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43 Cards in this Set
- Front
- Back
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what is often the weak link in soft tissue injuries of kids? |
bone-tendon jxn |
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what type of injury is osgood schlatter's? who is most commonly affected? |
overuse. Most common in active boys ages 11-13 |
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12 yo boy presents with anterior knee pain that worseness with exercise. There is swelling and tenderness present over the shinbone just below the knee. Dx |
Osgood schlatter |
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on PE there is tenderness and swelling at tibial tubercle. Xray reveals elevation at the tibial tuberosity. Dx:
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Osgood schlatter
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how do you tx Osgood schlatter?
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Ice, stretching, rest, limit painful activities (2-3 months) |
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why is there a higher incidence of hematogenous osteomyelitis in children? |
due to the unique anatomy of metaphyseal circulation (dec circulation) |
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what is a childs' spine more susceptible to? |
hematogenous diskitis and osteomyelitis
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what causes patellofemoral stress syndrome (PFFS)? |
abnormal patellar tracking in the trochlear groove due to imbalances in the forces controlling the tracking during knee flexion and extension |
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what is chondromalacia patella? |
irritation to the undersurface of the patella
*Characteristic of PFFS |
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11 yr old female presents with anterior knee pain that gets worse when walking down the stairs. Upon PE you notice that there is pain & crepitus present with flexion and extension. Dx |
Patellofemoral stress syndrome |
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how do you tx Patellofemoral Stress syndrom? |
rest, anti-inflammatories, PT (for quads and hamstring flexibility as well as VMO strenghening)
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what is the most common elbow injury in children under 5 yoa?
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Nursemaids elbow- subluxation of the radial head |
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how is nursemaids elbow caused?
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pulling on the forearm when the elbow is extended and the forearm pronated
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what happens to the annular ligament in nursemaids elbow?
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annular ligament slips proximally and becomes interposed btwn the radius and ulna.
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3 yo male comes in holding her left arm at her side with the elbow slightly flexed and the forearm pronated. Upon PE there is tenderness over the radial head and x-rays came up normal.Dx: |
Nursemaids' elbow |
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how do you tx nursemaids' elbow?
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reduction: place thumb over the radial head and supinate the forearm (if unsuccessful, flex the forearm) |
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if you suspect a foot infection, why would you order an Xray? |
to rule out or in- osteomyelitis or Foreign Body
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how do you tx foot infections?
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aggressive, early immobilization, antibiotics and close observation |
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how do you differentiate growing pains from other pains such as JIA or neoplastic pain? |
tx/relieve w: warm or cold compresses, massage or simple analgesics to relieve the symptoms, simple analgesics, and short term rest/ immobilization will make it feel better.
(usually in boys 2-5) |
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what should NOT be overlooked when examining a child complaining on pain (if you suspect growing pains)?
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a mass or metabolic disorder (leukemia)
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what is pes cavus? What is it generally associated with?
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a foot with an abnormally high arch (forefoot in equinus).
This frequently accompanies an underlying neuromuscular disorder and associated muscle weakness or spasticity. (examine spine to rule out) |
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how do you tx pes cavus? |
early foot disorders tx w/ shoe modifications and arch supports
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what is pes planus? what do you need to determine for pes planus?
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An abnormally low or absent longitudinal arch.
Need to determine that the flatfoot is not rigid. Have them stand on their toes and if the arch reappears then its a flexible flat foot. Rigid is more worrisome (neurologic) |
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T/F
Most pes planus pts are asymptomatic |
true
(no tx necessary) |
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what are the 4 components of club foot (Talipes Equinovarus)? |
1. plantar flexion (equinus) of the ankle 2. adduction of the heel (varus) 3. high arch (cavus) 4. adduction of the forefoot |
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what is the tx of club foot?
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stretching, casting-start immediately (2 to 4 months), surgery if unhealed after 3-4 months, bracing, rehab (good prognosis if tx early) |
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what is a torus (buckle) fractures? |
one side of the cortex is disrupted but the other side remains intact |
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how do you diagnose a buckle fracture? how do you tx?
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xrays, cast (about 3 weeks) |
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what is the acronym for the salter-harris fracture classification?
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S- slipped or separated physis |
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a transverse fracture through the physis. The width of the physis is increased. Name the fracture type.
S- slipped or separated physis |
Salter-Harris I |
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A fracture through the physis and the metaphysis, but the epiphysis is not involved in the injury. More proximal portion of the bone.
A- above the physis (physis & metaphysis only) |
Salter-Harris II |
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what is the metaphyseal fragment called? |
Thurston-Holland fragment |
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what is the most common type of salter-harris fracture? |
salter-harris II |
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a fracture through the physis and the epiphysis. This fracture passes thru the hypertrophhic layer of the physis and extends to split the epiphysis, inevitably damaging the reproductive layer of the physis.
L- lower than the physis (epiphysis & physis only)
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salter-harris III |
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fracture passes through the epiphysis, physis and metaphysis.
T- thru/traverse all Three |
salter-harris IV |
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which salter-harris classifications can result in chronic disability?
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SH 4 and 5 |
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A compression or crush injury of the epiphyseal plate with no associated epiphyseal or metaphyseal fracture
R- rammed physis |
salter-harris V
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which fracture is usually made in retrospect and is particularly difficult to diagnose?
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Salter-harris V |
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what type of history is typically assoc with SH V?
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axial load injury
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what is little leaguer elbow? where do you usually see this? |
traction apophysitis of the medial epicondyle--- overuse in throwing young athlete
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what is the main symptom of little leaguer elbow?
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pain to the medial epicondyle
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what do you do on diagnosis to confirm little leaguer elbow?
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xrays
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what is the tx for little leaguer elbow? how do you prevent little leaguer elbow?
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rest, no throwing for 3-6 wks. Rehabilitation to restore elbow motion and upper extremity strength.
Prevent: limit amount of pitching. |
