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61 Cards in this Set
- Front
- Back
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developmental dysplasia of hip (DDH)
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abnl relationship b/t femur head & acetabulum --> instability/dislocation
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DDH - associated anomalies (4)
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1.clubfoot
2.congenital torticollis 3.metatarsus adductus 4.infantile scoliosis |
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DDH - severity levels (3)
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1.subluxtable
2.dislocatable 3.dislocated |
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Barlow test
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posterosuperior dislocation of hip w/adduction & posterior pressure
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Ortolani maneuver
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abduction w/resulting "clunk" as femur head relocates
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Galeazzi sign
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-hold ankles
-knees bent, hip flexed -chcekc foreshorening of affected limb |
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x-rays in 0-3 month olds
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no good b/c bones have not ossified yet
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Pavlik harness
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Tx for DDH - keeps hip abducted & flexed
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DDH - most serious complication
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avascular necrosis of femur head (usually in kids w/o Tx > 6 months)
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DDH - later risks (1)
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degenerative hip arthritis
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metatarsus adductus
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in-toeing of forefoot w/o hindfoot abnl
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metatarsus adductus - etiology
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intrauterine positioning
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intact plantar & dorsiflexion - metatarsus adductus or talipes equinovarus?
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metatarsus adductus
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fixed plantar flexion hindfoot - metatarsus adductus or talipes equinovarus?
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talipes equinovarus
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most common cause of limp @ any age
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trauma
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DDH - causes
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1. fetus positioning
2. restricted fetal movement |
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T/F: U/S better to rely on than XR for DDH?
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U/S - good by 4-6 wks
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DDH Tx
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Pavlik harness (< 6 mos)
body cast (older kids) |
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T/F: DDH can stabilize w/in 1st 4 months?
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true
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metatarsus adductus - Tx
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mild cases - stretching exercises
severe cases - serial bracing/casting |
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clubfoot criteria
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1.tibia medial rotation
2.fixed plantar flexion 3.foot inversion 4.forefoot adduction |
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clubfoot - Tx
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bracing/serial casting
surgery |
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limp - consider what factor for differential?
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age
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limp in age 3-10: differential
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1.Legg-Calve-Perthes
2.toxic synovitis 3.JIA |
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avascular necrosis of femoral head
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Legg-Calve-Perthes disease
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painless / mildly painful limp + referred pain to thigh/knee + limited ROM + nl XR
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Legg-Calve-Perthes disease
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L-C-P disease - Tx
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bracing or surgery
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L-C-P disease - prognosis dependent on...
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amt & area of ischemic necrosis
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L-C-P disease - most serious acute complication
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femoral head collapse
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SCFE - what is it?
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gradual/acute separation of proximal femoral growth plate
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SCFE radiographic studies place child in X position
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frog-leg lateral position
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inflammation, swelling, tenderness over tibial tuberosity
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Osgood-Schlatter disease
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causes of Osgood-Schlatter disease
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mechanical forces
tendonitis of distal insertion of infrapatellar tendon 1.repetitive stress 2.trauma |
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Osgood-Schlatter disease - Tx
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1.activity modification
2.stretching 3.casting up to 6 wks (severe cases) |
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test for scoliosis
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Adam forward bending test
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kyphosis
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increase in posterior convexity of thoracic spine
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Scheuermann disease
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wedge-shaped vertebral bodies requiring bracing
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XR studies for spinal curvature
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standing PA & lateral
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Tx for curvature < 25
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observation
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Tx for curvature 25-45
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bracing
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Tx for curvature >40
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spinal fusion
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curvature > 50 have associated...
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decreased vital capacity
low functional pulmonary reserve |
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T/F: idiopathic scoliosis is associated w/pain & fatigue
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false
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T/F: bracing corrects curvature & halts progression
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false (only halts progression)
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achondroplasia - what is the reason?
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cartilage calcification & remodeling disorder
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bones in children qualities
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1.more porous
2.more substantial periosteum |
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greenstick fx
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force breaks one side of bone, bends the other
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spiral fx - common in what age group?
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toddlers (tibia)
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torus / buckle fx
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at metaphysis (compression load)
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epiphyseal growth plate fx classification
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salter-harris type
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blue sclera
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oi
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AKA radial head subluxation
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nursemaid's elbow
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strong jerking of pronated hand --> ?
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radial head subluxation
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fever + refusal to move limb = suspect ?
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osteomyelitis
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osteomyelitis peak ages
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1.neonates
2.age 9-11 |
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T/F: toxic synovitis gives tender joint, but can still bear weight
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true
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OI types w/blue sclera
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OI type 1,2
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osteomyelitis: most common sites
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tibia, femur
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osteomyelitis: tx
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IV abx 4-6 wks
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septic arthritis: most common site for infants vs. older children
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infants: hip
older children: knee |
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osteomyelitis: more sensitive dx test
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bone scan (than plain films)
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