Pediatrics MSK Flashcards
Blount Disease
Bow legged: Varus Deformity
Autosomal Recessive shortening of the Tibia
More common in early walkers and African Americans. Mostly painless
Rickets
Vitamin D deficiency that causes bow legged deformity.
Children with darker skin have larger chance to develop Rickets.
Medications that can contribute as well as malabsorption and genetic causes.
May cause Rachitic Rosary of the ribs. Can have protruding abdomens.
Can have X-linked PHEX gene problems.
TREATMENT: Give Vitamin D3 supplement to breast fed infants. 400 IU per day until they take 1000ml of formula or vitamin D milk.
Talipes Equinovarus
Club foot
Tarsals are hypoplastic.
Kids may get Calcaneovalgus foot in the womb and that isn’t the same.
1 in 1000 births. 2:1 for males. Common trisomy 18 and 22q11 deletion syndromes can cause club feet.
Developmental Dysplasia of the Hip. (DDH)
Abnormal tissue growing in the hip joint. This affects growth of ligaments and will dislocate the hip.
Femoral head and acetabulum form by 11 weeks gestation
This happens 1.5 of 1000
Usually have neurologically normal infants but can be teratologic.
Use Ortolani (lateral) or Barlow (downward) maneuver to dislocate the hip or pull them down out of the socket.
May cause Asymmetrical Thigh Folds
In older kids you can check for lower knees by using the Galeazzi sign.
Pavlik Harness is used to hold femur into acetabulum.
Legg-Calve-Perthes Disease
Avascular Necrosis of the Femoral head.
Common in 3-12 years old. Mean of 8
Bilateral in 10%
Atraumatic, Painless limp, May have intermittent hip or groin pain in anterior thigh or knee pain.
What is SCFE
Slipped capital femoral ephiphysis
The forming cap of the femur becomes detached. 2/100000
More in males age 10-16.
More common in Obese individuals and in African-American, Polynesian and Hipanic populations.
Explain Radial Head Subluxation
Nursemaid’s Elbow
Common kids under 4.
Caused by sudden pull of pronates arm. Radial head slips under annular ligament in the radiocapitellar joint.
Pes Planus
Flat Feet
All kids under 3 have flat feet.
Metatarsus Adductus
Foot deformity. Bones in the frontal half of the foot bend or turn in toward the side of the big toe.
Transient Monoarticular Synovitis
Toxic synovitis
Common cause of limping in children.
Diagnosis of exclusion because septic arthritis and osteomyelitis must be excluded first.
Etiology is uncertain but possible causes are viral or hypersensitive.
70% of these kids have had an URI in last 2 weeks.
Hip joint aspirations are negative for bacterial culture.
Treatment: Bed rest, limit activity, NSAIDs.
Erb-Duchenne Paralysis
5th and 6th Cerivical Roots
Can’t abduct the arm at the shoulder, externally rotate, or Supinate the arm.
Absent Moro Reflex on injured side. (Startle)
Klumpke’s Paralysis
Injury to C7, 8 and T1
Horner’s syndrome of droopy eye, abnormal pupils
Supinate arm, elbow bent, and wrist extended.
Osgood Schlatter Disease
Come in complaining of knee pain.
Have microfractures of the knee that may require rest and ice to let the fractures heal at tibial tuberosity.
Sever Disease
Common cause of heal pain
Presentation in girls at 9 and boys from 11-12
Cause by calf muscles causing microfractures at the calcaneal apophysis
Geriatrics:
What is Polymyalgia Rheumatica (PMR)
Inflammatory condition: aching/stiffness/weakness of girdle areas- proximal shoulders and leg/hips
Only in people over 50
Non-erosive polyarthralgia.
Diagnostic Criteria: Increased ESR/CRP markers.
Treatment: Responds rapidly to low-dose corticosteroids.
(May be associated with Giant-Cell Arteritis and potential malignancy (multiple Myeloma))
