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20 Cards in this Set

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blood culture+
0-3 years --> developmental dysplasia of hip
4-12 years --> Legg-Clave-Pethers disease
>12 years --> slipped capital femoral epiphysis
developmental dysplasia of the hip presentation
Barlow sign --> dislocates hip in neonate
Ortolani sign -->
Galeazzi sign -->
developmental dysplasia of the hip diagnosis
dynamic ultrasound of hips is best test
after 4 months --> frog lateral x-ray
developmental dysplasia of the hip treatment
Pavlik harness for 1-2 months then surgery
Legg-Calve-Perthes disease
idiopathic avascular necrosis of capital femoral epiphysis in 4-12 y/o
presentation --> mild intermittent pain in anterior thigh with painless limp and decreased range of motion
diagnosis --> AP and frog lateral x-rays shows compression, collapse and deformity of femoral head
treatment --> casts, bedrest or surgical correction
slipped capital femoral epiphysis
obese with delayed skeletal maturation or thin with recent growth spurt
mild antalgic gait with external rotation
sudden onset of pain and cannot stand or walk
knee pain also
diagnosis --> AP and frog-lateral x-ray shows femoral neck rotated anteriorly with head in acetabulum
treatment --> close the epiphysis by pinning
transient synovitis
7-14 days after URI
acute pain with limp
pain in groin, anterior thigh and knee
diagnosis --> small effusion, increased ESR, normal x-ray
treatment --> bedrest
metatarsus adductus
forefoot is adducted from flexible to rigid; can place foot flat on exam
treat with serial plaster casts, orthoses and corrective shoes
surgery if still significant by 4 years
talipes euinovarus
hindfoot equinus, hindfoot and midfoot varus, forefoot adduction
can't get heel flat on exam
treatment --> serial casting, orthoses, corrective shoes by 3 months; else surgery
internal femoral torsion
femoral anteversion
secondary to abnormal sitting habits
entire leg rotated inwardly at hip during gait
surgery if significant after 10y/o
popliteal cyst
Baker cyst
distension of bursa by synovial fluid behind knee
ultrasound for aspiration
surgery if symptomatic or enlargement
Osgood-Schlatter disease
traction apophysitis of tibial tubercle (overuse injury) in active adoloescent
swelling, tenderness, increased prominence of tubercle
treatment is rest and immobilization
scoliosis
more common in adolescent females
PA and lateral x-rays of entire spine
braces if < 40 degrees; surgery if > 45 degrees or brace failure
osteomyelitis etiology
staph MC overall
GBS in neonates
pseudomonas in puncture wounds
salmonella in sickle cell disease
septic arthritis
osteomyelitis presentation
pain with movements
fever
edema
erythema
limp or refusal to walk
osteomyelitis diagnosis
blood culture, CBC, ESR, CRP
x-rays --> to exclude trauma foreign body or tumor; are normal until after 10-14 days
ultrasound --> joint effusion
best is MRI
definitive diagnosis --> bone biopsy for culture and sensitivity
osteomyelitis treatment
always cover for staph initially
4-6 weeks
osteogenesis impefecta
fragile bones, blue sclera and early deafness
diagnosis --> rule out child abuse; confrim with collagen studies using cultured fibroblasts from biopsy
osteogenic sarcoma
more common after 10 y/o
predisposes to retinoblastoma
x-ray --> sclerotic destruction seen as sunburst
osteogenic sarcoma Vs. Ewing sarcoma x-rays
osteogenic --> sclerotic destruction seen as sunburst lesion
Ewing --> lytic lesion with laminar periosteal elevation seen as onion skin lesion