Term
| hip abductor weakness is seen with: |
|
Definition
- cerebral palsy
- hip dysplasia |
|
|
Term
| joint laxity pts have increased risk for: |
|
Definition
- dysplasia
- dislocating patella
- flat feet
- injury |
|
|
Term
| Prone extension test looks for: |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Infant and Juvenile Scoliosis(ages3-10 y/o): |
|
Definition
- Observe < 25 degrees
- Orthsosis > 25 degrees
- Operate > 40 degrees |
|
|
Term
|
Definition
- Observe to 30 degrees
- Orthosis 30-40 degrees
- Operate greater than 40 degrees or rapidly progressing curvature |
|
|
Term
| complications of osteomyelitis: |
|
Definition
- Systemic infection like bronchopneumonia and/or septic pericarditis
- pathological fractures
- growth disturbances |
|
|
Term
| Septic arthritis neonatal presentation: |
|
Definition
- few clinical signs
- loss of spontaneous movement of limb
- posturing of joint at rest
- fever often absent and may not appear ill |
|
|
Term
| Septic arthritis infant and child presentation: |
|
Definition
- local and systemic signs
- joint is swollen, tender, and child resists movement |
|
|
Term
| study used to follow progression of treatment with septic arthritis: |
|
Definition
CRP
(ESR can also be used but is not reliable in neonates) |
|
|
Term
|
Definition
- joint aspiration
- cloudy fluid, leukocytes > 50,000, with PMNS predominating |
|
|
Term
| most common isolates with septic arthritis: |
|
Definition
- Staph
- Strep
- Kingella kingae |
|
|
Term
|
Definition
- Parenteral abx for 3-21 days followed by 4 weeks of oralabx
- Serial needle aspiration for joint drainage, if response slow consider the following 2:
- Open drainage (mandatory for hip)
- Arthroscopic drainage |
|
|
Term
| what type of drainage is required for hip septic arthritis? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| MOI for distal radius fracture: |
|
Definition
| falling on outstretched arm |
|
|
Term
|
Definition
| fracture through growth plate |
|
|
Term
| Type II Salter Harris fx: |
|
Definition
| fracture in growth plate and metaphysis |
|
|
Term
| Type III Salter Harris fracture: |
|
Definition
| - fracutre through epiphysis and growth plate |
|
|
Term
| Type IV Salter Harris fracture: |
|
Definition
| - fracture through metaphysis and epiphysis |
|
|
Term
| Type V Salter Harris fracture: |
|
Definition
|
|
Term
| symptoms of organic causes of limp: |
|
Definition
- pain night and day
- pain on weekends and vacations
- pain with PROM
- pain that interrupts play
- pain isolated to joint
- unilateral pain (RED FLAG)
- limps or refuses to walk
- pain fits with local anatomic explanation
- concurrent signs and symptoms of systemic disease
- acute onset last 3 months |
|
|
Term
| MCC of hip pain or limp in children less than 2 years old: |
|
Definition
|
|
Term
| DDx of hip pain/limp in all ages: |
|
Definition
- Osteomyelitis
- Septic Arthritis
- Malignancies |
|
|
Term
| For kids less than 2 y/o, ddx of hip pain/dysplasia: |
|
Definition
- osteomyelitis
- septic arthritis
- malignancies
- congenital hip dysplasia
- toddler's fractures
- tibial stress fracture
- cerebral palsy |
|
|
Term
| DDx of hip pain/limp in kids ages 3-5: |
|
Definition
- Osteomyelitis
- Septic arthritis
- Malignancy
- Transient/toxic synovitis (most common)
- Leukemia |
|
|
Term
| MCC of hip pain/limp in kids ages 3-5: |
|
Definition
| Transient/toxic synovitis |
|
|
Term
| transient/toxic synovitis: |
|
Definition
- idiopathic benign hip joint inflammation
- MCC of hip pain/limp in kids ages 3-5 |
|
|
Term
| MCC of hip pain/limp in ages 5-9: |
|
Definition
| Legg-Calve-Perthes Disease |
|
|
Term
less than 2 y/o MCC of limp: congenital hip dysplasia
3-5 MCC of hip pain/limp: transient synovitis
Ages 5-9 MCC of hip pain: Legg-Calve-Perthes
Ages 11 to 16 MCC of hip pain: Slipped Capital Femoral Epiphysis |
|
Definition
|
|
Term
| MCC of hip pain/limp in children ages 11 to 16: |
|
Definition
| Slipped Capital Femoral Epiphysis |
|
|
Term
| DDx of hip pain/limp in ages 5-9: |
|
Definition
- Legg-Calve-Perthes
- Muscular Dystrophy
- Osteomyelitis
- Malignancy
- Septic arthritis |
|
|
Term
| Ages 11 to 16 ddx of hip pain/limp: |
|
Definition
- SCFE
- Legg-Calve-Perthes
- Tarsal coalition
- Juvenile RA
- Osteochondritis Dissecans of the knee
- Discoid meniscus |
|
|
Term
| imaging that should be done on any limping child: |
|
Definition
|
|
Term
|
Definition
|
|
Term
| Adjectives to describe club feet: |
|
Definition
- Equinus (plantarflexion)
- Adductus
- Varus
- Medial rotation |
|
|
Term
| differnce b/w club foot and metatarsus varus: |
|
Definition
|
|
Term
|
Definition
- Metatarsus adductus
- Metatarsus varus |
|
|
Term
| Metatarsus adductus is a common __ __ deformity presenting with __ of the __foot border.It is __ and resolves __. This is a form of __ __. May be called __ __ or __ __ due to the activity of the abductor hallicus muscle. |
