shoulder and upper extremities, Peds, hip and lower extremities, HPI/PE, spine, crossword 1 &2, rheumatology 1&2 Flashcards
which size of vessel?
- Polyarteritis nodosa
- Behҫet syndrome
- Kawasaki disease (pediatrics)
Medium vessel
Developmental Dysplasia of the Hip (DDH) tx:
Pavlik harness
Common laboratory finding indicating renal involvement in systemic lupus erythematosus
Proteinuria
____________ implies significant nerve root irritation when positive.
The Straight Leg Raise
stiffness decreases with exercise/ activity
Ankylosing spondylitis
Empty can test
supraspinatus strength
Ottawa Knee Rules
- age 55 years or older
- inability to weight bear 4 steps both immediately and in the emergency department
- inability to flex the knee to 90 degrees
- _______________
- tenderness at the head of the fibula
isolated patellar tenderness
Thickening and tightening of the skin of the fingers into contractures in patients with CREST syndrome
Sclerodactyly
x ray show: onion skinning
ewing sarcoma
Most common radiographic finding in reactive arthritis*
fluffy periostitis
Ottawa Knee Rules
- age 55 years or older
- inability to weight bear 4 steps both immediately and in the emergency department
- _______________
- isolated patellar tenderness
- tenderness at the head of the fibula
inability to flex the knee to 90 degrees
Four components of clubfoot?
rigid
ankle plantar flexion
inverted
complex apperance to latteral portion of the foot
Arthrocentesis: shows weakly positive; rhomboid-shaped
pseudogout
Direct blow or compression that is angulated
Bending force overcomes convex surface
Greenstick
Drying of the oral mucosa
xerostomia
- NEW ONSET OF URINARY OR BOWEL
- RETENTION/INCONTINENCE WITH SADDLE ANESTHESIA,
- UNI/BILATERAL LEG RADIATION
- DECREASED ANAL SPHINCTER
- TONE ON RECTAL EXAM*
cauda equina syndrome
Scaphoid fractures complications
A vascular necrosis
Common concomitant condition in patients with polymyalgia rheumatica
temporal arteritis
when do you need to re-image a fracture ina kiddo?
10-14 d
presents with:
- Extreme fatigue
- Sleep disturbances
Fibromyalgia
Purplish erythematous and scaly lesions over the various joints of the fingers in patients with dermatomyositis
Gottron papules
Joint inflammation in response to preceding viral or bacterial infection elsewhere
Reactive Arthritis
(+) ADSON : loss of radial pulse with head rotate to affected side
Thoracic outlet syndrome
(+)(antibody) anti-jo1= (condition)________
inflammatory myopathy
a benign cartilage-capped bony spur arising on the external surface of a bone
osteochondroma
Ganglion cyst are most common on the
Wrist
Nursemaids Elbow
treatment:
- Hyperpronation method
* supination/flexion method
Vasculitis of medium-sized arteries that causes ‘rosary sign’ with segmental aneurysms, but nothing involving the lungs
Polyarteritis nodosa
Progressive degeneration of cartilage surfaces, especially in weight-bearing joints*
osteoarthritis
autoimmune disorder that destroys the salivary and lacrimal glands
Sjögren Syndrome
Osgood-schlatter disease is d/t________
rupture of growth plate at the tibial tuberosity
PE will show flexing the infant’s hips and knees showing uneven knee heights (galeazzi test)
Developmental Dysplasia of the Hip (DDH)
Morning joint stiffness> 60 minutes after initiating movement, improves later in the day
rheumatoid arthritis
Overuse syndrome from excessive wrist FLEXION and repetitive gripping activities
Medial Epicondylitis
Finkelstein’s Test
DeQuervain’s Tenosynovitis
- obesity kids
- limp pain
- immedicate managment: stop weight-bearing and refer immediately
slipped capital Femoral Epiphysis
Autoantibody associated with diffuse systemic sclerosis
Antitopoisomerase I
Infection of bone caused by a microogranism
Osteomyelitis
Most common primary malignant bone tumor in children
osteosarcoma
Boutonniere deformity and swan-neck deformity
rheumatoid arthritis
Anatomical snuffbox tenderness
Scaphoid fracture
Potential complications of fractures through growth plates?
growth could be inhibited
- relapsing uveitis
- recurring genital ulcers
- recurring oral ulcers
Behçet Disease
Narrowed joint space, sclerosis and osteophyte formation
Osteoarthritis
Radiographic finding in pseudogout
chondrocalcinosis
Treatment for newborn clavicle fracture?
conservative treatment
AKA: eosinophilic granulomatosis with polyangiitis
Churg-Strauss Syndrome
Manifestation that is present in all patients with rheumatoid arthritis*
morning stiffness
symmetrical aching and stiffness about he shoulders, hip girdle, neck, torso
Polymyalgia rheumatica
Best diagnostic test for DDH?
ultrasound
BMD=
bone mineral density
ankylosing spondylitis, inflammatory bowel disease, psoriatic arthritis, polymyalgia rheumatica
spinal cause of LBP?
Inflammatory
“Sail Sign” =
Fat Pad Sign
softening and weakening of bones in infants and children
RICKETS
Autoimmune inflammation that targets the synovium –>joint pain, stiffness, erythema, swelling
Juvenile Idiopathic Arthritis
Is idiopathic scoliosis painful?
no
Flexor tendon catches when it attempts to slide through sheath
Trigger finger
Classic facial dermatologic finding in patients with systemic lupus erythematosus
malar rash
Most common pediatric elbow fractures
Supracondylar humerus fractures
Roos test
- Standing Abduct arm to 90°
- Ext Rot shoulder
- Open and Close hand for 3 minutes
spinal stenosis, patient EXTENSION leads to ______
increased pain
Heberden and Bouchard nodes
Osteoarthritis
Golfer’s, Baseball, or Suitcase Elbow
Medial Epicondylitis
What is an apophysis?
bony protuberance where muscle or tendon attach
Nondisplaced–> displaced anterior fat pad sign or (+) posterior fat pad sign*
Supracondylar humerus fractures
Polyarticular JIA: how many and which sized joints?
