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45 Cards in this Set
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etiology of child with a limp
birth to 3 yo 3-12 yo >12 yo |
birth to 3 yo - hip dysplasia
4-12 yo legg calve perthes disease >12 slipped capital femoral epipysis |
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What are risk factors for hip dysplasia?
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Family history, female, first born, breech
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What are the 2 exams for hip dysplasia
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barlow - will dislocate hip
ortolani - reduces dislocation |
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How do you dx hip dysplasia
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ultrasound
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how do you treat hip dysplasia?
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pavilk harness for 1-2 mo
surgery/casting |
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what are complications with hip dysplasia?
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acetabular dysplasia
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what is legg calve perthes disease
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idiopathic avascular necrosis of the capital femoral epiphysis in immature growing child
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where does hip pathology refer pain?
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knee
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what sex gets legg calve perthes disease more?
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males
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what is the presentation of legg calve perthes disease?
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mild intermittent pain in anterior thigh with painless limp (antalgic gait), decreased restriction of motion
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how do you diagnose legg calve perthes disease?
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ant/post & frog leg lat x-ray shows compression, collapse, & deformity of femoral head
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how do you treat legg calve perthes disease?
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containment with casting, bedrest
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who is the typical patient with slipped capital femoral epiphysis?
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obese or thin with recent growth spurt
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what is the presentation of slipped capital femoral epiphysis?
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pre slip: stable, antaglic gait, external rotaion
unstable slip: sudden onset of extreme pain, cannot stand/walk, knee pain |
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What are complications of slipped capital femoral epiphysis?
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osteonecrosis
chondrolysis - degeneration of cartilage |
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what is the diagnosis of slipped capital femoral epiphysis?
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AP & frog leg lateral XR
-widening of physis without slipage (preslip) -femoral neck rotates anteriorly while head remains in acetabulum (icecream cone) |
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what is the treatment of slipped capital femoral epiphysis?
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close capital femoral epiphysis, pinning
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What is the etiology of transient synovitis?
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viral: 7-14 days after URI
3-8 yo |
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What is the presentation of transient synovitis?
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acute pain with limp & mild restriction of movement
pain in groin, anterior thigh & knee |
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How do you diagnose transient synovitis?
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small effusion, slight increase in ESR, normal XR
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What is the treatment of transient synovitis?
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bedrest, no weight bearing
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What is metatarsus adductus?
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forefoot adducted
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What is talipes equinovarus?
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clubfoot
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what is talipes equinovarus?
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small, medially rotated, stiff
heel cannot go flat |
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What is the most common cause of intoeing > 2 years old?
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internal femoral torsion
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What is the cause of internal femoral torsion?
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abnormal "W" sitting
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What does internal femoral torsion look like?
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entire leg rotated inwardly @ hip during gait
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What is the most common cause of intoeing <2 yo?
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internal tibial torsion
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what is a baker cyst?
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distention of bursa by synovial fluid behind knee
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what is osgood schlatter dz?
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traction of apophysitis of tibial tubercle - overuse injury
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What does osgood schlatter dz look like?
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active teen
swelling, tenderness, increased prominence of tubrecle |
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How do you tx osgood schlatter dz?
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rest, immobilization
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What is nursemaid elbow?
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longitudinal traction causes radial head sublaxation
-sudden hx of traction or pulling on arm |
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What do you see on PE with nursemaid elbow?
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refusal to bend elbow
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What bugs cause osteomyelitis?
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S. aureus - MC
GBS/Gram Negative - neonates Pseudomonas - puncture wound Salmonella - sickle cell |
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What bug causes septic arthritis?
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s aureus
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what dz is characterized by fragile bones, blue sclera, early deafness?
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osteogenesis imperfecta
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what is a risk factor for osteogenic sarcoma?
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retinoblastoma, irradiation
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Pick osteogenic sarcoma vs ewing sarcoma
white race |
ewing
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Pick osteogenic sarcoma vs ewing sarcoma
males |
osteogenic sarcoma
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Pick osteogenic sarcoma vs ewing sarcoma
predisposition by irradiation |
osteogenic sarcoma
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Pick osteogenic sarcoma vs ewing sarcoma
sclerotic destruction sunburst |
osteogenic sarcoma
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Pick osteogenic sarcoma vs ewing sarcoma
lytic c laminar periosteal elevation - onion skinng |
ewing sarcoma
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codman's triangle is seen in...
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osteogenic sarcoma
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what is codman's triangle due to?
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periosteal bone formation @ diaphysis
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