Peds Ortho

Question 1

T/f - child get sprains commonly

Answer 1

false

Question 2

what is the most vulnerable in kids: bones, growth plates, ligaments

Answer 2

growth plates

Question 3

Salter Harris I

Answer 3

Fracture occurs transversely through physis, separating epiphysis from metaphysis

Question 4

Salter Harris 2

Answer 4

Fracture through a portion of the physis that extends through the metaphysis

Question 5

Salter Harris 3

Answer 5

Fracture through a portion of the physis that extends through the epiphysis and into the joint

Question 6

Salter Harris 4

Answer 6

Fracture across the metaphysis, physis, and epiphysis

Question 7

Salter Harris 5

Answer 7

Crush injury to the physis

Question 8

fracture of clavicle and proximal humerus most imp differential dx

Answer 8

septic arthritis

shoulder dislocation

Question 9

Legg-CalvÉ-Perthes Disease

Answer 9

Idiopathic osteonecrosis of femoral head in children 2-12 years*

Question 10

Legg-CalvÉ-Perthes Disease s/sxs

Answer 10

Limping 3-6 weeks
Activity increases pain
Aching in groin or thigh

Question 11

Slipped Capital Femoral epiphysis

Answer 11

Displacement of femoral head through an immature physis
typically during adolescent growth spurt*
Microscopic fractures and gradual or acute slip
Slips posterior and medial

Question 12

Slipped Capital Femoral epiphysis presentation

Answer 12

Pain increased with activity
Proximal anterior thigh or groin pain
Some patients have pain referred to distal thigh or lower
Screen all adolescents with lower ext pain

Question 13

osteogenesis imperfecta vs child abuse

Answer 13

osteogenesis imperfecta:
Connective tissue disorder
“brittle bone disease”
Multiple fractures with minimal or no trauma
Child abuse:
Exam: Full exam - consider the child!
Include funduscopic!
Retinal hemorrhages
Suspicious soft tissue injuries
Previous injuries
Bruises at different stages of healing
Sexual assault

Question 14

calcaneal Apophysitis aka

Answer 14

severs dz

Question 15

severs dz

Answer 15

Inflammation of the calcaneal physis
Pain associated with increased with activity
Stress and microtrauma (tension Apophysitis)

Question 16

Patellar apophysitis aka

Answer 16

Osgood-Schlatter Disease

Question 17

Osgood-Schlatter Disease

Answer 17

Traction apophysitis of the proximal tibial tubercle at the insertion of the patellar tendon
Overuse injury

Question 18

presentation

Answer 18

Pain and swelling at tibial tubercle
Ages 9 – 14 typically have undergone rapid growth spurt
Typically occur in 13 – 14 yo males and 11 – 12 yo female
More common in Adolescents active in sports
Bilateral 25 – 50% of cases

Question 19

Developmental Dysplasia of the Hip (DDH)

Answer 19

Acetabulum does not fully cover the femoral head

Increased risk of dislocation

Question 20

what tests do you do for Developmental Dysplasia of the Hip

Answer 20

Barlows

Ortolani

Question 21

Legg-CalvÉ-Perthes Disease tx

Answer 21

Nothing influences rate of bone remodeling and healing