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44 Cards in this Set
- Front
- Back
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What junction is often the weak link in children?
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Bone-tendon
(as opposed to ligament in adult) |
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What is the name of an overuse injury in the rapidly growing child, most commonly in active boys 11-13 yo?
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Osgood-Schlatter Disease
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A 12 yo boy presents with swelling and tenderness under his right knee and over the shinbone. He says that the pain gets worse when he runs.
What do you suspect he has? What might you see on an xray? |
Osgood-Schlatter Disease
xray may reveal elevation at the tibial tuberosity |
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How do you treat Osgood-Schlatter Disease?
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Treat symptoms. anti-inflammatories. ice*
Stretching* Rest. Limit painful activities* 2-3 mos |
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Due to a child's unique anatomy of the metaphyseal circulation, there is a higher incidence of what?
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Hematogenous osteomyelitis
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T/F
A child's spine is less susceptible to hematogenous diskitis and osteomyelitis than an adult's. |
False!
A child's spine is MORE susceptible! |
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A very common problem that is characterized by anterior knee pain due to abnormal patellar tracking in the trochlear groove is called what?
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Patellofemoral Stress Syndrome
(aka Anterior knee syndrome or Runners syndrome) |
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Patellofemoral Stress syndrome is caused by imbalances in what forces?
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the forces controlling patellar tracking during knee flexion and extension
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What is chondromalacia patellae?
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Irritation to the undersurface of the patella. It can be a/w patellofemoral stress syndrome.
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PFSS pain increases with what activities?
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Flexion-extension activities
such as: running, kicking, jumping (soccer) going up and down hills and stairs kneeling, squatting, sitting for long periods of time |
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A patient presents with anterior knee pain. They report that they have vague parapatellar pain, especially when climbing stairs. On physical exam, you notice that there is crepitation of the patella with flexion and extension. You compress the patella and the pain increases.
What is your diagnosis? |
PFSS
Diagnose based on anterior knee pain, crepitus, and pain with patellar compression |
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How do you treat PFSS?
With PT, what muscles would you want to address? |
Rest
Anti-inflammatories PT addresses strength and stretching (emphasis on quads/hams flexibility and VMO strengthening) |
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What is the MC elbow injury in children under 5 yo?
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Nursemaids Elbow
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Subluxation of the radial head is called what?
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Nursemaids Elbow
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What is the mechanism of Nursemaids Elbow?
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pulling on the forearm when the elbow is EXTENDED and the forearm is PRONATED
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A 4 yo girl presents with tenderness over the radial head of her left arm. She is holding her arm close to her body, flexed with her forearm pronated. She resists attempted supination.
However, you send for an x-ray, and the x-rays are normal. What is your diagnosis? |
Nursemaid's Elbow
xray will be normal! |
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How do you reduce a Nursemaid's Elbow?
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Place thumb over the radial head and supinate the forearm. then flex
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T/F
Foot infections are not anything to worry about. |
False!
They can be pretty serioud and can lead to osteomyelitis |
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How do you make a diagnosis of a foot infection?
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Exam
X-ray to rule out osteomyelitis or foreign body |
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How do you treat foot infections?
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Aggressive, early immobilization
Antibiotics Close observation |
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T/F
The exam of a patient with growing pains is normal in all aspects. |
True!
However, there may be tenderness to deep pressure. Don't miss a serious cause of the pain!! |
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How do you treat growing pains?
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Warm or cold compresses, massage or simple analgesics to relieve symptoms
Short-term rest or immobilization However, it is self-limiting and resolves after a few months |
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With growing pains, you want to make sure you don't overlook what?
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A mass or metabolic disorder (Leukemia)*
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A foot with an abnormally high arch is called what?
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Pes cavus
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Pes cavus frequently accompanies what?
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Underling neuromuscular disorder and associated muscle weakness or spasticity
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How do you treat pes cavus?
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Early foot disorders - shoe modifications and arch support
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An abnormally low or absent longitudinal arch on the foot, usually asymptomatic, is called what?
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Pes planus
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With flatfeet, what do you need to determine about them?
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If it is rigid. If flexible, the arch will reappear with plantar flexion (standing on toes)
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What is another name for Talipes Equinovarus?
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Club foot
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What are the 4 components of club foot? (should have at least 3)
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1. Plantar flexion (equinus) of the ankle
2. Adduction (varus) of the heel 3. High arch (cavus) 4. Adduction of the forefoot |
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What is the tx for club foot?
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Stretching (may help symptoms)
Casting immediately! for 2-4 mos Surgery (if unhealed for 3-4 mos; he thinks this is common earlier now) Bracing Rehab |
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Torus fractures (Buckle fractures) are very (uncommon/common) in children.
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common
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In what type of fracture is one side of the cortex disrupted while the other side remains intact?
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Buckle fractures aka Torus fractures
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How do you diagnose and treat Buckle fractures?
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Diagnose: xray
tx: cast about 3 wks |
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Describe types 1-5 of the Salter-Harris growth plate classification system.
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1-5 SALTR
1 - Slipped (break is thru physis) 2 - Above (break extends thru physis and metaphysis) 3 - Lower (break extends thru physis and epiphysis) 4 - Through (break extends thru both meta and epi) 5 - Rammed (compressive) |
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What is the Thurston-Holland fragment?
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metaphyseal fragment of type 2 growth plate fracture
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What is the MC type of Salter-Harris fracture?
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Type 2
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Which Salter-Harris fracture may cause minimal shortening but rarely results in functional limitations?
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Type 2
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Which Salter-Harris fracture is an intra-articular fracture that can result in chronic disability?
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Type 4
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This Salter-Harris fracture typically has a history of an axial load injury. Diagnosis often is not made until after premature closure of the physis, and it is especially hard to diagnose in older teens. These have a poor functional prognosis. What type is this?
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Type 5
The clinical history is paramount in the diagnosis of this fracture! |
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Traction apophysitis of the medial epicondyle (presenting as pain/tenderness to palpation of the medial epicondyle) is caused by what?
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Overuse in the throwing young athlete
Little Leaguer Elbow |
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How do you diagnose Little Leaguer Elbow?
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X-rays with comparison views of the contralateral side* (swelling, widening, or evulsion of the medial epicondyle)
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How do you treat Little Leaguer elbow?
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Rest, no throwing, for 3-6 wks
Rehab to restore elbow motion and UE strength |
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Can Little Leaguer Elbow be prevented?
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Yes! Limit the amount of pitching. there are lots of rules now
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