Peds Shelf Texas last 1/3 Flashcards
Most common cause kid w/ a limp?
Trauma
18month old F
Asymmetric gluteal folds
Clunk on barlow: adduct thigh, push posterior on knee to try to push hip out of socket
Development hip dysplasia
Tx: Pavlik harness, surgery
5yo painless limp initially
Now pain in knee or thigh
Leg-Calve’-Prethes Disease
- avascular necrosis
5yo cold 1 wk ago Now limp + effusion in hip Xrays normal ESR 35 (elevated) WBCs = 10k
Transient synovitis
- bed rest 1 wk NSAIDs
14yo lanky M w/ nagging knee pain
Decreased ROM of hip on exam
SCFE: often overweight
Tx: surgically close + pin the epiphysis to avoid osteonecrosis
14yo basketball/volleyball player knee pain + swelling of tibial tubercle
Osgood-Schlatter
- overuse from jumping
12yo F 2wk hx daily fevers to 102 + salmon colored evanescent rash on trunk, thighs, shoulders
Left and right knee swollen
Juvenile rheumatoid arthritis
Tx: NSAIDs = 1st line
2nd line = methotrexate
3rd line = steroids
2yo F w/ 2wk hx daily fevers to 102, desquamating rash on perineum.
Swollen hands/feet, conjunctivitis, unilateral swollen cervical LN
Kawasaki
Tx: IVIG + high dose Aspirin
Good/bad prognostic factor for JRA?
ANA - good
RF - bad
Best first test when Kawasaki is suspected?
2D echo + EKG
Then repeat echo after 2-3 wks of treatment
Most serious sequellae from Kawasaki?
Coronary aneurysm
MI
Onion skinning on Xray
Ewing Sarcoma
- if < 10yo more likely
Onion skinning = layers of perosteal development
Treat Ewing Sarcoma?
Rads +/- surgery
Sunburst or codman’s triangle on Xray
Osteogenic sarcoma
- if > 10yo more likely
Treat Osteogenic sarcoma?
Chemo +/- surgery