pediatric orthopedics Flashcards Preview

step 2 ck > pediatric orthopedics > Flashcards

Flashcards in pediatric orthopedics Deck (22)
Loading flashcards...
1
Q

What causes developmental dysplasia of the hip?

A

poor development of the acetabulum in utero

2
Q

What are risk factors for developmental dysplasia of the hip?

A

female, firstborn, breech, oligohydramnios

3
Q

What is Galeazzi sign?

A

knees at unequal heights when hips and knees are flexed

4
Q

What are the imaging studies that should be used to assess developmental dysplasia of the hip?

A

ULTRASOUND. Xrays not useful until after 4 months of age

5
Q

What is the treatment for developmental dysplasia of the hip?

A
  • less than 6 mo: Pavlik harness
  • 6mo-2 yrs: closed or open reduction and spica casting
  • 2-8 yrs: open reduction
  • Don’t fix after 8 yrs- limited benefit
6
Q

What is SCFE?

A

separation of the growth plate of the femoral epiphysis from the metaphesis

7
Q

How would hypothyroidism change the management of SCFE?

A

-If pt has hypothyroidism (risk factor for SCFE), they should have prophylactic pinning of the normal contralateral side

8
Q

What are the complications of untreated SCFE?

A

increased risk of avascular necrosis and premature OA

9
Q

What are the labs seen in rickets?

A
  • increased ALP, decr phosphorus
  • If due to low calcium, low calcium and decreased vitamin D, increase PTH
  • If due to impaired phosphate absorption, increased vitamin D
10
Q

What is the treatment for rickets?

A

phosphorus supplements, vitamin D supplements for poor intake, 1,25 dihydroxycholecalciferol for impaired vitamin absorption/metabolism

11
Q

What is Osgood-schlatter diseaes?

A

inflammation of the bone-cartilage interface of the tibial tubercle, esp in young boys during their growth spurts
-treatment is stretching and NSAIDs

12
Q

What is the tx for clavicular fracture in neonates?

A

no treatment (in older kids need a figure of eight sling)

13
Q

What is JIA?

A

Juvenile idiopathic arthritis- defined as nonmigratory arthropathy of 1 or more joints for >3 months
all involve arthralgias and fevers
may have osteopenia and subchondral sclerosis around involved joints

14
Q

Pauciarticular JIA: joints involved, age, extraosseous sx, labs

A

fewer than 4 joints, often large joints except the hips with swelling and decr ROM
presents age 2-3
30% have uveitis or iridocyclitis
weakly positive ANA

15
Q

Pauciarticular JIA: treatment , prognosis, complications

A

-NSAIDs and maybe methotrexate. usually resolves in

16
Q

What is polyarticular JIA? joints involved, age, extraosseous sx, labs

A
  • 5 or more joints, hips less common. Joint involvment usually symmetric and can involve hands and spine.
  • presents at many ages (2-5, 10-14)
  • can cause growth retardation, iridocyclitis is rare
  • Possibly positive ANA or RF
17
Q

What is the tx, prognosis and complications of polyarticular JIA?

A

NSAIDs, methotrexate, sulfasalazine, etanercept

  • 60% have remission by age 15 but some have chronic arthritis. worse prognosis with older age of onset
  • can lead to chronic arthritis and leg length discrepancies
18
Q

What is systemic JIA: what joints, age, extraosseus sx, labs?

A
  • any number of joints, any age under 17
  • kids have acute significant pain, may have fevers, jaw/neck involvment
  • may have a maculopapular rash, LAD, pericardiits
  • negative ANA
19
Q

What is Legg-Calve-Perth disease? When does it present?

A

avascular necrosis of the femoral epiphysis usually seen between the ages of 3-8

20
Q

What is the H/P for Legg-calve-perth disease?

A

gradual progressive limp with insidious onset of pain and decreased ROM

21
Q

What is the treatment for legg-calve perth disease?

A

containment of the hip within the acetabulum via bracing or surgery; acetabular reconstruction performed in cases of permanent hip dysplasia

22
Q

What are the complications of legg-calve-perth disease?

A

50% recover fully, but there is an incr. risk of OA, progressive AVN, and deed for early arthroplasty