Pediatric orthopedic disorders (obj 28) Flashcards

1
Q

3 risk factors for congenital hip dysplasia, in order of most to least risk

A

family history
breech position
female

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2
Q

How do you interpret the results of a hip abduction test on a baby?

A

suspect hip disease if asymmetric or if abduction > 60 degrees is possible

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3
Q

Testing a baby for hip DISLOCATABILITY (grasp knees, adduct legs, push down and back - dislocation is palpable as femur head slips out of acetabulum)

A

Barlow test

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4
Q

Testing a baby for hip DISLOCATION (start with knees together, abduct and externally rotate - clunk = reduction and is a positive finding)

A

Ortolani test

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5
Q

Allis sign

A

when hips and knees are flexed, the knees are at unequal heights, with dislocated side lower

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6
Q

On a 2 month old baby, xrays are the most useful way to look at hip dysplasia.
T/F

A

FALSE - up until 5-6 months of age, xrays are NOT useful because of lack of ossification centers - do ULTRASOUND

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7
Q

avascular hip necrosis caused by impairment of blood supply to the developing femoral head - cause unknown

A

Legg-Calve-Perthes disease

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8
Q

Parents bring their 12 year old son to your office - he is limping and complaining of pain on walking.
You see that he is overweight.
You observe his gait and see that his right thigh is externally rotated.
You obtain an xray, and see that Klein’s line does not pass through the right femoral head.
Diagnosis? Treatment?

A

Diagnosis: SCFE
Slipped Capital Femoral Epiphysis

Treatment: surgical fixation of femoral head

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9
Q

SCFE and Legg-Calve-Perthes disease are both known for affecting boys around the age of 10. What’s one way you can differentiate them?

A

SCFE has PAINFUL limp

Legg-Calve-Perthes has PAINLESS limp

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10
Q

The treatment for Legg-Calve-Perthes disease:

A

Legg-Calve-Perthes USUALLY RESOLVES ON ITS OWN!

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11
Q

Fancy term for clubfoot

A

talipes equinovarus

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12
Q

Treatment options for clubfoot:

A

mild clubfoot: serial plaster casting

severe clubfoot: surgery

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13
Q

“toeing-in”

A

tibial torsion

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14
Q

treatment for tibial torsion

A

usually resolves spontaneously

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15
Q

baby’s head is turned to one side due to anomalies of SCM

A

torticollis

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16
Q

torticollis can be associated with _____ so be sure to do a thorough full-body musculoskeletal exam

A

hip dysplasia

17
Q

two possible treatments for torticollis

A

stretching/passive ROM

surgery if necessary

18
Q

greater than 10 degree curve by Cobb angle = ______

A

scoliosis

19
Q

What physical exam test can be done to check for scoliosis?

A

Adams forward bend

20
Q

What xray views do you want to get for scoliosis?

A

STANDING full column AP and lateral

21
Q

What are three treatment options for scoliosis?

A

observation
bracing
surgical spinal fusion

22
Q

genu _____ is normal from 0 - 2 yrs old, then switches to genu _____, after which adult alignment is usually obtained.

A

genu varum is normal from 0 - 2 yrs old

genu valgus is normal from 2 - 8 yrs old

23
Q

most common foot deformity in newborns

A

metatarsus varus/metatarsus adductus

two names for the same thing

24
Q

metatarsus varus/adductus usually _________ by age _____________

A

usually spontaneously resolves by age 1-2

25
Q

treatment for femoral anteversion:

A

femoral anteversion is a variant of normal and requires NO treatment

26
Q

subluxation of the radial head = ________

and is caused by ________

A

nursemaid’s elbow; caused by pulling child’s arm or lifting by pulling on hand

27
Q

treatment for nursemaid’s elbow:

A

place elbow in full supination; slowly move from full extension to full flexion; palpate for click at radial head; this should provide immediate pain relief

28
Q

~6+ weeks of joint swelling
~no other cause of childhood arthritis
~diagnosis?

A

Juvenile Idiopathic Arthritis
aka
Juvenile Rheumatoid Arthritis

29
Q

Treatment for Juvenile Idiopathic Arthritis?

A
  1. NSAIDs
  2. glucocorticoids
  3. DMARDs
30
Q

Acute onset of hip or knee monoarticular joint swelling, redness, & pain = _____, most likely caused by _____ (or ______)

A

septic arthritis

most likely caused by MSSA or N. gonorrhoeae

31
Q

Synovial fluid findings in septic arthritis:

A

WBC count > 50,000
PMN > 80%
positive culture