Orthopedics Flashcards by Lauren Bainter

Ehlers-Danlos Syndrome (EDS)

joint hypermobility

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Juvenile Idiopathic Arthritis (JIA)

a chronic, inflammatory disease that affects children under the age of 16, causing joint inflammation and stiffness for more than six weeks

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Hemophilia

a hereditary bleeding disorder where blood clots more slowly or not at all due to a deficiency in one or more clotting factors

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what is blount disease?

tibial varia

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what is arthrogryposis multiplex congenita (AMC)?

congenital abnormality that causes permanent tightening of infants muscles, skin, and tendons that make their joints stiff & tight

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deficits in ____ leads to severe fetal weakness in AMC

motor units

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distinctive features of babies born with AMC

long face and large jaw
wrist bent up or out stiffly
hips bent up or out; may be dislocated
webbing of skin at knees, hip, elbows, or shoulders
knees bent or straight in stiff position
mind completely normal
shoulders turned in
arms stiff at elbow & weak
hands and fingers weak
spine curved
normal trunk strength
club foot

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what is a pterygium?

triangular membrane with shortness of skin and other soft tissues (on back of leg for knee)

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T/F: surgery is usually indicated for AMC

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causes of increased injury risk in peds sports

sport specialization
rapid growth & change in body portions
increased training volume

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when do growth spurts typically occur in boys vs girls?

boys: 12-14
girls: 10-12

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what is considered too high training volume in peds?

several hours each week & year-round
> 16 hrs a week (overuse & injury)
training in single sport

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what sports promote low weight and is increased risk for RED-S?

gymnastics
figure skating
ballet
diving & swimming
long distance running

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what is RED-S?

impaired physiologic function (metabolic rate, menstruation, bone health, immunity, protein synthesis, CV health) caused by relative energy deficiency; insufficient caloric intake and/or excessive energy expenditure

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components of RED-S

immunity
mensural function
bone health
endocrine
metabolic
hematological
growth+development
psychological
CV
GI

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PT implications for RED-S

decreased mm strength & endurance
chronic fatigue
bone loss –> stress fractures
physiological stress, depression, anxiety

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high risk category for RED-S

anorexia or other eating disorders
med conditions related to low energy
extreme weight loss techniques –> dehydration & hemodynamic instability

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medium risk category for RED-S

prolonged atypical % body fat
substantial weight loss
abnormal menstruation & hormones
reduced BMI
disordered eating behaviors
low energy availability

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low risk category for RED-S

healthy eating with appropriate energy
normal hormone & metabolic
healthy BMI
healthy MSK

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sports implications for RED-S:
low
medium
high

low - full participation
medium - w/i training plan once cleared
high - no competition; must be cleared

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which pts should be especially screened for RED-S?

recurrent injuries esp stress fractures

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what ages and sex is SCFE most common in?

boys 10-16

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SCFE hip sx

loss of IR and aDduction

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T/F: SCFE can sometimes only have knee pain has sx

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SCFE vs. LCP emergent/urgent

SCFE - emergent LCP - urgent

what is Legg-Calve Perthes?

avascular necrosis of femoral head

blood flow disruption in Legg-Calve Perthes typically in _____ artery

medial circumflex

typical presentation of Legg-Calve Perthes

3-12 yo w/ hx of limping, Trendelenburg, hip pain

ROM loss in Legg-Calve Perthes

IR and aBduction

Legg-Calve Perthes typically self-heals in ____

1-3 years

femoral neck stress fx common in ____ athletes

female endurance (w/ RED-S)

common sign of femoral neck stress fx

deep hip pain w/ WB and during sport

acetabular labral pathology & FAI typically occurs in ___ athletes

athletes that perform extreme ROMs ex: dancers excessive rotation (cut & pivot) ex: soccer and basketball

common sign of acetabular labral pathology

c/o intra-articular clicking and popping

how to diff dx acetabular labral pathology vs. FAI

MRI or MRA

cam vs pincer impingement

cam - femoral head pincer - acetabulum

coxa vara angle of inclination

120 or less

coxa valga angle of inclination

160+

normal femoral head to neck angle (of inclination)

130

FAI S&S

anterolateral hip pain pain with flex & IR limited hip ROM short hip flexors (+) FADIR or FABER Trendelenburg weakness in core & LE posterior chain mm

medial tibial stress syndrome is associated with dysfunction in what mm?

tib ant tib post soleus

S&S of medial tibial stress syndrome

- ache, diffuse LE pain - pain with running or ballistic mvmts - pain worse at beginning of exercise - TTP along medial ridge of tibia - hyperpronation on ST joints 2/2 impaired flexibility of triceps surae - weakness in core & hip mm

peak incidence of lateral ankle sprain

15-19 yo

motions that cause lateral ankle sprain

ankle inversion & ER

what weak mm can be a sign of lateral ankle sprain?

gastroc/soleus

ACL injury is more common in ___

female athletes

LE position leading to ACL injury

- land w/ knee in valgus or ext - sudden deceleration (high quad activity) - outside cut: varus w/ IR - anterior tibial shear forces

what is the weakest part of the bone?

growth plates

special consideration for peds ACL reconstruction

growth plate injuries common due to surgical site

which population is bracing post ACL reconstruction recommended?

peds

average time to return to sport post ACL reconstruction for peds

9-12 mo

average time to return to sport post ACL reconstruction for adults

6 mo

PCS criteria

persistent sx beyond 7-10 days 3+ of sx: fatigue, sleep disturbances, HA, dizzy, concentration difficulty, & memory difficulties

in peds ___ & ____ is associated with prolonged recovery post concussion

loss of consciousness & dizziness

precautions for PCS

avoid overstimulation --> HA, dizziness, or nausea

complication that could interfere with PT for PCS

- pre-existing conditions: anxiety, depression - eye alignment issues (amblyopia) - leaning disabilities (ADHD) - hx of migraines

65% of concussions occur in kids aged ____

4-15 yo

T/F: 50% of concussions in kids are due to falls not sports

what are the 4 pt severity outcome measures for PCS?

1. verbal rating scale 2. PCSS (Post-Concussion Symptom Scale) 3. ImPACT 4. DHI (Dizziness Handicap Inventory)

what test is used to screen for PCS?

VOMS (vestibular/Oculomotor Screen)

for children with prolonged recovery of concussion symptoms lasting more than 6-8 weeks, ____ management is recommended

multidisciplinary (ex: vision therapy)