Peds Ortho and rheumatology Flashcards
what is Legg-Calve Perthes Disease
blood supply interrupted to the femoral head and causes avascular necrosis
s/s of LCPD
- limp
- pain or stiffness in the hip
- limited ROM
diagnosis of LCPD
- Xrays
- MRI if xray inconclusive
treatment of LCPD
- minimize impact
- PT
- avoid weight bearing
- traction
- casting
types of developmental dysplasia of the hip
- unstable: hip loose in socket with abnormal movement
- subluxation: partial dislocation
- dislocation: hip completely out of socket
- dysplasia: wide spectrum term ranging from unstable to dysplastic to malformed
s/s of DDH
- hip clicks
- painless, but exaggerated waddling limp
- trendelenburg
diagnosis of DDH
- barlow and ortalani
- US under 4mo
- xray older
treatment of DDH
- 0-6mo: pavlik harness
- 6-18mo: closed reduction and spica casting
- 18mo-6y: closed reduction vs open reduction
- 6y+: no treatment
management of positive ortolani vs barlow
-ortolani: refer to specialist
-barlow: observe and follow
criteria for juvenile idiopathic arthritis
chronic arthritis in 1 or more joints for at least 6 weeks
presentation of oligoarticular JIA
- 4 or fewer joints
- asymmetrical
- mild pain or painless
- associated uveitis
presentation of polyarticular JIA
- 5 or more joints
- symmetrical
- may or may not have + RF
presentation of systemic JIA
- high fever
- salmon pink macular rash
- can involve any number of joints
presentation of Enthesitis-Associated JIA
- inflammation of tendinous insertions
- low back pain or sacroiliitis
labs for JIA
- some are RF+
- antiCCP
- ANA
- HLAB27
how do you diagnose JIA
Xray first
treatment of JIA
- NSAIDs
- methotrexate if NSAIDs fail
- steroids for severe, systemic
MOI for nursemaid’s elbow
pull on an extended arm
s/s of nursemaid elbow
- holds arm by side
- fully pronates
- refuses to use
treatment of nursemaids elbow
- hyper-pronation
- supinate and flex
osgood schlatter
inflammation of the tibial tuberosity
S/S Osgood-Schlatter Disease
- anterior knee pain
- limp
- relieved with rest
- tenderness on palpation
Treatment of Osgood-Schlatter
- Relative rest
- Ice
- NSAIDs
- Stretching exercises
MC type of scoliosis
right thoracic
Diagnosis of scoliosis
xray and cobb angle measurement
treatment of scoliosis
- <20: follow for progression
- > 20: refer for bracing or surgery
MCC of slipped cap femoral epiphysis
obseity
when does a SCFE occur?
during times of accelerated growth
s/s of SCFE
- knee or hip hain
- intermittent limp
- pain with internal rotation
stable vs unstable SCFE
- stable: can ambulate with assistance
- unstable: non-weight bearing
treatment of SCFE
internal fixation with screw
complication of SCFE
avascular necrosis
