paeds ortho Flashcards
what are growth plates made from
Hyaline cartilage
Why kids more prone to greenstick fractures?
Cancellous bone (less string)- one side break other stays intact
compression of long bone fracture is
Buckle/torus
SALTR mnemonic is…
- straight across
- above
3 beLow
4Through
5 cRush
pain ladder for kids
- Paracetamol or brufen
- Morphine
No codeine tramadol aspirin (unless kawasaki)
Joint pain in kids ages
0-4
5-10
10-16
0-4
Septic arthritis
Developmental dysplasia of the hip (DDH)
Transient sinovitis
5-10
Septic arthritis
Transient sinovitis
Perthes disease
10-16
Septic arthritis
Slipped upper femoral epiphysis (SUFE)
Juvenile idiopathic arthritis
Urgent assessment for limping child criteria…
<3 yo
>9 with WB issue or painful hip
No WB
Neurovascular
pain/agitation severe
red flag
abuse
most common septic arthritis bacteria?
Staph aureus
Other
Neisseria gonorrhoea (gonococcus) in sexually active teenagers
Group A streptococcus (Streptococcus pyogenes)
Haemophilus influenza
Escherichia coli (E. coli)
Antibiotic length of time for SA
3-6 weeks
assc with Viral URTI
transient synovitis
transient synovitis is assc iwth
Limp
Refusal to weight bear
Groin or hip pain
Mild low grade temperature
T/F transient synovitis is always a 1 off
no may recurr in 20%
Children 3-9 yo with Transient synovitis in primary need what kind of follow up
safety net to a and e with fever
48 hour check up
1 week check up
What is cause of perthes disease
Blood flow disruption- > avascular necrosis of bone. Affects epiphysis
all patients with perthes require total hip replacement T/F?
no but 5% will due to remodelling causing
choice of iomaging in perthes
XRAY
Then maybe some other
When do kids get SUFE?
During growth suprt (8-15yo) may have minor trauma
susepct SUFE when…
Pain dispoportionate to trauma
obese pre teen
Where does osteomyelitis effect in kids bones
Metaphysis
risk factors for osteomyelitis
Open bone fracture
Orthopaedic surgery
Immunocompromised
Sickle cell anaemia
HIV
Tuberculosis
Osteomyelitis is always febrile? T/F
no, but may have high fever if spread to join and causing sepctic arthtris
most common site for osteosacrcoma
Femur
Then tibia and humerus
How quick xray for sus osteosarcoma
48 hours
unexplained bone pain or swelling
if positive get specialist assessment in 48 horus after xray
blood test result in osetosacroma may show
ALP raised
talipes equinovarus is
Plantar flexion and supination
Talipes calcaneovalgus is
Doresiflexion and pronation
what method is used for talipes
ponsetti method
