Pediatric Conditions

Question 1

Thigh-foot angle

Answer 1

In prone with knee to 90°

Describes the degree of tibial torsion

Question 2

3 causes of toe-in

Answer 2

metatarsus adductus, internal tibial torsion (most common) and hip anteversion

Question 3

When is femoral anteversion considered excessive?

Answer 3

> 25°

10-15° is normal

Question 4

What would you observe with talipes equinovarus (clubfoot)?

How is it treated?

Answer 4

PF, inversion, adduction of the foot

Manipulation followed by casting, Stretching with orthoses in the day for 3 mo, and at night for up to 3 years

Question 5

What is the typical pattern for gene vacuum?

Answer 5

Normal for newborns and infants
Max at 6-12 months
Straightened by 18-24 months
Max valgus at 3-4 years
straightened by 7 years

Question 6

Hip Dysplagia

• etiology
• risk factors
• special tests
• treatment

Answer 6

Abnormality in size, shape, or orientation of femoral head, acetabulum or both.
Can result in subluxation or dislocation

• Females >males, breech position, family hx, low amniotic fluid, swaddling too tightly
• Barlow, ortolani, limited hip abduction, galeazzi sign, klisic sign
• Pavlik harness = gold standard: hip in flexion, abduction

Question 7

Transient synovitis

• etiology
• S/S
• Treatment

Answer 7

Acute hip pain in ages 3-10, inflammation of hip synovium

• unilateral hip or groin pain, crying at night, antalgic limp, recent upper respiratory tract infection
• NSAIDS, rest, lasts 7-10 days

Question 8

Legg-Calve Perthes Disease

Answer 8

Interrupted BS to femoral head

• ages 2-13 years
• Limp with psoas weakness, gradual onset pain, limited AROM in abduction/ extension
• cast, possibly surgery

Question 9

Slipped Capital femoral epiphysis SCFL

Answer 9

Most common hip disorder in adolescents: femoral head displaces posterior-inferior
-operative fixation

Question 10

What are the three tendon-lengthening conditions

Answer 10

Osgood-Schlatter disease: apophysitis of patellar tendon from tibial tubercle
Sever’s Disease: apophysitis of achilles from calcanea t tuberosity
Sinding-Larsen Johannson’s disease: apophsitis of patellar tendon from patella

Question 11

Oteochondritis Dissecans

Answer 11

Occurs in adolescents 12-15 years

- Separation of cartilage from bone, usually at medial femoral condyle

Question 12

Panner’s disease involves which joint

Answer 12

humero-radial: avascular necrosis of capitulum