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Exam 2 Skin block > Pediatrics orthopaedics > Flashcards

Pediatrics orthopaedics Flashcards

1
Q

Scoliosis: Description

A

lateral curvature greater than 10 deg, often associated with rotational deformity. M:F = 1:1 of curves less than 20, but girls are 7 times more likely to progress

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2
Q

Scoliosis: Sx

A

no pain. Ill fitting clothes

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3
Q

Scoliosis: Exam

A

forward bend test. Scoliometer.

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4
Q

Scoliosis Tests

A

Full length x rays measure vertebral angle

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5
Q

Scoliosis: tx

A

brace if angle > 30. surgery if > 40-50

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6
Q

Club foot Description

A

idiopathic congenital foot deformity, characterized by plantar flexion of ankle; adduction of the heel; high arch; adduction of the fore foot

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7
Q

Club foot: sx

A

none

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8
Q

Club foot: tests

A

none

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9
Q

Club foot TX

A

manipuation and casting immediately. surgery if still rigid at 3 years

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10
Q

Osgood schlatter: description

A

overuse injury causing apophyseal injury at tibial tubercule

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11
Q

Osgood schlatter: sx

A

pain over tibial tuberculev

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12
Q

Osgood schlatter: exam

A

pain over tibial tubercle

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13
Q

Osgood schlatter: tests

A

xrays show gramentation of tubercle

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14
Q

Osgood schlatter: tx

A

NSAIDS, rest, PT

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15
Q

hip dysplasia: description

A

malformed hip socket and femoral head, asscoiated with ligamentous laxity, left hip, female gender, breech presentation. Xray will show dislocation.

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16
Q

hip dysplasia: SX

A

limp

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17
Q

hip dysplasia: Exam

A

barlow and ortolani exam. Dislocation test then relocate it.

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18
Q

hip dysplasia: tests

A

ultrasound can help with difficult cases

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19
Q

hip dysplasia: tx

A

pavlik harness to force relocation of hip. mimic ortalani maneuver

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20
Q

perthes disease: description

A

idiopathic osteonecrosis of femoral head, between 4-8 years old

Good blood supply to lateral side can help with good prognosis. Femoral head is medial crcumflex and pulvinar artery.

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21
Q

perthes disease: sx

A

limp and stiffness

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22
Q

perthes disease: exam

A

decreased internal rotation and abduction

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23
Q

perthes disease: tests

A

x rays show sclerosis, coxa magna. MRI can help with diagnosis

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24
Q

perthes disease: tx

A

ROM and bracing. No good treatment

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25
Q

SLipped capital femoral epiphysis: description

A

displacement of the femoral head through the physis usually during growth spurt, associated with obesity, maes, sports, endocrine disorders

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26
Q

SLipped capital femoral epiphysis: SX

A

pain with activity

27
Q

SLipped capital femoral epiphysis: exam

A

loss of internal rotation with hip flexed

28
Q

SLipped capital femoral epiphysis: tests

A

AP and lateral X rays show slip. Workup for endocrine abnormality if bilateral

29
Q

SLipped capital femoral epiphysis: tx

A

surgical fixation in situ

pin it and let it heal

30
Q

Genu varum/valgum: description

A

normally the knee starts at birth in varum 10-15 deg, and by 18 months straightes out to 0. Maximum valgum of 15 degree at age 4, then 5-10 deg in adolescence

31
Q

Genu varum/valgum: SX

A

worried parents

32
Q

Genu varum/valgum: exam

A

measure knee angle

33
Q

Genu varum/valgum: tests

A

weight bearing x rays if outside normal

34
Q

Genu varum/valgum: tx

A

observation, bracing, occasional epiphyseal stapling osteotomy

35
Q

tarsal coalition: description

A

abonrmal connection between tarsal bones

36
Q

tarsal coalition: SX

A

pain, limp, frequent, ankle sprain

37
Q

tarsal coalition: exam

A

restricted hindfoot movement

38
Q

tarsal coalition: tests

A

x rays will show calcaneal navicular coaltion. CT scan can confirm

39
Q

tarsal coalition: TX

A

casting then surgery if needed.

40
Q

transient synovitis of the hip: description

A

sterile effusions of the hip causing pain.

41
Q

transient synovitis of the hip: SX

A

limp, refuses to walk, groin pain. History of viral infection elsewhere.

42
Q

transient synovitis of the hip: exam

A

limp, stiffness, afebrile

43
Q

transient synovitis of the hip: tests

A

x rays effusion. CBC, esr, crp are not elevated. Joint aspirate < 50000 WBC. Gets better with NSAIDS

44
Q

transient synovitis of the hip: TX

A

Supportive care

45
Q

Supracondylar humerus fracture description

A

affects 2-12 years old, most common elbow fracture

46
Q

Supracondylar humerus fracture: SX

A

fall of trampoline, elbow deformity, pain

47
Q

Supracondylar humerus fracture exam

A

neurovascular exam important

48
Q

Supracondylar humerus fracture tests

A

x rays show supracondylar fracture, positive posterior sail sign

49
Q

Supracondylar humerus fracture tx

A

casting vs surgical reduction

50
Q

Rickets: description

A

error in Vit D metabolism causes failure of mineralization

Large hypertrophic zone.

51
Q

Rickets: SX

A

pain in legs

52
Q

Rickets: exam

A

bowed lgs

53
Q

Rickets: xray

A

looser lines (osteoid seam). Widened growth plates

54
Q

Rickets: labs

A

low normal serum Ca, phos low

55
Q

Rickets: tx

A

nutritional supplementation. treat for underlying cause (meds)

56
Q

Non-accidental trauma incidence:

A

42/10000 children were victims of abuse or neglect

15-20% presents with fractures

humerus is the most common bone then femur

57
Q

Non-accidental trauma: risk factors

A

low income, first born, premature, stepchildren, handicapped, single parent, drug use, unemployed parents, abused parents

fractures in non amulatory children

58
Q

Non-accidental trauma: injuries to be aware of

A

posterior rib fractures

spiral fractures

metaphyseal corner fractures

Spiral fractures. Rib fractures (shaking baby syndrome)

Corner fracture: distal fracture.

Bucket fracture.

Salter harris classification of growth factors: Damage of growth plate.

59
Q

Non-accidental trauma : TX

A

contact CPS

rule out other causes (OI, caffey’s disease, leukemia, accidental trauma)

treat fracture

60
Q

Acute joint effusion

A

mono articular

oligoarticular

systemic sx: JIA, lyme, septic. Ophtalmology consult.

Sometimes painless

61
Q

Cerebral palsy

A

permanent non progressive brain injury in the peripartum period

upper motor neurons affected with spasticity

hemiplegia; diplegia

keeping mobile is key

be suspicious for cerebral palsy in a paitnet with delayed motor development, history of prematurity, prolonged NICU stay, toe walking

62
Q

Achondroplasia

A

disproportionate short stature

FGFR3 mutation

autosomal dominant

hypertrophic zone in growth plate is narrow

problems involve the spine

63
Q

Marfan syndrome

A

defect in collagen 1 from osteoblast

fibrillin mutation

hyper mobile thumb. really long fingers and narrow bone.

SX:

tx no treatment

Exam 2 Skin block (22 decks)

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