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44 Cards in this Set
- Front
- Back
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Ankylosing Spondylitis -
Clinical criteria |
1.low back pain > 3 months that improves with exercise, but not relieved with rest.
2. Limited ROM of lumbar spine 3. Bamboo spine 4. ESR may be elevated 5. HLA-B27 (remember it is elev in 8% of pop.of western Europeans) |
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What will an x-ray show with osteoarthritis?
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irreg joint space narrowing
osteophytes subchondral sclerosis subchondral bone cysts |
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Ankylosing Spondylitis -
Clinical criteria |
1.low back pain > 3 months that improves with exercise, but not relieved with rest.
2. Limited ROM of lumbar spine 3. Bamboo spine 4. ESR may be elevated 5. HLA-B27 (remember it is elev in 8% of pop.of western Europeans) |
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What will an x-ray show with osteoarthritis?
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irreg joint space narrowing
osteophytes subchondral sclerosis subchondral bone cysts |
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Developmental Dysplasia of Hip
Tx |
Start Tx early
< 6 mos. - Pavlik harness 6-15 mos. - spica cast 15-24 mos. - open reduction if no Tx started by 24 mos. - signif defect |
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What is a classic sign of a biceps tendon rupture?
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"Popeye" sign - bulging biceps
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Gout - Dx
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Joint-fluid aspirate -
needle-shaped, neg. birefringent crystals yeLLow when paraLLel to condenser inc. WBC advanced - "rat bite" = punched-out erosions - of long-standing tophus "overhanging margin" |
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What is scoliosis?
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a lateral curvature of the spine of greater than 10 degrees
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If scoliosis is developed after skeletal maturity it is usually secondary to?
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degenerative spondylosis and/or degenerative spondylolisthesis
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Idiopathic scoliosis usually develops in
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early adolescence
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In scoliosis, male to female ratio is?
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equal with curves < 20 degrees
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What gender is more likely to have a progression of the curve that will need treatment?
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Female
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Presenting symptoms of scoliosis
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Parents may notice the child’s clothes do not hang even. More commonly, however, the curvature is identified during a school screening or routine exam.
Pain is not associated with idiopathic scoliosis |
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How is scoliosis usually found
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With a forward bend test.
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Usual cause of a shoulder dislocation?
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Fall on outstretched arm in abduction and extension is the most common cause
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What is Legg-Calve-Perthes disease?
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an idiopathic osteonecrosis of the femoral head in children.
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Legg-Calve-Perthes disease is usually found at what ages?
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4 and 8 years, but the range of onset is 2 to 12 years
It is unilateral in 90% of patients, four times more common in boys, and uncommon in blacks. |
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Presenting symptoms of Legg-Calve-Perthes
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Typically, the child has been limping for 3-6 weeks at the initial visit
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What are the Diagnostic studies for Legg-Calve-Perthes disease?
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AP and frog-lateral radiographs of the pelvis should be obtained
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What to x-rays show in Legg-Calve-Perthes disease?
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Increased density of the femoral head is an early sign
crescent sign indicates that the shear fractures has occurred in the subchondral bone In the early stage of LCPD, plain radiographs may be normal, and MRI may be necessary to demonstrate the osteonecrosis. |
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If a child has bilateral involvement with Legg-Calve-Perthes disease it is important to?
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Get screening AP radiographs of the hand and knee are needed to rule out epiphyseal dysplasia or thyroid disease
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PE findings with Legg-Calve-Perthes disease
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mild to moderate restriction of hip motion.
Abduction typically measures 20 to 30 degrees compared to 60 to 70 degrees on the uninvolved side. |
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What are the characteristic phenotype in patients with Legg-Clave-Perthes disease/
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short stature, delayed bone age and hyperactivity
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What is chondromalacia?
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knee pain resulting from mechanical and biochemical changes to the patellofemoral joint
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What is the hallmark of a frozen shoulder (adhesive capulitis)?
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a contracted capsule on MRI
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What is the treatment of a frozen shoulder?
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NSAIDS, nonopioids, moist heat followed by gentle stretching. Ice is used after stretching to prevent swelling
Recovery time is 1-2 years |
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What are the PE findings with frozen shoulder?
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At least a 50% reduction in both PROM and ROM compared with the unaffected shoulder
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What is the most common risk factor for frozen shoulder (adhesive capulitis)?
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Type I diabetes
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What are clinical symptoms of shoulder bursitis (rotator cuff tendinitis)?
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Gradual onset of anterior and lateral shoulder pain exacerbated by overhead activity. Night pain and difficulty sleeping on the affected side are also common
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What are the PE findings with shoulder bursitis (rotator cuff tendinitis)?
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tenderness and crepitus with shoulder motion. Positive Neer and Hawkins signs.
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What is the treatment for shoulder bursitis (rotator cuff tendinitis)?
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NSAIDS, rest from the offending activity. Stretching program. Steroid injection can be considered if stretching not affective.
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weakness, catching and grating are common symptoms, especially when lifting the arm overhead is associated with?
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Rotator cuff tear
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What is a finding on PE with rotator cuff tear?
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The patient can only shrug or "hike" the shoulder when asked to lift the arm. Tenderness to palpation over the greater tuberosity.
Back of shoulder may appear sunken because of atrophy of supraspinatus and infraspinatus muscles |
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What is the treatment for rotator cuff tear?
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Non-surgical = NSAIDS, PT and avoiding overhead activities.
Surgery if significant symptoms and failed rehab over 3-6 months. Acute traumatic tear should be repaired early |
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What is Nursemaid's Elbow?
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an interposition of the annular ligament into the radial-humerus joint. Subluxation of the radial head
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How does Nursemaid's Elbow occur?
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Often when the extended arm was pulled.
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Epidemiology of Nursemaid's Elbow?
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1. Nursemaid's elbow is more common in girls than boys and more often on the left side.
2. Usually between 1-3 years of age and rare after age 4. |
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Treatment of Nursemaid's Elbow?
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While supporting the radial head, the forearm is supinated or pronated and flexed at the same time. A "click" will be heard or felt.
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What is the most common cause of paronychia?
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S. aureus
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What is a herpetic whitlow?
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A virally mediated hand infection characterized by formation of vesicles filled with clear fluid, located in and around the fingertip
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What is a felon?
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It is usually caused by a puncture An infection of the pulp or palmar tip of the finger and in the soft tissues directly surrounding the fingernail.
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What is the treatment a felon?
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Most require surgical drainage with a digital block
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What is De Quervain tenosynovitis?
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Swelling or stenosis of the sheath that surrounds the abductor pollicus longus and extensor pollicus brevis tendons at the wrist
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What is the test for De Quervain tenosynovitis?
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The Finkelstein test. Fully flex the thumb into the palm, followed by ulnar deviation of the wrist will produce pain
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