Ortho Flashcards
SCFE - associated conditions + concerning complication
Associated conditions: Obesity, hypothyroidism, GH deficiency, panhypopituitary, Down’s syndrome, renal osteodystrophy
Complication: Osteonecrosis
Non-painful limp in a toddler (<4 years old) - only x3
- DDH
- Congenital limb deficiencies
- Neuromuscular conditions
Non-painful limp in a child (4-10 years old)
- DDH
- Congenital limb deficiencies
- Neuromuscular conditions
- Leg length discrepancy
- Discoid meniscus
Non-painful limp in an adolescent
Limb length discrepancy
Painful limp in an adolescent
- SCFE
- JIA
- Overuse injuries
- OM
- SA
- Tumors
- Discoid meniscus
- Osteochondritis dissecans
- Trauma
Painful limp in a child (4-10 years old)
- SA
- OM
- Transient synovitis
- Discitis
- JIA
- Trauma
- Perthes
- Overuse injuries
- Osteochrondritis dissecans
- Tumors
Painful limp in a toddler (<4 years old)
- Toddler’s fracture
- OM
- SA
- Transient synovitis
- Reactive arthritis
- JIA
- Tumors
What is a Monteggia fracture dislocation?
Ulna # + radial dislocation
What do you need to consider when evaluating an elbow concern?
CRITOE = ossification centers
Mechanism + treatment for buckle fracture?
- Outstretched hand
- Splint
Mechanism + treatment for greenstick fracture?
- Outstretched hand, lots of force + unstable
- Closed reduction + casting
What is this + treatment for plastic deformation?
- Bending without breaking
- Splint
What bone lesions (x3) do you think about that are central?
- Enchondroma
- Fibrous dysplasia
- Simple bone cyst
- Ewing sarcoma
DDH investigations
- Screening serial physical exams
- Dynamic ultrasounds
- XR = AP/frogleg
What bone lesion is a cortical defect?
Osteoid osteoma
What bone lesions are metaphyseal in location?
Osteochondroma OM Osteosarcoma Non-ossifying fibroma Unicameral bone cyst
How to remember SALTER Harris classification of physeal fractures?
S = straight through A = above L = lower T = through ER = ram
Symptomatic treatment of overuse syndromes?
- NSAIDs
- Rest + activity modification
- PT
- Stretches and training changes
x4 types of scoliosis
- AIS
- Congenital
- Infantile
- Neuromuscular
What x2 important approach questions must you think about for AIS?
- How older are they?
2. How much growth do they have left?
After menarche, how many more years of growth does an individual have?
2 years
Red flags for scoliosis on history + physical?
- History: pain, gait changes, weakness, rapid progression, bowel/bladder symptoms
- Physical: foot deformity, kyphotic thoracic spine, abnormal reflexes, abnormal pattern, signs of dysraphism
What curve characteristics + physiologic age characteristics put AIS at risk for progression?
- Curve: larger, thoracic, double primary curves
- Physiologic age: based on menarche, Risser grade