DDH
Name 2 physical exam maneuvers to assess for DDH
1. Barlow/ortolani
2. Galeazzi
3. Klisic
4. Gait
What is a common cause of limp in a child usually after a URI?
Transient synovitis
What is a nursemaid's elbow
Radial head subluxation
What does the Lachman test evaluate?
ACL
How does unrecognized or untreated torticollis usually present?
Plagiocephaly
Between what ages can you obtain US to assess for DDH?
4-6 weeks to 4-6 months
Name 2 causes of painless limp
Developmental hip dysplasia, cerebral palsy, muscular dystrophy, leg-length discrepancy, LCPD (chronic phase), SCFE, scoliosis
What is the prevalence of growing pains?
15-30% of all children, F>M, ages 4-14
What is an avulsion fracture of the tibial tuberosity?
Osgood-Schlatter disease
What inclinometer and Cobb angles should be referred to ortho?
Name 4 risk factors for DDH
What labs should be obtained in a child with limp/refusal to bear weight and fever?
CBC, ESR, CRP, blood culture
Describe a method of reducing a nursemaid's elbow
Hyperpronation of the forearm or supination and elbow flexion
What are the indications for ankle XR according to the Ottawa ankle rules?
Pain in the malleoalar region +
Bone tenderness at the posterior edge of the distal 6cm or the tip of the lateral or medial malleolus or inability to bear weight for at least 4 steps after the injury and at the time of evaluation
What percentage of cases of back pain in adolescents and young adults resolve spontaneously in 2-8 weeks?
80-90%
What are the indications for use of a Pavlik harness?
<6 months and reducible hip
Where in the bone do most cases of osteomyelitis begin?
Metaphysis, highly vascularized
What type of fracture is described as cortex broken on tension side but intact on compression side?
Greenstick
What is an avulsion fracture of the inferior pole of the patella?
Sinding-Larsen-Johansson syndrome
What is the Risser sign?
Grading of the degree of ossification of the iliac crest to assess skeletal maturity, lateral to medial
Name an associated condition
Packaging deformities: congenital muscular torticollis, metatarsus adductus, congenital knee dislocation
Conditions characterized by increased amounts of type III collagen
What are the 3 most common organisms in septic arthritics for children aged 2mo-5years?
Staph, Srep, Kingella
What is the Salter-Harris type? Fracture through the epiphysis, extending into the physis
Type 3
What are the indications for foot XR according to the Ottawa ankle rules?
Pain in midfoot region+
Bone tenderness at the navicular bone, bone tenderness at the base of the fifth metatarsal, inability to bear weight for a least 4 steps both after injury and at the time of evaluation
What imaging would you obtained if you had a patient with scoliosis and abnormal abdominal reflexes? What are you looking for?
MRI, syrinx