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MSK > pediatric orthopedics > Flashcards

pediatric orthopedics Flashcards

1
Q

physis

A

longitudinal growth of long bones occurs here

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2
Q

gowers sign

A

weakness of proximal hip muscles. limit child’s ability to rise from sitting position

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3
Q

circumduction gait

A

patient will hold his or her arm to one side and drags his or her affected leg in a semicircle

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4
Q

antalgic gait

A

pattern of walking that ultimately causes a limp
the stance phase is shortened relative to the swing phase

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5
Q

trendelenburg gait

A

abnormal gait resulting from a defective hip abductor mechanism (jutting hip out to side when walking?)

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6
Q

acute limp can be due to

A

fracture/contusion, transient synovitis, osteomyelitis, arthritis

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7
Q

chronic limp

A

apophysitis, SCFE, rheumatic disease, legg-calve-perthes disease

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8
Q

what should you do if you can’t find the reason for a limp in a child?

A

evaluate weekly until problem resolves or diagnoses reached
do not take lightly

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9
Q

salter harris classification system

A

type 1 - fracture through growth plate
type 2 - fracture through metaphysis and growth plate
type 3 - fracture through epiphysis and growth plate
type 4 - fracture through metaphysis, epiphysis, and growth plate
type 5 - crushed through growth plate

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10
Q

most common salter harris fracture?

A

type 2

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11
Q

greenstick fracture

A

results from bending force applied perpendicular to shaft
usually occurs in forearm of young child

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12
Q

toddlers fracture presentation

A

limping and pain but minimal swelling

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13
Q

toddlers fracture imaging

A

xrays does not always show fracture
treat like fracture anyways and split

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14
Q

buckle fracture (torus fracture) etiology

A

FOOSH, axial load causes compression of bone

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15
Q

buckle fracture treatment

A

immobilization 4 weeks

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16
Q

supracondylar elbow fracture treatment

A

long arm cast, analgesics, serial radiographs
ORIF

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17
Q

nursemaid’s elbow (radial head subluxation) etiology

A

caused by being pulled/lifted by the hand
radial head subluxes under annular ligament

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18
Q

nursemaid’s elbow presentation

A

child not using arm, pronated wrist, tender elbow

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19
Q

nursemaid’s elbow treatemnt

A

pressure with thumb on radial head and gentle supination of forearm while flexing elbow

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20
Q

slipped capital femoral epiphysis pathophysiology

A

displacement of epiphysis relative to femoral neck/shaft
head slips posteriorly through growth plate

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21
Q

slipped capital femoral epiphysis presentation

A

groin/thigh pain, knee pain
external rotation or trendelenburg, decreased hip motion

22
Q

slipped capital femoral epiphysis imaging

A

ap hip and frog leg lateral

23
Q

slipped capital femoral epiphysis treatment

A

immediate referral to pedi ortho
non-weight bearing

24
Q

slipped capital femoral epiphysis prognosis

A

abnormal gait and rotated leg position are permanent

25
Q

developmental dysplasia of the hip etiology

A

aberrant development of hip joint

26
Q

developmental dysplasia of the hip risk factors

A

female
firstborn baby
family hx
spina bifida

27
Q

developmental dysplasia of the hip presentation

A

toe walking, waddling gait, limb length inequality, hyperlordosis

28
Q

developmental dysplasia of the hip PE

A

delicately examine hips
barlow, galeazzi, and ortolani test

29
Q

developmental dysplasia of the hip imaging

A

ultrasound
single AP xray

30
Q

developmental dysplasia of the hip treatment

A

conservative - pavlik harness, abduction orthosis
surgery - if conservative fails. closed reduction first, open reduction, spica cast.

31
Q

transient synovitis of hip etiology

A

self-limiting inflammatory condition of hip.
occasionally follows URI

32
Q

transient synovitis of hip presentation

A

rapid onset of limping and subsequent refusal to walk/bear weight

33
Q

transient synovitis of hip diagnostics

A

labs: +/- mild elevation of WBC, ESR, CRP
xray: ap pelvis/ frog leg lateral
US: evaluate effusion
must exclude septic arthritis

34
Q

transient synovitis of hip treatment

A

treat symptoms, rest, NSAIDs

35
Q

legg-calve-perthes etiology

A

idiopathic avascular necrosis of femoral head
osteonecrosis generally occurs secondary

36
Q

what arteries supply blood to femoral head

A

medial femoral circumflex, lateral femoral circumflex, artery of ligamentum teres

37
Q

legg-calve-perthes presentation

A

atraumatic hip pain or lip, coincidental trauma hx, persistent hip pain
more common in boys 5x

38
Q

legg-calve-perthes imaging

A

AP hip, frog leg lateral

39
Q

stages of legg-calve-perthes

A

initial, fragmentation, reossificiation, final

40
Q

legg-calve-perthes treatment

A

goal is maintaining ROM and containment of femoral head through petrie cast or abduction brace
non-weight bearing if in fragmentation phase
surgical

41
Q

osgood schlatters etiology

A

traction at insertion of patella tendon into tibial tuberosity

42
Q

osgood schlatters presentation

A

chronic focal pain at tibial tubercle, pain relieved with rest, +/- swelling, redness

43
Q

osgood schlatters treatment

A

RICE, NSAIDs, activity modification, cho-pat straps

44
Q

sever’s syndrome (calcaneal apophysitis) etiology

A

inflammatory condition of growth plate in heel
repetitive stress on growth plate as foot strikes ground

45
Q

stages of sever’s syndrome

A

hurts after activity, hurts during and after activity, hurts before during and after activity

46
Q

sever’s syndrome presentation

A

heel pain +/- limp

47
Q

sever’s syndrome treatment

A

RICE, activity modification, gel heel pads, NSAIDs, stretching of achilles

48
Q

toe walking etiology

A

tends to be habitual
achilles tendon contracture

49
Q

toe walking PE

A

+/- reduction of ankle dorsiflexion

50
Q

toe walking treatment

A

PT - heel cord stretching
serial casting
surgical - heel cord lengthening

51
Q

what should you rule out before diagnosing toe walking

A

neuromuscular disorder, cerebral palsy, autism

52
Q

Osgood-schlatters PE

A

pain with straight leg raise

MSK (20 decks)

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