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DU PA Peds MS Dz
Duke PA Pediatric Musculoskeletal Disease
| Question | Answer |
|---|---|
| Sub-periosteal swelling contained in suture lines | Cephalohematoma |
| Extra-periosteal swelling crosses suture lines, poorly defined | Caput succedaneum |
| Cephalohematoma reabsorbs within ____ | 2-12 weeks |
| Premature fusion of suture | Craniosynostosis |
| Treatment for torticollis | Active and passive stretching, botulinum injections in refractory cases. |
| When do you refer torticollis for surgical consult | If not improved in 6 months |
| Annular ligament entrapment due to traction. Presents as flexed and internally rotated forearm | Radial head subluxation (nursemaid’s elbow) |
| Treatment for nursemaid’s elbow | Therapeutic x-ray, hyperpronation, flexion/supination/extension |
| Treatment for polydactyly/syndactyly | Excision at 6-9 months |
| Stenosing tenosynovitis aka __ | Trigger finger (painful thickened flexor tendon or nodule at the A-1 pulley |
| What is the classification of physeal fractures | Salter-Harris |
| What does the mnemonic SALTR stand for when referring to Salter-Harris fractures | S=straight (I), A=above (II), L=lower (III), T=through (IV), R=ram (V) |
| Treatment for greenstick fx | Reduction if needed and short arm cast for 3-4 months |
| Buckle fracture with intact periosteum | Torus fx |
| Treatment for torus fx | 3-4 weeks immobilization in a short arm cast (young children need long arm cast) |
| __ fat pad sign is usually normal | Anterior |
| __ fat pad sign is always pathologic and indicates supracondylar fx | Posterior |
| What is the most common elbow fx in children | Supracondylar fx |
| Which epicondyle is most commonly fractured | Medial |
| What is the mnemonic for the ossification of the elbow | CRITOL, C=capitellum, R=radius, I= internal epicondyle, T=trochlea, O=olecranon, L=lateral epicondyle |
| For scoliosis monitor curves less than __ | 20 degrees |
| For scoliosis curves <__ are unlikely to progress | 20; monitor (6-12 month xrays) |
| Scoliosis; for curves __ x-ray and bracing | 25-45 degrees |
| Scoliosis; for curves >__ rod and grafting | 45-50 degrees |
| When should you order an MRI for scoliosis | Onset before 8 yo |
| Most common place for spondylolysis | L5 |
| Growing pains are more common in __ | 2-5 year old boys, calves most common location |
| Osgood-schlatter is more common in __ | 10-14 year old boys |
| What should be in your differential for a limp | Transient synovitis, septic joint, Legg-Calve-Perthes, SCFE, fractures, contusion, malignancy |
| Septic joint and osteomyelitis frequently follows __ | URI |
| SS of septic joint/osteomyelitis | Fever, joint or bone pain, leukocytosis |
| Common etiologic organisms for septic joint and osteomyelitis | Bone: GAS, S. aureus Joint: H. flu, GAS, E. coli, N. gonorrhea |
| Avascular necrosis of the femoral head, 2-11 yo, insidious groin and anterior thigh pain, limp. Loss of int and ext rotation. Mottled femoral head on x-ray | Legg-Calve-Perthes disease |
| Femoral head displace from femoral neck through the physis. Obese, hypogonadic, adolescent boys, presents with limp and hip/thigh, or knee pain, loss of IR, flexion/abduction; 60% bilateral | Slipped Capital Femoral Epiphysis (SCFE) |
| #1 bone tumor in children, pain free mass, rarely malignant | Osteochondroma |
| Most common foot deformity of the newborn, caused by uterine packing, can be passively corrected, self correcting by 12-18 months | Metatarsus adductus |
| Tibial torsion self corrects by __ | 2-4 years |
| Bow legs | Genu varum |
| Differential for genu varum | Rickets, Blount’s disease |
| Knock knees | Genu valgum |
| Gait appears clumsy, patellae and feet point inward, child may trip often and tends to sit in “W” position, spontaneous resolution by late childhood | Femoral anteversion |
| Congenital deformity, fixed ankle plantar flexion, heel inversion, varus forefoot | Talipes equinovarus “club foot” |
| Well localized posterior calcaneus pain along Achilles insertion, very common in 7-15 y/o | calcaneal apophysitis (Sever’s disease) |
| Absent longitudinal arch of foot | Pes planus |
| Spondylo imaging | Spondylolysis oblique (Scottie dog); spondylolisthesis lateral (step-off sometimes seen) |
| Intoeing DDx | Metatarsus adductus; Tibial torsion; increased femoral anteversion; Genu varum |
| Club foot epidemiology | 1:1000, M>F slightly |
| Tx (Poseti) for club foot | Serial casting; Surgical tendon release; Night brace 2 years |
Created by:
bwyche
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