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20 Cards in this Set
- Front
- Back
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blood culture+
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0-3 years --> developmental dysplasia of hip
4-12 years --> Legg-Clave-Pethers disease >12 years --> slipped capital femoral epiphysis |
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developmental dysplasia of the hip presentation
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Barlow sign --> dislocates hip in neonate
Ortolani sign --> Galeazzi sign --> |
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developmental dysplasia of the hip diagnosis
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dynamic ultrasound of hips is best test
after 4 months --> frog lateral x-ray |
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developmental dysplasia of the hip treatment
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Pavlik harness for 1-2 months then surgery
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Legg-Calve-Perthes disease
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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 |
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slipped capital femoral epiphysis
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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 |
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transient synovitis
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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 |
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metatarsus adductus
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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 |
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talipes euinovarus
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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 |
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internal femoral torsion
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femoral anteversion
secondary to abnormal sitting habits entire leg rotated inwardly at hip during gait surgery if significant after 10y/o |
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popliteal cyst
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Baker cyst
distension of bursa by synovial fluid behind knee ultrasound for aspiration surgery if symptomatic or enlargement |
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Osgood-Schlatter disease
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traction apophysitis of tibial tubercle (overuse injury) in active adoloescent
swelling, tenderness, increased prominence of tubercle treatment is rest and immobilization |
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scoliosis
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more common in adolescent females
PA and lateral x-rays of entire spine braces if < 40 degrees; surgery if > 45 degrees or brace failure |
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osteomyelitis etiology
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staph MC overall
GBS in neonates pseudomonas in puncture wounds salmonella in sickle cell disease septic arthritis |
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osteomyelitis presentation
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pain with movements
fever edema erythema limp or refusal to walk |
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osteomyelitis diagnosis
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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 |
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osteomyelitis treatment
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always cover for staph initially
4-6 weeks |
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osteogenesis impefecta
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fragile bones, blue sclera and early deafness
diagnosis --> rule out child abuse; confrim with collagen studies using cultured fibroblasts from biopsy |
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osteogenic sarcoma
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more common after 10 y/o
predisposes to retinoblastoma x-ray --> sclerotic destruction seen as sunburst |
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osteogenic sarcoma Vs. Ewing sarcoma x-rays
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osteogenic --> sclerotic destruction seen as sunburst lesion
Ewing --> lytic lesion with laminar periosteal elevation seen as onion skin lesion |
