musculoskeletal

what are stronger than bones until puberty?

ligaments and tendons

what is the most common area for a child to break a bone?

distal forearm

plastic deformation

buckle/torus break

greenstick fracture

complete fracture

complete break with periosteal hinge

a child who had a cast placed complains of pain and tightness - what do you suspect?

compartment syndrome

a group of conditions that cause the femoral head and the acetabulum are improperly aligned

developmental dysplasia of the hip (DDH)

what is a common causative factor DDH?

breech position

an infant’s one knee is lower than the other when their legs are flex, this is known as -

Galeazzi sign

what maneuvers can be done by a physician to check for HHD?

Ortolani and Barlow

when do minor cases of DDH normally resolve?

4 months

what is the treatment for DDH if the infant is less than 6 months old?

bracing (23 hours a day)

what is the treatment of DDH if the child is older than 6 months?

closed reduction with spica casting

plantar flexion of the foot, inversion of the heel, and medial deviation of the forefoot are all parts of -

clubfoot

what is the treatment of choice for clubfoot?

serial casting (Ponseti method)

what are options of serial casting is not working to repair clubfoot?

tenectomy or surgical repair

medical adduction of the toes and forefoot are referred to as -

metatarsus adductus

what normally causes metatarsus adductus?

positioning in utero

what are the common treatments for metatarsus adductus?

usually stretching, can be surgical

inherited connective tissue disorder where the production of collagen is effected, resulting in fragile bones -

osteogenesis imperfecta

what is the most severe form of osteogenesis imperfecta?

type 2

what is the most common type of osteogenesis imperfecta?

type 1

what dietary changes should be suggested for a child with osteogenesis imperfecta?

high vitamin D and calcium intake

a self-limited condition of avascular necrosis of the femoral head as a result of an interruption in blood supply

Legg-Calve-Perthes disease

what is a hallmark sign of Legg-Calve’-Perthes disease?

limp with mild to severe pain

condition where the femoral head is displaced from the femoral neck

slipped capital femoral epiphysis

what is a common predisposing factor for slipped capital femoral epiphysis?

obesity

what is the hallmark sign of slipped capital femoral epiphysis?

pain and a limp

a lateral curvature of the spine that is associated with a rotational deformity?

scoliosis

dose a child with scoliosis experience pain?

rarely

how often should a child with a brace wear it within the day?

23 hours

how should a brace be worn for scoliosis?

over a shirt; not directly on the skin

where is osteomyelitis more common?

lower extremities

what is the most common cause of osteomyelitis?

bacterial infection

what is the most common bacteria that causes osteomyelitis?

staph aureus

what are the expected laboratory findings associated with osteomyelitis?

elevated WBCs, elevated ESR, and elevated CRP

what is the treatment for osteomyelitis?

broad spectrum antibiotics (vancomycin and clindamycin)

what are common side effects of vancomycin use?

hearing and kidney problems