November 12, 2015 - Common Pediatric

Question 1

Ossification Centers in Elbow

Answer 1

- Capitellum

- Radial head

- Medial epicondyle

- Trochlea

- Olecranon

- Lateral epicondyle

Question 2

Pulled Elbow

Answer 2

“Nursemaid’s elbow”

Common in age 1-3, and rarely seen after age 5.

Caused by a sudden pull or extension of the elbow, usually in pronation. Patient will present with not using their arm, no apparent swelling, and with a normal neurovascular exam.

Reduction maneuver is to supinate and flex the elbow and it often completely resolves in 24-72 hours. There is no long-term consequences.

Question 3

Knee Injury in Pediatrics

Answer 3

Instead of having the patellar tendon tear like it would in an adult, often the tendon stays intact but it rips off a piece of bone from the epiphysis on the tibia.

Question 4

Erythrocyte Sedimentation Rate

Answer 4

Is the rate at which red blood cells sediment in a period of one hour. It is a common test and is a non-specific measure of inflammation.

Similar to CRP.

Question 5

Kocher Criteria for Septic Arthritis

Answer 5

Useful for a child with a painful hip.

Criteria include non-weight-bearing on affected side, greater than 40 mm/h sedimentation rate, WBC count of more than 12, and a fever.

With 4/4 = 99% chance of septic arthritis

With 3/4 = 93% chance

With 2/4 = 40% chance

With 1/4 = 3% chance

Question 6

Septic Arthritis

Answer 6

Bacterial infection in a joint.

Hip and knee are the most common, but can also occur in the ankle, elbow, or shoulder.

Treatment is surgical drainage.

Question 7

In-Toeing

Answer 7

Extremely common which is often familial.

Concerns are often raised by parents/grandparents.

Common complaints are tripping, falling, appearence. It is seldom disabling for the children.

There is a range in in-toeing.