DDH
For testing DDH if a Galeazzi sign was positive what would it look like
asymmetrical shortening of the affected leg
what does a clubfoot present with
medial twisting, plantar flexion, inversion, forefoot adduction (metavarus)
what are the four types of scoliosis
congenital or infantile: before 6 months
juvenile: 3-9 years old
idiopathic or adolescent: 9- adulthood
neuromuscular: occurs in children with a neurological condition at any age or stage of growth , cerebral palsy, myelodysplasia
what is slipped capital femoral epiphysis (SCFE) and what ages are typically seen
fracture through the growth plate causing slippage of the overlying end of the femur
males 10-16 years old
females 10-14 years old
what is the second most common malignant bone cancer in children and where are these typically found
ewing sarcoma
usually grows in the bone marrow or tissues around the bones
What is the proper positioning for a baby with DDH
Spread squat positioning even in a car seat and swaddling!
if treating clubfoot with dennis brown splints how often should they be worn
23 hours of the day
what is legg calves perthes disease and what are some impairments we may see
avascular event affecting the capital epiphysis
we may see a limp, pain with activity and relieved by rest, pain around groin, anterior hip or lateral by greater trochanter, we will also see muscle weakness, ROM limitations and gait deviations
what are the clinical presentations for a slipped capital femoral epiphysis
anterior thigh and knee pain (above and below joint), antalgic gait, externally rotated lower leg, decreased hip ROM
what is the difference between ewing sarcoma and rhabdomyosarcoma
ewing: occurs between 4-25 years old and is a malignant bone cancer
rhabdomyosarcoma: soft tissue sarcoma and occurs in children younger than 7 years old
In DDH what is the alpha angle? beta angle?
greater than or equal to 60 degrees
less than 77 degrees
what is the most common form of congenital foot deformity?
how much adduction is normal in infancy?
metatarsus adductus
5-10 degrees of adduction is normal in infancy
what is the lateral pillar classification used for and what does ABC represent
LCPD
A- hips do not involve the lateral pillar
B- limited involvement with maintenance of over 50% of the lateral pillar
C- over 50% collapse of the pillar height
what are some risk factors and complications with slipped capital femoral epiphysis
obesity, developmental delay, juvenile hormonal changes
complications: avascular necrosis
what are the common causes of rickets
caused by vitamin D or phosphate deficiency
What is the definition of developmental dysplasia of the hip?
abnormal development of the hip joint resulting in abnormal relationship of the femoral head to the acetabulum
what are some characteristics of type 1 OI? what about type 2 OI
1: most common and mildest; bones fx easily and before puberty; normal or near normal stature; loose jts & muscle weakness etc.
2: most severe form, frequently lethal at or shortly after birth often due to respiratory problems, numerous fxs and severe none deformity, small stature w/underdeveloped lungs, tinted sclera
what is blount disease and what are the 3 different types
growth disorder of the medial aspect of the proximal tibia= tibia vara (genu varum/bowlegged)
infantile: <3 yrs old
Juvenile: 4-10 yrs old
Adolescent: >11 yrs old
what is juvenile idiopathic arthritis and what are some common areas of pain
formerly known as juvenile rheumatoid arthritis (JRA), pain and inflammation at multiple joints
common areas include ankles, knees, hips, unilateral and bilateral
what are children with rickets at risk for
curvature, deformity, fractures
What are some treatment options for babies with DDH for 18 months and under? what about 2 yrs and older?
splints and harnesses
surgical correction is required - 2 yrs and older
The spread squat position can be implicated always
what are some characteristics of type 3 OI? type 4?
3: bones fx easily, fx often present at birth, short stature, barrel-shaped rib cage, triangular face, spinal curvature, respiratory problems possible, collagen improperly formed, etc.
4: bones fx easily, most fxs before puberty, shorter than average stature, sclera are white or near white, mild to moderate bone deformity, etc.
toddlers that have tibia vara are what?
often obese
early walkers
may exhibit a lateral thrust of the knee during stance
what should we monitor for with JIA
nutritional deficits, uveitis, growth disturbances, psychological concerns
physeal regions enlarged (wrists will appear swollen)