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Peds EOR > Ortho > Flashcards

Ortho Flashcards

1
Q

what 3 things should you think about if you think someone has AVN

A

trauma, steroid use, or sickle cell

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2
Q

AVN in kids is called

A

Legg-Calve’ Perthes disease

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3
Q

sx Legg-calve perthes

A

acute or insidious onset of hip pain and/or limp which is worse w activity

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4
Q

PE for Legg-calve perthes

A

decreased abduction & internal rotation

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5
Q

what will radiographs show for Legg-calve perthes

A

early - increased density and smaller appearance of the femoral epiphysis

advanced - deformity, positive crescentic sign

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6
Q

tx Legg-calve perthes

A

observation - activity restriction - self-limiting within 2 years

pelvic osteotomy if > 8

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7
Q

when is exam of the hip in newborn performed

A

at every well visit until 9 months

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8
Q

biggest RF for dysplasia of the hip

A

breech presentation

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9
Q

what two maneuvers can you do to assess for hip dysplasia

A

ortolani - abduction and elevation - reduces the hip

Barlow - gentle adduction without downward pressure – dislocates the hip

galeazzi test - flex hip and knees so that ankles are near buttocks; test is positive if knees are at different heights

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10
Q

tx dysplasia of the hip

A

< 6 mos - pavlik harness
6mos - 2 years: closed reduction

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11
Q

how old do you have to be to be diagnosed wit juvenile idiopathic rheumatoid arthritis

A

< 16

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12
Q

how long do sx have to last to be diagnosed with juvenile rheumatoid arthritis

A

> 6 weeks

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13
Q

3 types of juvenile idiopathic rheumatoid arthritis

A

systemic (still’s disease)

oligo (pauci) articular

polyarticular

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14
Q

what is systemic (still’s disease) for JRA

A

daily or diurnal high fever
salmon-colored pink migratory rash on trunk and extremities

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15
Q

what is oligo (pauci) articular for JRA

A

< 5 joints involved
idiocyclitis (anterior uveitis)

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16
Q

what is polyarticular for JRA

A

5 or more small joints
most similar with adult RA (usually have morning stiffness)
iridocyclitis (anterior uveitis)

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17
Q

dx JRA

A

clinical
elevated ESR and CRP

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18
Q

tx JRA

A

NSAIDs

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19
Q

what is the MC primary bone malignancy in kids and young adults

A

osteosarcoma

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20
Q

where does osteosarcoma MC metastasize to

A

lungs

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21
Q

sx osteosarcoma

A

bone pain worse at night

22
Q

tx osteosarcoma

A

radiographs - hair on end or sunburst appearance

biopsy - definitive

labs - increased alkaline phosphatase

CT to evaluate lungs

23
Q

tx osteosarcoma

A

neovascular - chemo + surgical removal w amputation

not neovascular - limb-sparing resection

24
Q

what is the second MC primary bone malignancy in kids and young adults

A

Ewing sarcoma

25
Q

where is Ewing sarcoma MC located

A

50% found in the diaphysis of the long bones - femur MC then pelvis

26
Q

sx Ewing sarcoma

A

localized bone pain and swelling

27
Q

dx Ewing sarcoma

A

radiographs - multilayers periostea reaction with an onion skin/peel appearance or a moth-eaten appearance

28
Q

what lab carries prognostic significance for Ewing sarcoma

A

LDH

29
Q

tx Ewing sarcoma

A

chemo following by limb-sparing resection when possible

30
Q

MC benign bone tumor

A

osteochondroma

31
Q

dx osteochondroma

A

XR - pedunculated – grows away from the growth plate

32
Q

tx osteochondroma

A

observation

33
Q

nursemaid’s elbow is also called

A

radial head subluxation

34
Q

when is nursemaid’s elbow MC

A

kids 2-5 yo

35
Q

mechanism for radial head subluxation

A

lifting, swinging or pulling a child while forearm is pronated and extended

36
Q

dx nursemaid’s elbow

A

radiographs

37
Q

tx nursemaid’s elbow

A

closed reduction via hyperpronation or supination/flexion method

can repeat two times

38
Q

osgood schlatter disease is also called

A

tibial tuberosity avulsion

39
Q

osgood-schlatter disease is due to

A

inflammation of the patellar tendon at the insertion of the tibial tubercle due to overuse or small avulsions from repetitive knee extension and quad contraction

40
Q

sx osgood-schlatter disease

A

activity-related anterior knee pain and swelling
relieved with rest

may have bony prominence, swelling, and tenderness to the anterior tibial tubercle

41
Q

tx osgood-schlatter

A

conservation - rest, ice, elevation, NSAIDs, stretching etc

42
Q

kyphosis vs lordosis

A

kyphosis - humpback

lordosis - sway back

43
Q

screening for scoliosis

A

Adams forward bend test

44
Q

what is used to measure the ankle of trunk rotation if asymmetry is noted on Adams test

A

scoliometer; positive for scoliosis if a >/= 7 degree curve is measured

45
Q

Cobb angle on XR for scoliosis

A

Cobb’s angle >/= 10 degrees

46
Q

tx scoliosis

A

Cobb angle < 25 - observation

bracing to stop the progression if 20-49 degrees

surgery if > 40 degrees

47
Q

what is slipped capital femoral epiphyses

A

displacement of the femoral head from the femoral neck through the growth plate

48
Q

sx scfe

A

pain and altered gait - dull, achy hip, groin thigh or knee pain w a painful limp worse w activity

49
Q

PE for SCFE

A

externally rotated leg + limited internal rotation

50
Q

dx SCFE

A

XR - posterior displacement of femoral epiphysis, similar to ice cream slipping off a cone

51
Q

tx SCFE

A

strict non-weight bearing crutches to prevent further slippage – operative stabilization (internal fixation with a screw)

52
Q
A

Peds EOR (9 decks)

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