- More than 5
* Small to medium joints (hands, feet, ankles, wrists)
a chronic systemic inflammatory disorder that primarily involves synovial joints
rheumatoid arthritis
MC frequently affected joint: first MTP joint MC
Gout
Nodes found at the PIP joints in osteoarthritis*
Bouchard
Lower limb evaluation for Achilles Tendon ruptures
Thompson’s Test
leads to contraction of MCP
Dupuytren Contracture
Malar butterfly rash and
renal disease common in
childhood ________
Systemic Lupus Erythematosus
Most common intoeing in toddlers
*patellae straight with feet turned inwards
Internal Tibial Torsion
Toxicity associatd with administration of hydroxychloroquine
retinal toxicity
X ray show “scoop of ice cream slipping off an ice cream cone”
Slipped capital femoral Epiphysis “SCIFFY”
Rotator cuff muscles
SITS supraspinatus infraspinatus teres major subscapularis
(+) anti-centromere AB
systemic sclerosis
Conglomerations of urate crystals surrounded by giant cells in an inflammatory reaction in chronic gout
tophi
(+)(antibody) anti-dsDNA= (condition)________
*lupus
Three mechanical forces that may cause acute brachial plexus injury?
Neck-shoulder traction
Direct blow
Compression (due to contralateral hyperextension)
Overuse Injury of the lateral knee
iliotibial band syndrome
manifest as joint pain: commonly asymmetrical and/or monoarticular
Osteoarthritis
Most common joint affected by arthritis associated with Lyme disease*
knee
Ottawa Knee Rules
- age 55 years or older
- inability to weight bear 4 steps both immediately and in the emergency department
- inability to flex the knee to 90 degrees
- isolated patellar tenderness
- _________________
tenderness at the head of the fibula
Spondylolysis and Spondylolisthesis
treatment
Restrict activity and Physical therapy
General term for inflammation of sciatic nerve
Sciatica
HIP, THIGH OR KNEE PAIN WITH LIMP*
SLIPPED CAPITAL FEMORAL EPIPHYSIS-“SCIFFY
positive Roos test indicates
thoracic outlet
Location of pain from diseased hip?
medial knee
Most specific* for non-accidental injury
Suspicious Fractures
syndactyly =
webbed toes
PIP node
Bouchard node
Apley scratch test
rotator cuff / adhesive capsulitis
Idiopathic inflammatory myopathy with associated skin manifestations
Dermatomyositis
Chemical composition of crystals in pseudogout*
calcium pyrophosphate
pt will be complaining of persistent, unexplained arthritis in one or more joints for more than 6 weeks in children younger than 16 yo
Juvenile Rheumatoid Arthritis
- postural-flexible
- congenital-progressive
- scheuermann disease
Kyphosis
Autoantibody associated with CREST syndrome
Anticentromere
- Partial disruption of joint
* altered but bones of the joint still remain in contact
Subluxation
Force along the axis
Longitudinal
- terminal end of long bone
* Ultimately forms articular cartilage.
Epiphysis
caused by uric acid crystals
gout
scotty dog appearance on X-ray
spondylolysis
- focal necrotizing vasculitis
- necrotizing granulomas in the lung and upper airway
- necrotizing glomelonephritis
Granulomatosis with Polyangiitis
BMD between 1 and 2.5 DS below the mean (T-score -1 to -2.5)
Osteopenia
Ottawa Knee Rules
- age 55 years or older
- ________________
- inability to flex the knee to 90 degrees
- isolated patellar tenderness
- tenderness at the head of the fibula
inability to weight bear 4 steps both immediately and in the emergency department
bones involved in articulation no longer in contact
Dislocation
“Toddler’s fracture” is what type of fracture in which bone?
tibia
“pencil in a cup”
HLA-B27 positive
Psoriatic Arthritis
Blood test: that confirms JIA? associated with uveitis?
none , yes can be associated with uveitis
- Most common foot deformity of infants, usually flexible
- Convex lateral surface of foot
- Possibly due to intrauterine position
Metatarsus Adductus
*complaining of low back pain and stiffness when walking that is relieved when leaning forward
spinal stenosis
_________is the most common non-sicca symptom in Sjögren Syndrome
Chronic fatigue
Autoantibody associated with drug-induced lupus
antinuclear
Rupture of ulnar collateral Ligament
Skier’s Thumb (Gamekeeper’s Thumb)
hx of fluoroquinolone use
PE: shows absent plantar flexion upon calf squeeze ( thompson test)
achiles tendon rupture
anterior slippage of a lumbar vertebra, usually occurring due to bilateral defects or fractures of the pars interarticularis
*MC location is L5-S1
Spondylolisthesis
PE: show arm abducted, externally rotated
anterior shoulder dislocation
Most common source of bone and joint infections?
blood
(+)(antibody) anti-smith= (condition)________
lupus
Defect or stress fracture of the pars interarticularis
*MC location is L5
Spondylolysis
Occult fractures are common ________
in kids
injury to skeletal muscle, followed by release of intracellular contents
Rhabdomyolysis
