Findings: popping sensation, rapid swelling, limited full range of motion, positive anterior drawer test
Question: Which ligament is injured per findings below?
Blount Disease
Category: generalpediatrics-Orthopedics
Findings: bowed legs, abnormal medial epiphysis of proximal tibia, more common in African American
Klippel-Feil Syndrome
Category: generalpediatrics-Orthopedics
Findings: limited neck motion, short webbed neck, meningocele, deafness, fusion of cervical vetebrae
Legg Calve Perthes Disease (Avascular Necrosis Of The Femoral Head)
Category: generalpediatrics-Orthopedics
Findings: limp, pain in hip and knee, irregular appearance of femoral head
Medial Collateral Ligament
Category: generalpediatrics-Orthopedics
Findings: caused by valgus stress to knees (knees closer together), pain on the inside of your knee over ligament, popping sensation, knee instability
Notes: Obtain MRI, prescribe NSAIDs, rest, bracing, and refer to orthopedic surgery.
Question: Which ligament is injured per findings below?
Meniscus
Category: generalpediatrics-Orthopedics
Findings: occur from twisting motions, locking and clicking sensation, tested by McMurry and Alpey compression tests
Question: What is injured per findings below?
Osgood Schlatter Disease
Category: generalpediatrics-Orthopedics
Findings: pain and swelling below knee, caused by traction at tibial tubercle, treated supportively and with physical therapy, usually unilateral, more common with growth spurts
Notes: If pain is worsening despite conservative treatment, need referral to orthopedics for potential surgery.
Findings: fragile bones, frequent fractures, blue sclera, dental imperfections, sensorineural hearing loss
Notes: Collagen defect. Treat with bracing, splinting, or casting.
Patellofemoral Syndrome
Category: generalpediatrics-Orthopedics
Findings: anterior knee pain, more common in females, occurs with prolonged sitting-running-jumping
Notes: Also known as runners knee.
Question: What fits these findings?
Prepatellar Bursitis
Category: generalpediatrics-Orthopedics
Findings: tender and warm knee, rapid swelling of knee cap, fall on anterior knee
Notes: Treat with rest, ice, elevations, and NSAIDs. Consider needle aspiration if not improving with conservative management.
Septic Arthritis
Category: generalpediatrics-Orthopedics
Findings: pain with manipulation of joint, fever, elevated inflammatory markers, diagnosed by joint aspiration
Notes: Common culprits are K. kingae in infants and toddlers, S. aureus in children, and N. gonorrhoeae in adolescents
Question: What fits these findings?
Sever Apophysitis
Category: generalpediatrics-Orthopedics
Findings: heel pain from high impact foot activities in preadolescents, treated with heel cups or cushions
Notes: Due to stress reaction through the cartilaginous calcaneal apophysis. May also treat with regular icing and calf stretching.
Question: What fits these findings?
Slipped Capital Femoral Epiphysis (SCFE)
Category: generalpediatrics-Orthopedics
Findings: knee pain, leg externally rotated at hip, obese adolescent male
Notes: Knee pain is referred. There is a Salter Harris type 1 fracture at femoral growth plate.
Subluxed Radial Head (Nursemaid Elbow)
Category: generalpediatrics-Orthopedics
Findings: pronated forearm, arm flexed and at side, treat with forced supination or hyperprotonation
Thumb Spica Cast
Category: generalpediatrics-Orthopedics
Findings: fall landing on hand, tenderness at base of thumb or anatomic snuffbox, normal hand and wrist xray
Notes: Apply thumb spica cast and refer to orthopedics. X-ray may not show scaphoid fracture until 10 to 14 days later.
Question: What is the best treatment for a problem with these findings?
Toddlers Fracture
Category: generalpediatrics-Orthopedics
Findings: limping toddler, no trauma reported, initial negative xrays
Notes: Formally tibial shaft fracture that may be caused by unwitnessed minor leg twist or fall. May not been clearly seen on xray until 2 weeks later when healing starts. Treat by placing in below knee walking boot for 4 to 6 weeks.
Type 1 Salter Harris Fracture
Category: generalpediatrics-Orthopedics
Findings: fracture through growth plate, negative X-ray for fracture, treat with casting for 2 weeks
Type 2 Salter Harris Fracture
Category: generalpediatrics-Orthopedics
Findings: fracture through growth plate and metaphysis, treat with casting for 4 weeks
Notes: Most common Salter Harris fracture
Question: What fits these findings?
Type 3 Salter Harris Fracture
Category: generalpediatrics-Orthopedics
Findings: fracture through growth plate and epiphysis, may require open reduction for realignment, may cause bone growth retardation
Type 4 Salter Harris Fracture
Category: generalpediatrics-Orthopedics
Findings: fracture through epiphysis-growth plate-metaphysis, requires open reduction
Type 5 Salter Harris Fracture
Category: generalpediatrics-Orthopedics
Findings: crush injury of growth plate, growth retardation after injury, negative x-ray, posterior fat pad
Notes: Epiphysis and metaphysis are crushed towards each other.