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Pediatrics - clinical > Ortho/Rheum > Flashcards

Ortho/Rheum Flashcards

1
Q

What is the onset of symtpoms for AVN of proximal femur

A

insidious onset of a dull ache or throbbing localized to groin, lateral hip or buttocks

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2
Q

What is AVN of the hip called for children

A

Legg-Calve Perthes disease

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3
Q

what ages is legg-calve perthes disease common in

A

ages 2-11
peak incidence of 4-8yo

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4
Q

how is AVN of the proximal femur diagnosed

A

MRI is study of choice

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5
Q

How is AVN of the proximal femur treated

A

may be conservative or may eventually need joint replacement

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6
Q

what is it called when the socket or acetabulum and the femoral head are misaligned

A

congenital or developmental hip dysplasia

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7
Q

what is the presentation of children with congenital hip dysplasia

A

legs of unequal lengths
asymmetric skin folds around groin
may develop limp/waddling gait when they start walking

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8
Q

when should children be screened for hip dysplasia

A

every well-child visit until 2 years old

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9
Q

what are the hip examining techniques

A

Barlow
Ortolani
US for assessment

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10
Q

what is the Barlow test

A

hip adduction causes dislocation

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11
Q

What is the Ortolani test

A

hip flexion and abduction with anterior pressure causes reduction of hip dislocation (CLICK auscultated)

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12
Q

what is the treament for congenital hip dysplasia

Heather and Melissa you are going to hate this one… think ortho minded…

A

< 6 months: Pavlik harness
6-15months: hip spica cast
15-24months: open reduction followed by hip spica cast

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13
Q

What are the three types of Juvenile idiopathic arthritis (JIA)

A
  1. Oligoarticular JIA
  2. Polyarticular JIA
  3. Systemic JIA
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14
Q

what is oligoarticular JIA

A

most common form typically affecting young girls
involvement of <4 joints during first 6 months of the disease

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15
Q

what is Polyarticular JIA

A

2nd most common. affects >5 joints at onset
dividied into RF negative and RF positive

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16
Q

what is systemic JIA

A

least common
involves fever and systemic manifestations

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17
Q

when should JIA be suspected in children

A

children with symptoms of arthritis, signs of iridocylitis, generalized adenopathy, splenomegaly or unexplained rash/prolonged fever

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18
Q

what is the treatment for Juvenile Idiopathic arthritis

A

NSAIDs, INtra-articular corticosteroids, disases modifying meds - Methotrexate.

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19
Q

what age group is Osteosarcoma typically seen in

A

Kids 10-14yo

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20
Q

what is the presentation of osteosarcoma

A

progressively worsening night pain, bone pain/joint swelling - may look similar to growing pains and can easily be missed

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21
Q

what is seen on XR with osteosarcomas

A

sun ray/burst or hair on end appearacne

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22
Q

what is the most common sit of metastasis for osteosarcoma

A

Lungs

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23
Q

what is the treatment of osteosarcoma

A

Limb-sparing resection or radial amputation

24
Q

what ages are Ewing Sarcomas typically seen in

A

kids 5-25 yo

25
Q

what is the presentation of Ewing’s sarcoma

A

pain often accompanied by fever, often mimics an infection.
may have palpable mass, swelling and local tenderness

26
Q

what is seen on XR with Ewing’s sarcoma

A

Lytic lesion with an onion-skin appearance of the periosteum

27
Q

what is the treatment of Ewing sarcoma

A

chemo, surgery and radiation

28
Q

what age group is typically affected by osteochondroma

A

10-20 yo

29
Q

what is a benign chondrogenic lesion derived from aberrant cartilage

A

osteochondroma

30
Q

who is most commonly affected by osteochondroma

A

males ages 10-20

31
Q

what is seen on x-ray with osteochondroma

A

sessile (broad base) or pedunculated stalk lesions found on the surface of bones

32
Q

what is the treatment of ostochondroma

A

observation
resect if it becomes painful

33
Q

what is the most common benign bone tumor

A

osteochondroma

34
Q

what is nursemaids elbow

A

dislocation of the elbow caused by sudden pull of extended pronated forarm

35
Q

what age is most commonly affected by nursemaids elbow

A

ages 1-3yo

36
Q

what is the presentation of nursemaids elbow

A

significant pain
partial limitation of flexion/extension of elbow
or
total loss of pronation/supination in affected arm

37
Q

how is nursemaids elbow diagnosed

A

clinically
XR only to rule out fractures or other dislocation

38
Q

what is the treatment for nursemaids elbow

A

Supination-flexion technique

39
Q

what is inflammation of the patellar ligament at the insertion point of the tibial tuberosity

A

osgood-schlatters

40
Q

what population is osgood-schlatters commonly seen in

A

boys age 9-14 who recently underwent rapid growth spurt and doing sports that involve running

41
Q

what is the treatment for osgood-schlatters

A

reduce physical activity
Ice
Physical therapy
short term NSAIDs

42
Q

how is scoliosis measured

A

Cobb angle of 10 degrees or more

43
Q

when does scoliosis typically begin to present itself

A

ages 8-10

44
Q

what test is used to screen for scoliosis

A

Adams test - foward bend

45
Q

what is seen with Adams test if scoliosis positive

A

asymmetry in scapular height

46
Q

what other tests are commonly done in those with scoliosis for the workup

A

MRI - rule out intraspinal anomalies
PFTs to see if breathing is affected

47
Q

what type of airway pattern would be seen if scoliosis was affecting breathing abilities

A

restrictive airway pattern

48
Q

what is the treatment of scoliosis with a curve of 10-15 degrees

A

6-12 month follow up with clinical eval and possible xr

49
Q

what is the treatment of scoliosis with a curve of 15-20 degrees

A

serial AP Xrays and follow up every 3-4 months

50
Q

what is the treatment of scoliosis with a curve of 20 degrees or greater

A

referral to ortho for continuous monitoring and management

51
Q

when is surgery usually indicated for scoliosis

A

curve > 40 degrees

52
Q

what injury occurs when the head of the femur slips off the neckof the femur inferiorly and posteriorly

A

slipped capital femoral epiphysis
(SCFE)

53
Q

what popuation is often affected by slipped capital femoral epiphysis

A

obses boy, 10-16yo with groin or knee pain worsening with activity

54
Q

what x-ray series should be obtained if concerned for SCFE

melissa.. dont get this wrong

A

AP and Frog-leg lateral of both hips
MRI when XR negative

55
Q

what is the treatment of SCFE

A

Surgical fixation with screw for all patients

Pediatrics - clinical (13 decks)

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