Peds Rheumatology and MSK Flashcards
What is JIA?
juvenile idiopathic arthritis (fma juvenile rheumatoid arthritis)
How do you diagnose JIA?
Must be chronic
evidence of joint inflammation (redness, swelling, limited ROM, pain)
duration of arthritis > 6 weeks
age at onset < 16
what is oligoarticular JIA?
involvment of less than 5 joints
what is the rash of systemic JIA?
dermatographia
what are the clinical manifestations of HSP?
palpable purpura on buttocks
subcutaneous edema
arthralgias/arthritis (80%)
avascular necrosis of the femoral head is a common complication of what disease?
sickle cell anemia
in which disease can a pediatric patient develop pain and swelling over the tibial tubercule?
Osgood Schlatter Disease
what is the treatment of Osgood Schlatter?
Rest
NSAIDS
Ice
lower extremity flexibility and strength
course benign (can last 1-2 years)
what is in-toeing associated with?
W sitting
what is the most common treatment for in-toeing and out-toeing?
reassurance
how common is polydactyly?
2nd most common hand deformity
What are the risk factors for congenital hip dysplasia?
- breech presentation
- caucasian
- female
- left hip > right hip
- first born
+ve family hx
What are the signs of developmental hip dysplasia?
- Galezzi’s sign - flexed legs with feet on table, pt. lying supine, one thigh higher than other (shorter dislocated)
- uneven number of thigh folds between legs
+ve Barlow sign - hip dislocation and clunk when adducting knees and pushing in
+ve Ortolani sign - hip relocation and clunk when abducting knees and lifting trochanters
How is developmental hip dysplasia diagnosed?
ultrasound < 6 mos
plain film > 6 mos
what is the treament for developmental hip dysplasia?
Pavlik harness
if that fails, spica cast
if that fails open reduction after 18 mos.
How is scoliosis defined?
Lateral curvature of the spine greater than 10 degrees
what is the epi of scoliosis?
- idiopathic in most cases
- scoliosis requiring treatment 7-8x more common in girls
- congenital, neuromuscular, neoplastic and infectious conditions
- connective tissue disorders
- metabolic bone disease
how do you diagnose?
- forward bend test most sensitive
- pain should not be present
- obtain PA and lateral radiographs
- determine Cobb angle from x rays
- refer to ortho when curve reaches 20 degrees
how do you treat scoliosis?
bracing 18-23 hours/day until growth is complete
surgery - sometimes with curves > 40 go straight to surgery
what is nursemaid’s elbow?
it is subluxation of the radial head due to laxity of the annular ligament
