Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pediatrics > Musculoskeletal Conditions in Children > Flashcards

Musculoskeletal Conditions in Children Flashcards

1
Q

Hx in children:

A 
birth
age of symptom onset
 family history
 recent illness or injury
pain profile – Faces Pain Scale-Revised, FPS-R
 gait deviations, i.e., limping
 previous interventions
 preferred sleeping and sitting positions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Torsional conditions:

A

internal tibial torsion

external tibial torsion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Tibial torsion

A

measure thigh-foot angle in prone with knee flexed; longitudinal thigh axis and foot angle (FPA).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Internal tibial torsion (ITT)

A

negative value; prone sleeping or sitting on feet (risk factor)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

External tibial torsion (ETT)

A

positive value; associated with medial knee osteoarthritis, osteochondritis dissecans, Osgood-Schlatter syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Femoral anteversion:

A

Comparison of proximal and distal reference axes.

Femoral head lies anterior to frontal plane, excessive medial hip rotation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

IR= 70-80 degrees

A

mild

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

IR 80-90 degrees

A

moderate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

IR=90

A

severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How is femoral anteversion measured?

A

Measure hip rotation in prone, neutral hip, knee 90 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Interventions for Femoral Anteversion

A

Most not proven effective, e.g., bracing, twister cables, special shoes.
Avoid W-sitting, encourage tailor sitting.
Most cases spontaneous improvement without disability or degenerative arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does persistent femoral anteversion (10-14 years) indicate?

A

surgery (derotational osteotomy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Foot Progression Angle (FPA):

A

axis of foot and line of progression.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

FPA:

A

Mean(range): +10 degrees (-3 degrees to +20 degrees).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

In -toeing FPA -5 to -10 degrees:

A

mild

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

In-toeing FPA -10 to -15

A

moderate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

In-toeing greater than -15

A

severe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Differential dx of in-toeing/out-toeing:

A

prematurity, difficult birth, delayed motor skills, worsening over time, asymmetry may be signs of spastic diplegia (in-toeing) or Duchenne’s MD (out-toeing.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Metatarsus Adductus (MTA)

A

Medial curvature of forefoot, slightly valgus hindfoot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Grade I MTA:

A

flexible, resolves 4-6 mos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Grade II MTA:

A

moderately flexible, corrects to midline; Rx: stretching exercises, straight-last shoes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Grade III MTA:

A

severe, no midline correction; Rx: manipulation, serial casting, corrective shoes; surgery if unresolved by 4 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Calcaneovalgus

A

Hindfoot valgus, lateral forefoot curvature, excessive dorsiflexion; resolves spontaneously

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Incidence of calcaneovalgus:

A

bilateral in > 30% of neonates; ‘packaging’ deformity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Angular condition:

A

genu varum

genu valgum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Genu varum:

A

often with ITT, bowlegged and pigeon-toed.

Physiologic genu varum improves after age 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Red flags in genu varum:

A

systemic disorders, e.g., Rickets, if developed after age 4 or worsening over time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Different dx in genu varum:

A

early weightbearing, weight > 95th percentile, African-American, family history; obesity in adolescence.
Tx: observation < 3 yrs; surgery after age 4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Genu valgum:

A

associated with overweight, out-toeing FPA, awkward gait, flat feet; c/o anterior knee pain, patellofemoral instability, circumduction gait, difficulty running

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Secondary impairments in genu valgum or varum:

A

varum or valgum) with torsional malalignment: knee extensor injuries, ITB syndrome, stress fractures, plantar fasciitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

When does the arch develop?

A

2-6 years

32
Q

Flexible flat foot:

A

present in sitting, disappears in standing, arch on tiptoes

33
Q

Talipes Equinovarus (TEV), Clubfoot

A

Congenital deformity – forefoot adductus, hindfoot varus caused by tarsal bone deformities, capsular and ligamentous changes.
shorter foot, smaller calf, flexible heel, decreased talocalcaneal angle

34
Q

Treatment for TEV:

A

Correction for mobility and strength, plantigrade, cosmesis, shoe wear using serial casting, percutaneous tenotomy, bracing (3 mo), night splinting (2-4 yrs) (Ponseti technique

35
Q

Developmental Dysplagia of Hip (DDH)

A

abnormal development or growth due to mechanical causes (36-40 wks).

36
Q

Incidence of DDH:

A

23% of breech presentations,
60% of affected infants are firstborn,
5x more females

37
Q

Red flags for DDH:

A

Postnatal swaddling with ligamentous laxity; high rate of associated torticollis, MTA

38
Q

Red flags for DDH in infancy:

A

limited hip ROM, or at least 5-10o asymmetry after 1 mo, asymmetrical thigh skin folds, +Galeazzi sign, positive Barlow or Ortolani signs until 2-3 mo

39
Q

Interventions for DDH in infancy:

A

Pavlik harness (0-9 mo) - hip flexion and abduction enhances acetabular development, allows kicking that promotes spontaneous reduction

40
Q

Complications of DDH in infancy:

A

AVN of femoral head, femoral nerve palsy, inferior dislocation, erosion of posterior acetabular rim, monitoring through ultrasonography.

41
Q

Red flags for mild DDH:

A

undiagnosed or mild DDH in infants, toddlers without impairments or restrictions

42
Q

Mild DDH 18-24 months:

A

abnormal gait, limp, Trendelenberg sign (unilateral), waddling gait (bilateral).

