Orthopedics Flashcards
What is the DDx for pathologic scoliosis?
2nd-ary (muscle spasm, leg length), congenital (development d/o), neuromuscular d/o, metabolic d/o, trauma, neoplasm
When does scoliosis need intervention?
25+ degrees = brace, 45+ degrees = surgery
When is genu varum normal?
6mos to 2yo
When is genu valgum normal?
3 to 8yo remember valGUM–GUM makes your knees stick together (knock knees)
What are limping red flags?
nocturnal pain/limp, pain at rest, systemic findings (fever, LAD, HSM, wt loss), pain out of proportion
Work up for limp may include:
Xray, MRI, bone scan, US, CBC/blood culture/ESR/CRP, joint aspiration & fluid analysis, CK, renal fxn,
Limping DDx should include:
trauma/structural abnormality, septic jt, neoplasm, SCFE, LCPD, osteomyelitis, hair tourniquet, FB, shoes, Osgood-Schlatter, rheumatic dz, Lyme dz, muscular causes, spine pathology
What is the MCC of limping in kids?
trauma
Describe Toddler’s fracture
sudden twisting of the tibia causes spiral or oblique fracture presenting as limb or antalgic gait
What are Ortolani and Barlow maneuvers?
Ortolani = abduction of leg Barlow = adduction & push down (toward Butt) for developmental hip dysplasia
What is Legg Calve Perthes Dz?
unilateral AVN of proximal femoral head, boys>girls, around age 7, antalgic limp/knee pain, loss of abduction
How is Legg Calve Perthes Dx treated?
bed rest, NSAIDS, bracing x12-18mos, surgery
What is slipped capital femoral epiphysis (SCFE)?
displacement of femoral head by salter-harris type I fx thru physis, age 7-15yo, males, overweight
S/sx’s of SCFE?
hip/knee pain, antalgic limp, externally rotated/abducted thigh, pain on internal rotation
Complications of SCFE?
avscular necrosis, chondrolysis, arthritis
What is Osgood Schlatter dz?
knee pain at tibial tuberosity-teenage boys, from jumping, microtrauma in patellar tendon or avulsion
What are s/sx’s of Osgood Schlatter, what is the tx?
edema, heat, pain/tender at tuberosity. NASIADS, ice, rest, stretching, resolves on own w/skeletal maturity
Describe osteoid osteoma
benign tumor, focal pain, worse at night & w/activity, usually long bones, 1.5-2cm in size w/radiolucent nidus (center)
Describe osteochondroma
asymptomatic or painful benign tumor of bone, male>females, femur or tibia (causes limp)
Describe osteosarcoma
3rd MC cancer in teens, painful esp w/activity, limp, swelling
Describe Ewing’s sarcoma
malignant tumor, causes pain, neuro sx’s, wt loss, fever
