Orthopedics / Rheumatology Flashcards
Caused from lifting/swinging/pulling a child while forearm is pronated and extended - radial head wedges into the stretched annular ligament
Radial head subluxation (nursemaid’s elbow)
Management of radial head subluxation (nursemaid’s elbow)
Reduction - pressure on radial head with supination and flexion
Most common in 7-16 y/o african american males
Slipped capital femoral epiphysis
Femoral head epiphysis slips _________ and ___________ at growth plate in SCFE
Posterior
Inferior
Pt presents with hip, thigh or knee pain with limp, external rotation of affected leg
Slipped capital femoral epiphysis
Management of SCFE
Non weight-bearing with crutches
ORIF - risk of avascular necrosis
Most common cause of chronic knee pain in active, young adolescents
Osgood-schlatter disease
Diagnosis of osgood-schlatter disease
XR shows prominence or heterotrophic ossification at tibial tuberosity
Management of osgood-schlatter disease
- RICE, NSAIDs, quadriceps stretching
2. Surgery only in refractory cases
Lateral curvature of spine > 10 degrees
Scoliosis
Scoliosis most commonly begins at ages:
8-10 y/o
If scoliosis is associated with cafe au lait spots, skin tags and axillary freckles:
Neurofibromatosis type I
Diagnosis of scoliosis
Adam’s forward bending test
Cobb’s Angle
Management of scoliosis
Observation, +/- bracing
Surgical correction if > 40 degrees
Most common in children 4-10 y/o, 4x MC in boys, low incidence in african-americans
Legg-Calve-Perthes Disease
Painless limping x weeks - worsens with continued activity especially at the end of the day
Legg-Calve-Perthes Disease
Restricted range of motion - loss of abduction and internal rotation with painless limping
Legg-Calve-Perthes disease
Diagnosis of Legg-Calve-Perthes disease
XR:
Early - increased density of femoral head
Advanced - crescent sign
Management of Legg-Calve-Perthes disease
Observation - activity restriction - non-weight bearing with ortho followup
Physical therapy
Autoimmune mono or polyarthritis in < 16 y/o
Juvenile rheumatoid arthritis
Juvenile rheumatoid arthritis often resolves by:
Puberty
Diagnosis of rheumatoid arthritis
Clinical diagnosis
Increased ESR, CRP
+ ANA in oligo, + rheumatoid only in 15%
Management of rheumatoid arthritis
NSAIDs and/or corticosteroids
Methotrexate or leflunomide
Frequent eye exams
