pedmsk

Question 1

common msk in kids - 16

Answer 1

Torticollis*
Developmental Hip Dysplasia*
Limp*
Slipped Capital Femoral Epiphysis*
Transient/Toxic Synovitis *
Septic Hip*
Patellofemoral Syndrome*
Osgood-Schlatter *
Extremity pain* 
Subluxation of the Radial Head*
Back pain* 
Scoliosis*
Femoral Anteversion*
Clubfoot*
Joint pain*

Question 2

Normal Variants of gait in kids - 4

Answer 2

Intoeing *
Outtoeing*
Knock knees*
Bow legs*

Question 3

Risk factors for MSK issues - 10

Answer 3

FHx of MSK disorders
Genetic disorders
Sports
Obesity
Medications 
History of injury
Poor supervision/accidents
Inadequate Nutritional Intake of minerals
Non-accidental trauma (NAT)

Question 4

Torticollis

TX?

Answer 4

sternocleidomastoid muscle (SCM) is damaged. 
        Hematoma causes fibrosis and contraction.

Present in neonates up to 3 mo

Highly a/w DDH (20%)

O/E: infant holds head tilted with face turned to other side

Often causes secondary Plagiocephaly*

May palpate mass in SCM muscle in neck

Can perform passive ROM of neck with muscular Torticollis only, other forms result in resistance w/ passive ROM

Treatment: refer to PT for stretching; parents must stretch muscles 15-20 reps, 4-6 x daily until 1 yr!

Question 5

Plagiocephaly

Answer 5

flat head

Question 6

Developmental Dysplasia of the Hip (DDH)

cause? more prevalent in whom?

what happends if not caught and not corrected?

Answer 6

80% female

Disruption in the normal relationship between the head of the femur and the acetabulum

Cause: hereditary; uterine packing stresses (ie. Breech, multiples, small uterine pelvis); neonatal positions

If head of femur is relocated soon after birth, soft tissues surrounding joint will tighten after few weeks

If hip is not corrected, soft tissue and bony prominences can become permanently deformed

Question 7

risk factors for DDH? 5 Fs

special test for DDH? 2

Answer 7

family hx
frank breech
leFt foot

Barlow & Ortonali

Barlow - dislocate in and post
Ortolani - reduce out and ant

Question 8

Galeazzi Sign

Answer 8

unequal knee heights (after 3 mos)

Question 9

how to dx DDH

Answer 9

US

Xray only good if >4 mos, unreliable <4mos cuz cartilaginous tissues

Question 10

Femoral Anteversion

Answer 10

Femoral neck is rotated forward or anteriorly more than usual from the femoral shaft

• looks like knees together

Presents 1+ yrs; peaks at 4-5 years

girls>boys

Usually bilateral

W-sitters have increased risk

Idiopathic etiology; W sitting does NOT cause the deformity

Usually naturally corrects by 10-12 years

Braces or bars have no effect