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61 Cards in this Set

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