Q4: Pediatric Pathologies

Question 1

Developemental Displacement of the Hip

DDH

Answer 1

• Cause - hereditary/breech birth
• Barlow test/Ortolani sign
• Treated with Pavlik Harness (abduction Ox) or hip spica

Question 2

Slipped Capital Femoral Epiphysis

SCFE

Answer 2

• Adolescent Coxa Vara
• typically gradual onset
• Caused by endocrine imbalance (weakens epi- plate)
• Treated with Surgical Fixation

Complication - Avascular Necrosis

Question 3

Legg-Calve-Perthes Disease

Answer 3

• Avascular necrosis of femoral head

Look for antaligic gait, trendelenberg, atrophy (thigh)

Treat with Scottish Rite

Complication - Subluxation or fracture

Question 4

Blount’s Disease

Answer 4

AKA Tibia Vara
* common in children that gain weight quickly
* progressive varus with int. rot. of tibia
* Treated with KAFO, night splint, osteotomy

Question 5

Osgood-Schlatter’s Disease

Answer 5

• Inflammation at tib. tubercle (avulsion possible)
• resolves spontaneously
• pain at knee w ext.
• treated with chopat strap (like tennis elbow)

Question 6

Sever’s Disease

Answer 6

• strain or avulsion of calc.
• pain at heel
• treated with heel lift to shorten achilles
• gel heel cups, short boot, ice

Gone when growth plate closes

Question 7

Idiopathic Toe Walking

Answer 7

• Normal until older than 2
• related to CP, Mus. Dystrophy, Autism
• Good ROM, walk on toes
• Treated w/ AFOs for ambulation and contracture prevention

Question 8

Arthrogryposis Multiplex Congenita

Answer 8

• multiple nonprogressive joint deformities
• Associated with clubfoot
• Treated with PT (contractures) and Sx

Question 9

Osteogenesis Imperfecta

Answer 9

• brittle bone disease (caused by mutated gene)
• associated with blue sclera and small body compared to head
• treated with fx management, AFOs (mobility&positioning), Sx

Question 10

Duchenne Muscular Dystrophy

Answer 10

• ony males, common
• symmetrical weakness of pelvic/glutes
• Gower’s sign (climbing up legs)
• Treated w/ night stretching, Ox for transfers

KAFOs not indicated due to weight

Question 11

Rickets Disease

Answer 11

• vit. D defiency OR renal insufficiency
• soft bones or progressive deformities
• treated with vitamin D regimen, splinting when healing

promote alignment during healing phase

Question 12

Sacral Agenesis

Answer 12

• severe sacral development abnormality
• caudal regression syndrome (Zion video)
• Common deformities - coxa vara; hip/knee dislocations; Taliples Equinovarus

Treat the deformities

Question 13

Spinal Muscle Atrophy

Answer 13

• LMN presentation
• progressive symmetrical atrophy
• Common to see hypotonia, not hitting developmental milestones
• Treat with PT and lightweight Ox

Respiratory Complications