|
Definition
- intrauterine positional deformity
- convexity of the lateral foot border
- benign and resolves spontaneoulsy
- form of in-toeing
- Monkey toeing or Search toeing |
|
|
Term
| 2% of pts with metatarsus adductus also have __ __. |
|
Definition
|
|
Term
| both metatarsus adductus and metatarsus varus are forms of ___. |
|
Definition
|
|
Term
| managment of metatarsus varus: |
|
Definition
- infant: cast
- young child: long leg cast series
- older child: nothing or osteotomy |
|
|
Term
|
Definition
- Metatarsus adductus
- Metatarsus varus
- Internal tibial torsion
- Internal femoral torsion |
|
|
Term
|
Definition
- Infantile external hip rotational contracture
- External tibial torsion
- External femoral torsion |
|
|
Term
| 2 ways besides pain and altered function to distinguish physiological flatfeet from pathological flatfeet: |
|
Definition
- notice an arch with no weight on feet= physiologic
- when patient does a heel raise, an arch forms= physiologic |
|
|
Term
| Causes of pathological flatfeet: |
|
Definition
- Heel cord contracture
- Tarsal coalitions
- Verticaltalus
- Neuromuscular (C.palsy)
- Cutting of post tib tendon
- Club foot overcorection
- Obesity
- Overloaing with external tibial torsion
- Ankle valgus |
|
|
Term
| Most severe cases of vertical talus cause __ __ and __ of the __, which can be surgically fixed late in year one. This is also a cause of ___. |
|
Definition
- hindfoot equinus
- dorsiflexion of the forefoot
- flattfeet |
|
|
Term
| causes of Bowlegs (genu varum): |
|
Definition
- Osteochondral dystrophy
- Rickets
- Tibia vara |
|
|
Term
| causes of genu valgum (knock knees): |
|
Definition
- Osteochondral dystrophy
- Rickets
- Post-traumatic |
|
|
Term
| bowlegs common in __ year olds.knock knees more common in __ to __ year olds. What is the managemetn for this? |
|
Definition
- 2 year olds
- 3 to 4 year olds
- take a picture and follow up in 3-6 montsh |
|
|
Term
| Bow legged(genu varum) are more at risk for __ compartment syndrome. |
|
Definition
|
|
Term
| Knock kneed pts (genu valgum) are more at risk for __ compartment syndrome. |
|
Definition
|
|
Term
| Osgood-Schlatter's is a __ ___ more common in __. However it presents __ in girls.Pain over __ __,relieved with rest. There is a prominent __ __ possibly with __ and __. |
|
Definition
- traction apophysitis
- boys
- younger in girls (10-11) (boys 13-14)
- tibial tuberosity
- tibial tubercle
- swelling and redness |
|
|
Term
| Sever Disease is an __ at the insertion of the __ __ into the __. |
|
Definition
- apophysitis
- achilles tendon
- calcaneus |
|
|
Term
|
Definition
- look at difference in knee height
- test for congenital hip dysplasia |
|
|
Term
| management of hip dysplasia under 6 months of age: |
|
Definition
|
|
Term
| CHD management b/w 6 and 18 months old: |
|
Definition
| - reduce hip under general anesthesia + immobilization with spica cast |
|
|
Term
| CHD treatment over 18 months old: |
|
Definition
| - Operation: Salter osteotomy: femoral and pelvic osteotomy at same time |
|
|
Term
| baby age 0-1 month how long do harness for CHD: |
|
Definition
|
|
Term
| baby 1-3 month, how long do you harness? |
|
Definition
|
|
Term
| baby3-6 months, how long do you harness? |
|
Definition
|
|
Term
|
Definition
- like a hip fracture
- 30% get AVN
- arthritis |
|
|
Term
| Legg-Calve-Perthes Disease is __ __ of the __ __ __. There is vascular interruption to __ __, the __ __ is NOT affected.There are __ changes due to subchondral fracture. |
|
Definition
- osteonecrosis of the capital femoral epiphysis
- vascular interruption to subchondral bone |
|
|
Term
| Legg-Calve-Perthes prsent for weeks but child often doesn't complain.Symptoms include: |
|
Definition
- hip or groin pain, may be referred to thigh
- mild to intermittent pain in anterior thigh/knee
- limp
- no history of trauma |
|
|
Term
| Legg-Calve-Perthes physical exam: |
|
Definition
- Decreased ROM
- Painful gait
- Atrophy of thigh muscles secondary to misuse
- Muscle spasm
- Leg length inequality d/t collapse
- Thigh atrophy
- Short stature:have dleayed bone age
- Roll test |
|
|
Term
|
Definition
- for LCP
- have pt supine, roll affected leg into internal and external rotation
- should invoke guarding/spasm, espcially with internal rotation |
|
|
Term
|
Definition
Hip Xrays:
- AP
- Lateral
- Frog leg |
|
|
Term
|
Definition
- Rest, bracing
- Surgery
- Ortho consult |
|
|
Term
| Spondylolysis is a __ defect of the __ __. Spondylolisthesis is if the vertebrae __ __ on the vertebrae below it. |
|
Definition
- radioluscent defect of the pars interarticularis
- slips forward |
|
|
Term
|
Definition
| seen on oblique view with Spondylolisthesis |
|
|
Term
|
Definition
| - reduce activity- often heal if acute acute, manage with NSAIDS |
|
|
Term
|
Definition
| if severe fusion is required |
|
|
