Pediatric Musculoskeletal Flashcards
If a pediatric patient admits to the ER with a contusion, what is the therapeutic management of it?
RICE (rest, ice, compression, elevation)
What is a sprain?
partial or complete tear of a ligament
What is a strain?
tear to musculotendinous unit
What are the two most common types of fractures?
distal forearm (radius, ulna, or both), clavicle
How are growth plate injuries classified?
Salter-harris classification
What is a complicated fracture?
Bone fragments have damaged other organs or tissues
What is a comminuted fracture?
Small fragments of bone are broken from the fractured shaft and lie in the surrounding tissue
What does a buckle or torus fracture look like?
raised or bulging projection at the fracture site
What are the goals of fracture management?
To regain alignment and length of the bony fragments (reduction)
To retain alignment and length (immobilization)
To restore function to the injured parts
To prevent further injury and deformity
What is the most useful diagnostic tool when looking for a fracture?
x-ray
What is a spica?
hip or knee injury that requires a cast
What are the 6 P’s?
Pain, pulselessness, pallor, paresthesia, paralysis, pressure
What are 3 things seen with pallor?
Pale-appearing skin, poor perfusion, capillary refill greater than 3 seconds
What is paresthesia?
tingling or burning sensation
What is assessed when assessing pressure for a fracture/casted region?
Involved limb or digits may feel tense and warm; skin is tight, shiny; pressure within the compartment is elevated
Why is a spica cast placed?
to immobilize the hip joint
What pulses need to be checked in relation to a fracture?
distal
What is the purpose of traction?
To fatigue the involved muscles and reduce muscle spasm so that bones can be realigned
What are the three types of traction?
manual, skin, and skeletal
What is an example of skeletal traction?
halo brace for cervical traction
What is an example of skin traction?
Buck traction
When is manual traction used?
closed reduction
What are the two pathological groups of developmental dysplasia of the hip?
idiopathic (neurologically intact) and teratologic (neuromuscular defect)
What is subluxation?
incomplete dislocation of a joint
What are the two most common tests done to evaluate hip dysplasia?
Positive ortolani test and positive barlow test
Can an x-ray be used to diagnose hip dysplasia of a newborn?
No, because the femoral head is not ossified yet
When should DDH be fixed?
as early as possible
What is a pavlik harness used for?
abduction of the hip
How often does a Pavlik harness need to be worn?
22-24 hours a day
What is osteogenesis imperfecta characterized by?
excessive fragility and bone defects
What kind of medication would a child with osteogenesis imperfecta be given?
medications that promote bone density and prevent fractures
what is the most common spinal deformity?
idiopathic scoliosis
What are the three planes that spinal deformities are found?
lateral curvature, spinal rotation causing rib asymmetry, and thoracic hypokyphosis
What technique is used to measure the angle of curvature for idiopathic scoliosis?
Cobb technique
What angle would the spine have to be to consider operative management of scoliosis?
45-50 degrees
What is osteomylitis?
infectious process in the bone
What is the most common causative organism for osteomyelitis?
staphylococcus aureus
How can osteomyelitis be diagnosed?
X-ray vs bone scans
Labs: leukocytosis, ESR, CRP, culture
What is septic arthritis?
bacterial infection of the joint
What is the most common causative agent of septic arthritis?
Depends on the age
Where is septic arthritis most common?
hip, knee, ankle, elbow
What are the clinical manifestations of septic arthritis?
Joint pain, swelling, warmth to area, erythema
Fever, malaise, headache, N/V, irritability
How can juvenile idiopathic arthritis be diagnosed?
It is a diagnosis or exclusion and there are no definitive tests
What is juvenile idopathic arthritis?
inflammation in joint synovium and surrounding tissue
When is JIA diagnosed?
mid school aged years to teenage years
What are the therapeutic management goals for JIA?
control pain, preserve joint ROM and function, minimize effects of inflammation, promote normal growth and development
What medications are given to manage JIA?
NSAIDS, DMARDs, glucocorticoids
