1When getting an Xray, at least obtain an ____ and a ______ view because _______
- AP
- Lateral
- Fractures can hide other fractures
2CT: detects ________ but has significantly higher _________; Reserve this for when you can't make a proper diagnosis
- Fine bony detail
- Radiation exposure
3MRI: evaluates ________ & _______ issues, detect __________ fractures, no radiation but long exam in a tight space
- Soft-tissue and bone marrow
- Radiographic occult
4US: Evaluate ___________ ; great for _____ injuries; Keep in mind, theres a much higher component of __________
- Tendon and ligamentous
- Joint
- Operator technique/error
5Compartment Syndrome is a ________ d/t Increase in _______ pressure -> ↓ _______ leading to _____, _____, & _____ damage
- Medical Emergency
- Osteofascial Compartment
- Perfusion
- Muscle, nerve, & tissue
6Compartment syndrome occurs anywhere ________ is surrounded by ______ b/c fascia is not _____
- Skeletal muscle
- Fascia
- Flexible
7Most commonly we see compartment syndrome in the __________, the _______, ______, and the __________ muscles
- Upper and lower extremities
- Buttock
- Shoulder
- Paraspinal
8Compartment syndrome presentation: 5 P's= Pain w______, Pain _______ to injury, ________, _________, & __________
- Passive stretch
- Out of proportion
- Paresthesia
- Paralysis
- Pulselessness
9Compartment syndrome in younger pediatric patients may present with the 3 A's:
- Anxiety, agitation and analgesic requirement
10We diagnose compartment syndrome by making a _______ & insert a wick or needle to measure the compartment pressure. Pressure >_____ = surgical intervention
- Slit in the skin
- 35mmHg
11After fasciotomy pt will need _______ that cover skin pathogens including a broad spectrum _______ like _______; may also need MRSA coverage with _______ or _______
- Prophylactic antibiotics
- Cephalosporin
- Cefazolin
- Vancomycin
- Linezolid
12Hip Dysplasia is a gait disturbance as a result of ________ of the _________ leading to _______
- Subluxation
- Femoral head within the joint
- Avascular necrosis
13Barlow Maneuver used to eval. __________; w/ pt on their back, _____ their hips by holding their knees and pushing _______
- Hip Dysplasia
- Adduct
- Outward
14_____ & _____ are used to diagnose hip dysplasia. US in children <______ old have a much higher risk of giving you a ______
- Xray & US
- 6 w.o
- False positive
15Pavlik Harness is used to Tx ________ in children < ______
- Hip Dysplasia
- 6 m.o
16Closed reduction is used to Tx _______ in pts > _______
- Hip Dysplasia
- 6 m.o
17Open reduction with internal fixation may be required to tx _________ in children > _____ . This pt. will need a _____ post op
- Hip Dysplasia
- 2 y.o
- Spica cast
18The goal of treatment for hip dysplasia is preventing or stopping _______
Avascular Necrosis
19Legg-Calve-Perthes Disease is ______ & subsequent ____ of the bone as a r/o ____________ to the _________ or femoral head
- Necrosis
- Repair
- Temporary interruption in blood supply
- Proximal femoral epiphysis (growth plate)
20Highest incidence of Legg-Calve-Perthes Disease in ____ to ____ y.o
4 to 8 y.o
21There are 4 stages of Legg-Calve-Perthes Disease: ______, ______, ______, & ______
ossification, fragmentation, re-ossification, remodeling
22Legg-Calve-Perthes Disease pts will present w/ _______ on effected side & ________ bc the reduced blood supply ________ of the effected leg
- Persistent/chronic mild to moderate pain
- Leg discrepancy
- Slows down growth
23Legg-Calve-Perthes Disease is diagnosed by a _________ that shows
- Frog leg X-ray
- sclerosis of femoral head, widening of joint space
24The goal of tx for Legg-Calve-Perthes Disease is to keep the ______ seated in the ______
- Femur head
- Acetabulum
25Pts w/ Legg-Calve-Perthes Disease should avoid ______ & _____
- Contact sports
- Strenuous exercise
26Osteomyelitis is an ______ of the bone; Can occur in any bone but is most commonly seen in the ____ & _____
- Infection
- Femur
- Tibia
27The most common bugs seen in osteomyelitis: _______, _______, ________ (neonates), & _________ (puncture wounds)
- S. aureus
- Group A strep
- GBS (neonates)
- Pseudomonas (puncture wounds)
28In pts w/ Osteomyelitis, early X-rays are usually ________
Normal looking
29Our image of choice for osteomyelitis is ______
- MRI
30Labs for Osteomyelitis include ____, ____, & _____
- CRP
- ESR
- Blood cultures
31_____ is the lab value that _____& is the most sensitive to osteomyelitis, but the ____ will rise and decline _____ as the infection occurs and gets better
- CRP
- Rises 1st
- ESR
- Slower
32Abx of choice for non-operative osteomyelitis are a _________ +/- ______ or _____ for MRSA coverage. Will need IV abx for about ________. weeks
- 3rd gen cephalosporin
- Vancomycin, linezolid, Clindamycin
- 6-8
33Osteomyelitis pts are at higher risk for _____ & ______; esp. pts w/ ____ infections & ______
- DVT's & venous thrombus embolism
- MRSA
- Mod. to severe osteomyelitis
34Septic Arthritis is a _________ infection in the ______ in the joint causing _________. This is a ________
- Purulent bacterial
- Synovial fluid
- Rapid destruction
- Medical emergency
35Peak incidence of septic arthritis is in pts < ____ y.o & ____ are 2x more likely than _____
- 3
- Males
- Females
36The most common areas seen w/ septic arthritis in kids are the ______, _____, _____ &, _____
- Hip, knee, elbow, and ankle
37The most common bugs we see in septic arthritis are _____, _____, & ______
- S. aureus, moraxella, & GBS
38Toxic synovitis is inflammation of the _____
synovium
39Highest prevalence for toxic synovitis is seen in ______ y.o
3 to 8
40Slipped Capital Femoral Epiphysis is the separation of the _______ & _______ w/epiphysis slipping _________, causing potential complete dislocation
- growth plate & femoral head
- posteriorly
41Highest incidences of Slipped Capital Femoral Epiphysis occur in
Males 12-15 y.o
42Osgood-Schlatter Disease is a common form of _______ or _______ of the ______ tuberosity in early adolescence
- Growing pains
- Stress overuse
- Tibial
43Osgood-Schlatter Disease Red Flags include _______, ______ y.o, and ______
- Athlete
- 10-15
- Localized pain
44Slipped Capital Femoral Epiphysis hip and frog leg x ray show
femoral head slipping like
“ice cream falling off cone”