Pediatric examinations

Question 1

Physical exam for limping child

Answer 1

• General appearance
• Ill/toxic looking
• FEVER
• PEWS (Pediatric early warning score)

Question 2

Local

Answer 2

Expose
Look, Feel, Move, Measure, Function (e.g. GAIT)

Question 3

On inspection of leg for limping

Answer 3

Attitude
Swelling
Asymmetry
Redness, bruise, rash
Muscle wasting/ atrophy

Ask parents/carers about changes
Don’t forget to check for foreign bodies + look at associated structures (e.g. spine for legs)
+ take full obs (temp, O2)

Question 4

How to assess movements in babies

Answer 4

Moving their healthy leg can get babies to kick out their other leg

Question 5

How to figure out indication of which leg is affected in babies

Answer 5

get parent to pick up and put back on ground
- baby refuses to put affected leg on ground

Question 6

Types of limp

Answer 6

• Antalgic
• Trendelenburg
• Vaulting or circumdiction

Question 7

Paeds psychosocial history

Answer 7

• Intro
• Family tree (check about past partners/other children)
• Home situation (who’s there atm + who isn’t)
• Anyone else help look after kids (including professionals - SW)
• Smoking, alcohol, drugs
• Has your partner ever hurt you/threatened to hurt you
• School (do they go to achool, how is attendance, what do they do while there / when not there, who can they talk to there)