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Peds and other


What might subdural or retinal hemorrhaging suggest in a child? possible abuse from shaking
What fractures indicate possible abuse? (5) posterior rib, scapula, posterior process of spine, sternum, corner fractures of long bone metaphysis
Pt (child) presents w/ posterior heel pain and a limp. Pain inc w/ activity. clacanel apophysitis aka Sever's dz
what age/gender is assoc w/ sever's dz male 8-11 y/o
tx for calcaneal apophysitis (sever's dz) activity restriction, heel lift, achilles tendon stretching, casting 4-6 wks, NO SURGERY OR INJECTION
associated w/ ligamentous laxity in hip and detectable at birth. assymptomatic in neonates and sometimes picked up when child starts to walk. Developmental dysplasia of the hip
Dx Develop. Dysplasia of the hip PE. Barlow test. Ortolani maneuver for relocatability. hip limiter abduction. US. Geleazzi sign for leg length
What are the adverse outcomes of Dev. Dysplasia of the hip longer the hip is dislocated the harder to reduce AND possible early DJD
Tx Develop. dysplasia of the hip <3 mos - PAVLIK HARNESS3-9 mos try harnesslater - closed or open reduction
congenital deformity, autosomal dominant, mild scoliosis, moderate limb deformity, mild limb shortening. BLUE SCLERAE osteogenesis imperfecta
adverse outcomes of growth plate damage? limb length discrepancy or angulation
congenital dislocaton of the radial head subluxation of radial head
what is the most common childhood dislocation? elbow dislocation
Are most elbow dislocations anterior or posterior? 80% posterior
tibia becomes laterally deviated from midline as it progresses distally Valgum
"knock knees" valgum
"bow legged" varus
how do you dx valgum measure height and plot on nomogram; measure tibiofemoral angle or intermalleolar dist
tx for valgum None: usually corrects itself
deformity w/ tibia medially deviated more as it progresses distally genu varum
tx varum ITV-bracing; tibial osteotomy 30-60 mos
what can cause mild intoeing? mild CP
after what age is an osteotomy used to treat in toeing/out toeing 7-8 yrs
What age should is in/out toeing considered severe at? severe beyond age 4 and watch until age 8
what age is metatarsus adductus severe beyond 6 mos
idiopathic osteonecrosis of femoral head in children 2-12 y/o legg-calve-perthes dz
is legg-calve-perthes dz more common in males or females males 4:1
what leads to a worse prognosis for legg-calve-perthes dz advanced age and involvement; also bone death w/ collapse may lead to deformity and DJD
pt presents w/ limping x 3-6 weeks, pain increasing w/ activity and aching in groin or thigh legg-calve-perthes dz
dx legg-calve-perthes dz limited abduciton; AP and frog-lateral views of hips; inc density of FH, CRESCENT SIGN of shear fracture in subchondral bone; poss MRI
CRESENT SIGN on and xray indicates... legg-calve-perthes dz
tx legg-calve-perthes dz observation for children w/mild involvement:bracing in abduction (marginally effective), bed rest and traction, osteotomy for older pts
displacement of femoral head through an immature physis typically during adolescent growth spurt slipped capital femaoral epiphysis
what directions does SCFE usually slip posterior and medial
what factore predispose SCFE obesity, male, sports activities
What age range for female and males w/ SCFE F: 12y/o M: 13y/o
pt w/ proximal anterior thigh or groin pian possibly radiating to distal thigh. pain inc w/ activity. loss of hip internal rotation w/flexion. abduction and extension dec. shortening of affected extremity SCFE
Dx SCFE AP and frog-lateral pelvic films
"ice cream slipping off ice cream cone" SCFE
Adverse outcomes of SCFE progressive arthritis, chondrolysis, osteonecrosis, DJD
tx SCFE in situ stabilization, reduction and emergent stabilization, realignment osteotomy, PINNING IN SITU IS STANDARD OF CARE
After what age do you worry about toe walking? 18 mos
antibiotic used to treat animal bites Augmentin
organism involved in cat/dog bites pasturella multocida
when do you close a cat bite? NEVER!!!!
swelling or stenosis of the tendon sheath, pain swelling, triggering at base of thumb. Swelling and tenderness over first dorsal compartment DeQuervain's tenosynovitis
+ finkelstein test DeQuervain's tenosynovitis
tx DeQuervain's tenosynovitis thumb spica splint, NSAID, injection surgery
nodular thickening and contracture of the palmar fascia. usually men >50 Dupuytren contracture
Created by: mczarko