Peds Orthopedics, Ferril

Question 1

causing limp in child 4-10 years old

Answer 1

trauma
infectious
osteochondroses
neoplasms:leukemia
inflammatory: juvenile idiopathic arthritis

Question 2

causes of limp in child 10-18 y.o

Answer 2

trama: slipped capital femoral epiphysis
neoplasm
infectious: lyme and gonococcal
microtrauma
tarsal coalition

Question 3

+ L trendelenberg

Answer 3

AB ductors lower extremity weak

L AB ductors challenged

Question 4

slipped capital femoral epiiphysis

Answer 4

femoral head falls off

Question 5

imaging for hip pain

Answer 5

frog leg XR b/l

Question 6

SCFE

Answer 6

overweight boys
endocrine disorders
acute
subacute/chronic

Question 7

scale of SCFE

Answer 7

mild: 1-1/3 slip 0-30 degrees
mod 1/3-2/3 slip 30-60
severe: 2/3- complete slip 60-90

Question 8

Tx SCFE

Answer 8

stabilize femoral head
surgically
good prognosis
risk avascular necrosis

Question 9

OMT SCFE

Answer 9

great
before after and long term
improve vascular and lymphatic circulation
improve muscular tone

Question 10

methods to balance tone in jiont

Answer 10

counterstrain!

BLT

Question 11

tender warm nodules over ant superior aspect tibias b/l

Answer 11

osgood schlatter

Question 12

imaging for osgood schaltter

Answer 12

lateral plain XR to see if tibial avulsion

Question 13

Tx osgood schlatter

Answer 13

OMT is great
tibial rotation and hip restriction
so balance quads hamstrings
ICE NSAIDs when severe
conservative

Question 14

in-toeing in kids intrinsic to foot

Answer 14

meta-tarsus ADductus

Question 15

common SD for in toeing of feet

Answer 15

tightness medial fascia and ADductors
torsion first and second metatarsals inversion rotation of 1st cuneiform
everted calcaneus
lateral longitudinal arch flattened
posterior fibular head

Question 16

growth center for iliac crest

Answer 16

11-14 years open

close 20 yr

Question 17

growth center for ischial tub

Answer 17

13-15 open

16-18 close

Question 18

growth center for femoral head

Answer 18

4 mo

close 16-18

Question 19

growth center for greater trochanter

Answer 19

4-6 years open

16-17 close

Question 20

growth center for femoral condyle

Answer 20

39 weeks open

16-19 close

Question 21

growth center for tibial plateau

Answer 21

birth open

16-19 close

Question 22

when do children develop adult gait

Answer 22

5-6 y.o

Question 23

gait in children

Answer 23

high guard and low guard

Question 24

common ortho problems of lower extremities in nkids

Answer 24

hip dysplasia
legg calve perthes disease
slipped capital femoral epiphysis
osgood schlatter disease
intoeing
pes planus (rigid vs functional)

Question 25

static visual inspection of lower extremity

Answer 25

line and shape (minimal varus normal in kid

Question 26

flat feet normal for what age

Answer 26

up to 3 y.o

Question 27

best outcome for hip dysplasia

Answer 27

if detect before 6 mo

Question 28

exam for hip dysplasia

Answer 28

ortalani and barlow | need XR is + or high suspicion

Question 29

congeintal coxa vera

Answer 29

decreased ABduction with dec femoral neck shaft angle

Question 30

Legg calve perthes disease

Answer 30

aseptic necrosis of femoral head 2-12 y.o usually 4-8 y.o boys > girls

Question 31

Sx legg calve perthes disease

Answer 31

aching groin or proximal thigh worse at end of day antalgic gait XR narrowed irregular epiphysis

Question 32

which way does physis femoral head change in adolescence

Answer 32

horizontal to oblique

Question 33

signs SCFE

Answer 33

pain and antalgic gait decreased physical activity b/l in 40-50%

Question 34

most common ped overuse syndrome

Answer 34

osgood schlatter

Question 35

age for osgood schlatter

Answer 35

girls 8-13 | boys 10-15

Question 36

description of mech of action osgood schlatter

Answer 36

repetitive tensile forces on developing tibial tubercle

Question 37

type I vs II osgood schlatter

Answer 37

I- soft tissue swelling only | II- XR evidence fragmentation

Question 38

most common cause intoeing in infants

Answer 38

metatarsus adductus

Question 39

kidney bean or C shape heel bisector line

Answer 39

metatarsus adductus

Question 40

course of metatarsus adductus

Answer 40

resolves spontaneously by 2 y.o

Question 41

rigid vs functional flat foot

Answer 41

functional- great toe passively extended and median arch will lift up rigid- remain flattened

Question 42

what movements of hip can affect osgood schlatter

Answer 42

posterior rotations and lateral flares increase tensile forces on patella anterior rotations alter tone in knee flexors and may influence knee rotation

Question 43

which way does tibia rotate with knee extension

Answer 43

laterally

Question 44

what can cause external tibial rotation

Answer 44

hypertonic sartorius

Question 45

effets of a shortened biceps femoris

Answer 45

can limit external rotation during knee extension | can limit internal rotation of tibiea during knee flexion

Question 46

pes planus causes what

Answer 46

compensatory internal rotation tibia during loading

Question 47

what is the keystone of medial arch of foot

Answer 47

navicular

Question 48

what maintains osseous architecture of foot

Answer 48

transverse arch of foot