Musculoskeletal Flashcards

1
Q

What diagnoses SCFE?

A

Radiographs

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2
Q

What salter has fractures require open reduction with internal fixation?

A

Salter 3 and 4

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3
Q

What is gower’s maneuver? Why does it occur?

A

Due to the loss of tone in the core muscles the child walks hands up legs to attain a standing position one getting up. Also suggest pelvic girdle weakness

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4
Q

What is the term for bowleg?

A

Genu Varum

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5
Q

Describe a grade one ankle sprain.

A

Local tenderness, minimal edema, full range of motion present but maybe uncomfortable, patient can wear weight

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6
Q

What arm injury is often associated with a straight, outstretched arm fall?

A

Elbow fracture

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7
Q

When does genu valgum typically resolve?

A

7 years of age

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8
Q

Describe a typical person who has suffered from slipped capital femoral epiphysis?

A

Obese, sedentary, adolescent

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9
Q

What is a lateral curvature of the spine?

A

Scoliosis

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10
Q

How are salter Harrison fractures classified?

A

There are five classifications. They go slipped, above, lower, through, crushed

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11
Q

When is referral needed for Genu Varum?

A

Continues after age 2, unilateral, becomes worse after walking

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12
Q

Until what age is tibial torsion normal?

A

Self resolves by age 4

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13
Q

You see a child with an insidious onset of a limp with knee pain that has migrated to the groin or lateral hip. They are afebrile. What is this disease?

A

A vascular necrosis of the femoral head

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14
Q

What is the classic sign or symptom of Osgood-Schlatter disease?

A

Pain and tenderness at the tibial tubercle

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15
Q

What is the hallmark laboratory change in muscular dystrophy?

A

Markedly elevated creatinine kinase levels

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16
Q

What type of injury occurs in the growth plate of long bones during development as a traumatic injury?

A

Salter Harris fractures

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17
Q

When does a child with Legg-Calve-Perthes Disease need to be referred to orthopedics?

A

When more than one half of the femoral head is involved and in children older than 6 years of age

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18
Q

What is the management of Osgood-Schlatter disease?

A

Limit the activity to control pain and use knee immobilizers if helpful

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19
Q

What is the most common inherited neuromuscular disease in children?

A

Duchesne’s muscular dystrophy

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20
Q

What sign or symptom distinguishes slipped capital femoral epiphysis from avascular necrosis of the hip?

A

There is an acute onset in severe pain causing the inability to emulate or move the hip

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21
Q

When is it appropriate to observe Legg-Calve-Perthes Disease?

A

If the child has full range of motion, is less than 6 years of age and involvement is less than 1/2 of the femoral head

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22
Q

By what age is a child with muscular dystrophy wheelchair dependent?

A

12 years of age

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23
Q

What physical exam finding is found with a vascular necrosis of the femoral head?

A

Limited passive internal rotation and abduction of the hip joint

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24
Q

On assessment a painful limp is seen that is unilateral it was insidious in onset. Also internal rotation of the hip caused a spasm and there were no obvious signs infection on inspection or palpitation. What is this?

A

Toxic synovitis

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25
what is an inflammation of the tibial tubercle as a result of repetitive stressors in patients with immature skeletal development?
Osgood-Schlatter disease
26
what is the spontaneous dislocation of the femoral head both downward and backward relative to the femoral head and secondary to disruption of the epithelial plate?
Slipped capital femoral epiphysis
27
How are salter Harris fractures diagnosed?
X-ray
28
What salter hairs fractures can be casted or splinted with closed reduction?
Salter one and two
29
Describe a grade three ankle sprain.
Complete ligament tearing causing severe pain significant edema and bruising, in the patient is unable to bare weight or rotate the ankle
30
What is Legg- Calve- Perthes disease?
A vascular necrosis of the femoral head
31
Until what age is femoral anterversion normal?
Normal until adolescence (in-toeing)
32
How is a vascular necrosis of the formal head diagnosed?
Radiograph studies
33
What is the most common musculoskeletal injury?
Ankle sprain
34
What is the most common age and race of a vascular necrosis femoral head?
Caucasian, 4-9 years old
35
In the following years what will need to be watched after the repair of an SCFE?
Recurrence in the opposite hip
36
What injury of the arm results in a young child being swung or pulled causing radial subluxation?
Nursemaids elbow
37
What is the most common age range for toxic synovitis?
2 to 6 years old
38
Describe a grade two ankle sprain.
Partial tearing of the ligament causing pain some edema and bruising and pain with weight bearing, decreased range of motion
39
When are radiographs of genu valgum necessary?
Over the age of seven or if unilateral involvement
40
What is seen on the radiograph of toxic synovitis?
They are normal
41
What is an abnormal distance between the medial malleolus in genu valgum?
More than 3 inches
42
What is the fat pad sign?
when no fracture is visible on x-ray the lateral view demonstrates elevation of the anterior and posterior fat pads suggesting presence of a fracture
43
What is a self-limiting inflammation of the hip, most likely due to a viral or immune cause?
Toxic synovitis
44
what is a progressive genetic disorder beginning the lower extremities and progressing to the upper extremities and torso?
Duchesne's muscular dystrophy
45
Is scolio more common in males or females?
Fem
46
When does scoliosis need to be referred to an orthopedist?
If the curvature causes pain, or if the curvature is greater than 25°
47
What physical findings are seen with slipped capital femoral epiphysis?
Limb may be shorter from proximal displacement of metaphysis and the child will likely be unable to properly flex the hip as the femur abducts externally
48
What is the correct term for knock knee?
Genu Valgum
49
What is the Ottawa ankle rule?
Recommendations for x-rays in ankle injuries. there is pain near the malleoli and bone test tenderness is present at the posterior edge, distal 6 cm from the tip of either malleolus or the patient is unable to bear weight for at least 4 steps at the time of injury and evaluation
50
What are the peak ages of Osgood-Schlatter disease?
11 to 14 years associated with their rapid growth spurt
51
What is a normal variant up until the age of two?
Genu Varum
52
What is the most common soldier Harris fracture?
Salter 2 above
53
What will a muscle biopsy show in muscular dystrophy?
Necrotic degenerating fibers
54
What are radiographs used for in scoliosis?
Quantification of the degree of scoliosis
55
What is the classic sign of a nursemaid elbow?
Holding arm across the bunny with the thumb up
56
What is the management of SCFE?
Surgery with an orthopedist
57
What is the management for an ankle sprain?
RICE and NSAIDS
58
What is the general classification for JIA?
Arthritis for more than 6 weeks and yard and 16 years old
59
Is systemic JIA autoimmune or uncontrolled activity of phagocytes?
Phagocytes
60
What are the exam findings of JIA?
Fever, salmon colored rashes, leukocytosis, lymphadenopathy, joint swelling, joint pain, heat and inflammation, loss of range of motion
61
What signifies risk for uvitis in JIA?
Positive ANA
62
Foit promocologic management options for JlA?
NSAIDS, steroids, MTX and biologics
63
What is the age and gender range for SLE?
11 to 12 years and female
64
What are some classic symptoms of SLE?
Joint pain, butterfly rash, mouth ulcers
65
What is the positive lab finding in 97% of children with SLE?
A n a
66
When are steroids most often used in SLE management?
If Reno, cardiac, or CNS involvement