Musk Flashcards
When would intervention be required for genu Varus (bow leg)
When unilateral, worsens after age 1, does not resolve by 2 yrs of age
Ddx includes rickets and Blount disease
Salter Harris type 1 presentation and tx
Fracture through the physis
Cast 2-3 wks
Salter Harris type 2 presentation and tx
Fracture through the metaphysis and physis
Closed reduction casting 3-6 wks
Salter Harris type 3 presentation and tx
Fracture through the growth plate extending to the epiphysis into the joint space
Open reduction may be needed
(Type 3 is worse!)
Salter Harris type 4 presentation and tx
Fracture through all layers
Requires reduction in OR
OI type I
Autosomal dominant
Blue sclerae, fractures during preschool years
Hearing loss by the time they are adults
OI type 2
Usually lethal, most severe
Dominant new mutation or germinal mosaicism
Born with multiple fractures
Rarely live past postnatal period
OI type 3
Born with fractures and deformities are progressive
Gray sclera at birth and lighten over time
Microcephaly and short stature
OI type 4
Fractures in preschool years not before
WHITE sclera (not blue)
What other condition can congenital torticolis be associated with
Hip dysplasia
What is klippel-feil syndrome
Fusion of the cervical vertebrae
Presents as congenital torticollis, short neck and low occipital hairline
Associated findings with klippel-feil syndrome
Scoliosis, Spina bífida, renal problems, sprengel deformity, deafness
Risk factors for DDH
Breech, family Hx of DDH, female, first born, oligohydramnios
How do you assess for DDH after 3 months of age
Limitations in hip abduction
Unequal knee height (galeazzi)
Asymmetric gluteal folds
Common pathogens for septic arthritis in neonates, infants/children, adolescents
Most common is staph aureus
Neonates - group b strep and ecoli
Infants/kids - strep pneumonia, group a beta hemolytic strep, h. Flu
Teens - n. Gonorrhea
Tx for septic arthritis based on age
Neonates - cloxacillin/gent
Infants to 3 mo- cefuroxime or cefotaxime
Kids - cefazolin (ancef)
Adolescents - ceftriaxone or cefixime (Suprax) and need to add azithromycin to cover GC
If MRSA - vancomycin
If sickle cell - cefotaxime (claf) to cover salmonella
Screening workup for congenital scoliosis
Renal ultrasound and cardiac echo
Spinal MRI
Tx for scoliosis based on curvature
<25 degrees - observation
25-40 degrees- bracing
>40 - surgery
What is scheuermann disease
Fixed kyphosis which presents at puberty. Round back and back pain
Kyphosis is abnormal when above 60 degrees
When is toe walking a problem
Persists after age 2-3 yrs and when unable to put the heel down at rest
What conditions do you think of in kids that initially walk normally and then later develop toe walking
Muscular dystrophy, Charcot Marie tooth l, hereditary neuropathies
What is sprengel deformity
Failure of the scapula to descend to its normal position during fetal development
If a pt with JIA has a positive rheumatoid factor what is this associated with
Bone erosions
If a patient with JIA has a positive ANA this is asociares with a higher risk of what
Uveitis (iridocyclitis)
