Paeds Ortho Summary Q's Flashcards
child presents with pain and limp in unilat leg, what is intial DDx?
perthes
transient synovitis
SUFE
?dev dysp
what might differentiate each?
- SUFE - tends to be obese child aged 10-15
- transient synovitis - child aged 3-8 and holds hip flexed and ext rotated.
- perthes - boys aged 3-8, similar to transient syno but symptoms WILL NOT settle
- dev dysp - should be seen at neo-natal exam, waddling gait and depayed walking hx
what radiographical test for each condition?
perthes, SUFE = xray
dev dysp, tranisent syno = USS
if there is pain in hip/knee and any mention of infection what must be consiered?
septic arthritis nd transient synovitis
osteomyelitis
what might be seen on an xray positive for perthes disease?
small femoral head
joint space widening
what would be acceptable when assessing child of a NORMAL VARIANT (5S’s)
and a few examples of these
symptomLESS symmetry SYSTEMICALLY FINE no STIFFNESS no SKELETAL DYSPLASIA
in-toeing, knock-knees, flat feet
what sort of complications are concerns in ortho?
AVN, malunion, non-union
5 components of baby check
FEPCH
Foot deformities Erbs Palsy Polydactlyl Congen musc torticolis Hip Exam (dev dysp)
signs of malignant growing pains
unilateral, pain at night persisting into day, loss of function next day (sitting out of sport), tender and mass o/e, unresponsive to analgesia
red flags for paeds Back Pain (6)
- age 4 weeks
- decreased ROM because pain
- under age 4
- functional disability
- neuro signs
- night pain
how to assess child age on elbow xray
CRITOL Capitellum - 1 Radial Head - 3 Internal Epicondyle - 5 Trochlea - 7 Olecrenon - 9 Lateral Epicondyle - 11
Juvenile Idiopathic Arthritis - CF
if Stills = systemic upset
walking on tiptoes, painful joints, often young girl affected
what would typical investigations for Juv Idio Arth look like, and how is the diagnosis made.
bloods would commonly be to exclude other causes of joint pain. diagnosis made clinically
what is a common assoc condition with juv idio arthr?
Asymptomatic chronic anterior uveitis
treatment of juv idio arth
- start conservatively = NSAIDs and mild exercise +/- physio
- progress to naproxen –>pred –> Methotrex–> biologics
- finally if refractory = surgery
