Peds Rheumatology and MSK Flashcards

1
Q

What is JIA?

A

juvenile idiopathic arthritis (fma juvenile rheumatoid arthritis)

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2
Q

How do you diagnose JIA?

A

Must be chronic

evidence of joint inflammation (redness, swelling, limited ROM, pain)

duration of arthritis > 6 weeks

age at onset < 16

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3
Q

what is oligoarticular JIA?

A

involvment of less than 5 joints

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4
Q

what is the rash of systemic JIA?

A

dermatographia

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5
Q

what are the clinical manifestations of HSP?

A

palpable purpura on buttocks

subcutaneous edema

arthralgias/arthritis (80%)

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6
Q

avascular necrosis of the femoral head is a common complication of what disease?

A

sickle cell anemia

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7
Q

in which disease can a pediatric patient develop pain and swelling over the tibial tubercule?

A

Osgood Schlatter Disease

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8
Q

what is the treatment of Osgood Schlatter?

A

Rest

NSAIDS

Ice

lower extremity flexibility and strength

course benign (can last 1-2 years)

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9
Q

what is in-toeing associated with?

A

W sitting

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10
Q

what is the most common treatment for in-toeing and out-toeing?

A

reassurance

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11
Q

how common is polydactyly?

A

2nd most common hand deformity

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12
Q

What are the risk factors for congenital hip dysplasia?

A
  • breech presentation
  • caucasian
  • female
  • left hip > right hip
  • first born

+ve family hx

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13
Q

What are the signs of developmental hip dysplasia?

A
  • Galezzi’s sign - flexed legs with feet on table, pt. lying supine, one thigh higher than other (shorter dislocated)
  • uneven number of thigh folds between legs

+ve Barlow sign - hip dislocation and clunk when adducting knees and pushing in

+ve Ortolani sign - hip relocation and clunk when abducting knees and lifting trochanters

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14
Q

How is developmental hip dysplasia diagnosed?

A

ultrasound < 6 mos

plain film > 6 mos

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15
Q

what is the treament for developmental hip dysplasia?

A

Pavlik harness

if that fails, spica cast

if that fails open reduction after 18 mos.

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16
Q

How is scoliosis defined?

A

Lateral curvature of the spine greater than 10 degrees

17
Q

what is the epi of scoliosis?

A
  • idiopathic in most cases
  • scoliosis requiring treatment 7-8x more common in girls
  • congenital, neuromuscular, neoplastic and infectious conditions
  • connective tissue disorders
  • metabolic bone disease
18
Q

how do you diagnose?

A
  • forward bend test most sensitive
  • pain should not be present
  • obtain PA and lateral radiographs
  • determine Cobb angle from x rays
  • refer to ortho when curve reaches 20 degrees
19
Q

how do you treat scoliosis?

A

bracing 18-23 hours/day until growth is complete

surgery - sometimes with curves > 40 go straight to surgery

20
Q

what is nursemaid’s elbow?

A

it is subluxation of the radial head due to laxity of the annular ligament

21
Q
A