43
Q

Mild DDH Mid-30’s (women), mid-50’s (men)

A

degenerative hip disease may require total hip replacement; residual hip dysplagia may be associated with osteoarthritis

44
Q

Mild DDH in late teens:

A

degenerative arthritis, hip pain, limp

45
Q

Clinical Dx of Growing pains

A

mild-severe pain in non-articular, bilateral pain in shins, calves, thighs, popliteal fossa; c/o late in day or night, pain-free in morning; episodic

46
Q

Exam of growing pains:

A

no signs of inflammation, r/o more serious conditions; possibly related to rapid growth and joint hypermobility

47
Q

Treatment of growing pains:

A

symptomatic, e.g., massage, stretching, anti-inflammatory meds

48
Q

Idiopathic Scoliosis

A

lateral curvature of spine > 10°
unknown origin, most common form
diagnosed by age of onset: infantile (0-3y), juvenile (3-10y), adolescent (after 10 yrs

49
Q

Adolescent idiopathic scoliosis, AIS – structural scoliosis

A

fixed, visible rotary component with forward trunk flexion.
identified by location and apex of primary curve

50
Q

Why does a compensatory curve develop?

A

keep head and trunk aligned, i.e., convexity to left in cervical or lumbar regions
More than 90% of AIS is Right thoracic or Left lumbar.

51
Q

Monitoring for curves in scoliosis:

A

less than 25 degrees

52
Q

Scoliosis curves treated non surgically:

A

25-40 degrees

53
Q

Scoliosis curves treated surgically:

A

greater than 40 degrees

54
Q

Idiopathic Toe Walking (ITW)

A

Common in new walkers; may be family history

May be associated with soft neurological signs, speech/language, fine/gross motor delays

55
Q

Inverventions for ITW:

A

Exercise program of GAS stretching, dorsiflexor strengthening and gait training.
Night splints, dynamic AFO’s, serial casting for prolonged stretch

56
Q

Septic Arthritis

A

bacterial joint infection that can destroy joint within 48 hours of symptom onset, causing permanent deformities

57
Q

Limping DD birth-5 years:

A

JRA, nonaccidental trauma, hemophilia, discitis, popliteal cycts, bone tumors

58
Q

Limping DD 3-8 years:

A

Kohler syndrome - osteochondrosis of navicular due to temporary loss of blood supply; generally resolves spontaneously

59
Q

Transient Synovitis

A

< 10 years, resolves in 7 days w/ conservative treatment, i.e., limited WB/activity, bed rest

60
Q

Occult fractures

A

usually benign, acute limp, limp or refusal to walk, no history of trauma, infection

61
Q

Osteochondroses

A

5-10 years: – localized necrosis, regeneration during periods of rapid bone growth., Osgood Schlatter; irritation of tibial tubercle; idiopathic cases typically stress related, e.g., repetitive trauma

62
Q

Accessory Navicular

A

Prevalence 10%; Type II (projection from medial navicular) due to repetitive trauma, pain in adolescence

63
Q

Tarsal Coalition:

A

8-12 years; failed segmentation between tarsal bones, e.g., talocalcaneal, calcaneonavicular

64
Q

Tarsal coalition red flags:

A

limited subtalar joint motion (inversion), rigid flat foot causing increased stress on adjacent joints; secondary degenerative arthritis, pain, peroneal spasm

65
Q

Freiberg disease

A

13-18 year old girls, is idiopathic segmental AVN of the second metatarsal head caused by repetitive stress, e.g., running, with micro-fractures

66
Q

Freiberg disease red flags:

A

forefoot pain, swelling localized to 2nd metatarsal, limited MP ROM; treatment with proper footwear, metatarsal pad, limited activity for 4-6 weeks; casting if more severe

67
Q

4 stages of Legg-Calve-Perthes disease

A

inital, fragmentation, reossification, residual

68
Q

Chronic SCFE:

A

most common, hx of limp and pain lasting weeks/months, loss of hip ROM (IR/abd).

69
Q

Acute SCFE:

A

immediate, severe pain and restricted hip IR/abd from significant trauma or minor fall or twisting injury

70
Q

Acute-on-chronic SCPE:

A

sudden epiphyseal slippage with acute symptoms after chronic slip with hip, thigh, or knee aching

71
Q

SCPE red flags:

A

groin pain referred to anteromedial thigh, knee; obesity with knee pain; antalgic gait; limited hip IR/flexion with positioning in ER/shortened

72
Q

PT goal for SCPE:

A

minimize displacement, maintain ROM, prevent joint collapse through activity modification, limiting weight-bearing (AMD); anti-inflammatory meds to prevent degenerative arthritis

73
Q

Sever Disease (calcaneal apophysitis):

A

7-14 year-olds; osteochondrosis of calcaneous due to overuse, repetitive sheer on Achilles tendon causing cartilage fragmentation/avulsion

74
Q

Osteochondritis Dissecans (OD):

A

12-20 year-olds, 2:1 males, active in sports.
Localized necrosis of medial femoral condyle, separation of subchondral bone&raquo_space; revascularization, reabsorption, re-ossification

75
Q

Achondroplasia (dwarfism)

A

2-4.7/10,000, 80% random mutation; most common osteochondrodysplasia.
abnormal limb to trunk length ratio, shorter proximal limb segments, frontal forehead bossing, cuboid-shaped vertebrae may cause narrowing, spinal cord compression

76
Q

Secondary complications of achondroplasia:

A

(20-47%): lumbar lordosis, short tubular bones, pedicles, hands

Pediatrics (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions