture occurs in the growth plate of long bones during development. Boys are twice as likely as girls to sustain this fracture.
Salter-Harris Fracture
SALTER fracture–SALTER stands for what?
S-slipped A-Above L-Lower T-Through/transverse E- R-Rammed/Ruined (rare)
What is the most common type of SALTER HARRIS fracture
Type II, extending through both they physis and metaphysis
Salter 1 and 2 fractures require _____ _____ and cast/splint
closed reduction
Salter III and IV requires ____ ____ and internal fixation.
Open reduction
Often associated with injuries resulting from straight, outstretched arm falls
Elbow fractures
What does the XR show on elbow fractures?
Fat pad sign
Is there a fracture visible on XR is fat pad sign is present?
No
Common injury in young children resulting from swinging or pulling child’s arm which causes radial head sublaxation
Nursemaid elbow
