Peds - Musculoskeletal Flashcards
Inflammation of the tibial tubercle as a result of repetitive stressors in patients with immature skeletal development.
Osgood-Schlatter
Peak age of incidence for Osgood-Schlatter
11 - 14 years
Osgood-Schlatter -
Treatment (2)
o some limitation of activity to control pain
o knee immobilizers may provide some relief
Insidious, unilateral, self-limiting inflammation of the hip, most likely due to viral or immune cause.
Toxic synovitis
TOXIC SYNOVITIS - epidemiology
o peak
o age range
o gender
o peak in ages 2 - 6 years
o occurs ages 1 - 15 years
o males > females
Toxic synovitis -
signs and symptoms
o painful limp
o internal rotation of hip causes spasm
o no obvious sign of infection
Toxic synovitis -
treatment (2)
analgesics
bed rest
Toxic synovitis -
red flags
high fever / suspicion of septic arthritis
= hospitalization
Toxic synovitis -
diagnostics
Xrays - normal
Joint fluid aspiration - normal (not usually done)
Afebrile aseptic or avascular necrosis of the femoral head causing insidious limp with knee pain that radiates UPWARD to the hip.
Legg-Calve-Perthes Disease (LCPD)
Legg-Calve-Perthes Disease -
observation vs. aggressive treatment
OBSERVATION if:
o FROM is preserved
o < 6 years old
o < 1/2 of femoral head involved (xray)
AGGRESSIVE if:
o worse than above criteria
o refer to ortho –> eventual hip replacement
Spontaneous dislocation of femoral head (capital epiphysis) both downward and backward relative to the femoral neck and secondary to disruption of the epiphyseal plate; pain radiates DOWNWARD from hip to knee
Slipped Capital Femoral Epiphysis (SCFE)
“skiffy”
Slipped Capital Femoral Epiphysis (SCFE) -
epidemiology (4)
more common in
MALES
AFRICAN AMERICANS
SEDENTARY
OBESE
Scoliosis -
two red flags that lead to referral
REFER for
any PAIN
-or-
>25 degree curvature
Painless dislocation of the hip in which the femoral head is partially or completely displaced from the acetabulum.
Developmental dysplasia of the Hip (DDH)
Up until what age is each test useful?
- Barlow
- Ortalani
- Galeazzi
Barlow – 6 months
Ortolani – 12 months
Galeazzi – ??
Stretching and/or tearing of the ligaments around the ankle.
Ankle sprain
Ankle sprain - grade I
- definition
- signs and symptoms (4)
stretching but no tearing of ligaments; no joint instability
o local tenderness
o minimal edema
o ecchymosis insignificant or absent
o able to ambulate
Ankle sprain - grade II
- definition
- signs and symptoms (4)
partial tear; some joint instability
o pain immediately upon injury
o local edema and ecchymosis
o limited ROM
o increased pain with weight bearing
Ankle sprain - grade III
- definition
- signs and symptoms (5)
complete tear; joint unstable
o severe pain immediately upon injury o significant edema of foot and ankle o profound ecchymosis o cannot bear weight o no ROM
When is radiograph indicated for ankle sprain -
According to Ottawa Ankle Rule:
o pain near malleoli -and-
o bone tenderness at posterior edge of distal 6 cm of either maleolus -OR-
o patient is unable to walk 4 steps at injury AND evaluation
Ankle sprain management
o R-I-C-E
o NSAIDS
Injury often associated with outstretched arm fall.
Elbow fracture
Elbow fracture -
x-ray findings
+ fat-pad sign on lateral view suggests occult fracture
Elbow fracture -
follow up for + fat pad sign on lateral view
o follow up with oblique view
o refer to ortho
Radial head subluxation is otherwise known as:
Nursemaid’s elbow
