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Peds EOR > Ortho/rheum > Flashcards

Ortho/rheum Flashcards

1
Q

Avascular necrosis of the proximal femur epi

A

2-11 yo Legg–Calvé–Perthes (LCP) disease

Peak at 4-8 yo

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2
Q

Avascular necrosis of the proximal femur presentation

A

Dull ache, throbbing pain localized to groin, alteral hip or buttocks

Pain w// weight bearing activity releived w/ rest

↓ rotation or abduction

Pain, limp, loss of motion

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3
Q

Avascular necrosis of the proximal femur tx

A

Protected weight beating for early stage

Alendronate to prevent early collapse

Cast

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4
Q

Avascular necrosis of the proximal femur w/u

A

MRI * TOC for early etection

Radiography→ crescent sign

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5
Q

Congenital hip dysplasia age

A

4-6 Wk

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6
Q

Congenital hip dysplasia presentation

A

Clicky hip

Barlow and Ortolani

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7
Q

Congenital hip dysplasia w/u

A

U/S

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8
Q

Congenital hip dysplasia tx

A

harness

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9
Q

barlow

A

infant fully relaxed, attempt to dislocate the hip via posterior pressure, adduct the fully flexed hips while pushing the thighs posteriorly

If during this maneuver the femoral head is felt to dislocate or leave the acetabulum → positive

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10
Q

ortolani

A

ID hip that s dislocated,grasp medial aspect of flexed knee w/ thumb fand fully abduct hip → feel for spasm or clunk (not click)

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11
Q

Nursemaid elbow age

A

1-4 yo

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12
Q

Nursemaid elbow mechanism

A

Axial traction on a pronated forearm with elbow in extension→ annular ligament slips over head of radius & becomes trapped in radiohumeral joint

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13
Q

Nursemaid elbow presentation

A

Not using arm, g consistent w/ mech, holding arm close to ody w/ fully extended or slightly flexed elbow and pronated forearm

Pain w/ active supination

No swlling, bony tenderness or deformity

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14
Q

Nursemaid elbow tx

A

Thumb on Osgood-Schlatter disease of radial head and apply gentle traction, supinate forearm and flex elbow

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15
Q

Osgood-Schlatter disease epi

A

Teenage athletes

MC boys

11 yo girls, 13-14 yo boys

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16
Q

Osgood-Schlatter disease presentation

A

Painful knee w/ swelling ver tibial tubercle

17
Q

Osgood-Schlatter disease tx

A

Stop exercising (curative) or play through it which may cause a palpable nodule

Rest, NSAIDs, ice

Benign course (may last 1-2 yrs)

18
Q

Scoliosis epi

A

Adolescent (>11 yo) *MC

F>M

19
Q

Scoliosis presentation

A

Lateral curvature of spine

Truncal asymmetry, school screening or incidental finding

20
Q

Scoliosis tx

A

Brace if 20-40 deg

Spinal fusion surg if >40 deg

21
Q

Slipped capital femoral epiphysis epi

A

10-16 yo

M>F

↑ incidence in AA, athletes and obese

22
Q

Slipped capital femoral epiphysis etiology

A

Weakening of epiphyseal plate of femur → displacement of femoral head

23
Q

Slipped capital femoral epiphysis presentation

A

Hx of insidious hip, thigh or knee pain associated w/ painful limp

24
Q

Slipped capital femoral epiphysis w/u

A

Frog leg view**

Lateral radiograph→ post and med displacement of epiphysis

25
Q

Slipped capital femoral epiphysis tx

A

Pinning in situ

Crutches, avoid weight bearing before and after surgery

26
Q

Juvenile Rheumatoid Arthritis epi

A

F>M (2:1)

Females onset 1-3 yo
Males onset 8-12 yo

27
Q

Juvenile Rheumatoid Arthritis presentation

A

Must be <16 yo and lasts for >6 wk

Chronic synovitis + extra-articular manifestations (fever, rash, weight loss)

28
Q

Juvenile Rheumatoid Arthritis Systemic

A

AKA Still’s Disease

spiking fevers, myalgias, polyarthralgias, hepatosplenomeg, lymphadenopathy, leukocytosis, oericarditis, myocarditis

29
Q

Juvenile Rheumatoid Arthritis Pauciarticular

A

4 or less medium to large joints involved, at risk for asymptomatic uveitis

30
Q

Juvenile Rheumatoid Arthritis Polyarticular

A

resembles adult RA w/ symmetric involvement and involved 5 or more of small and large joints, low-grade fever, fatigue, rheumatoid nodules and anemia

31
Q

Juvenile Rheumatoid Arthritis w/u

A

10-15% of pts have + RF or anti-CCP Ab

ESR and CRP ↑ or nrml

ANA may be ↑ for pauciarticular type and indicates risk for uveitis

imaging studies

32
Q

Juvenile Rheumatoid Arthritis tx

A

NSAIDs and physical and occupational therapy are most beneficial

Methotrexate or leflunomideas secon line early on if no improvement with NSAIDs

Monitor for growth abnormalities, nutritional deficiencies and school/social impairment

33
Q

Osteosarcoma presentation

A

distal femur pain (or prox tib pain)

xray sunburst

34
Q

Osteosarcoma tx

A

resection

35
Q

Best radiographic test for bone tumors

A

MRI

36
Q

best diagnostic test for bone tumors

A

Bx

37
Q

Ewing’s Sarcoma presentation

A

mid-shaft pain

x-ray shows onion skin

38
Q

Ewing’s Sarcoma tx

A

resection

Peds EOR (14 decks)

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