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Staph Aureus (gram +)
Sickle cell kids get what type of osteomyletis?
Most common site of osteomyleitis
- growing end of long bones (bones of the limbs)
- - metaphysis
osteomylitis bug in neonates?
- 1) GBS
- 2) S. aureus
- 3) E. coli
Tx: Oxacillin and Cefotaxime (worry about billi)
osteomylitis bug in 1-15yr old?
- S. aureus
- GAS (pyogenes)
- S. pneumoniae
Tx: Nafcillin and Ceftrioxone
Osteomylitis Dx perl
- ESR (70mm/hr)
- CRP - peaks at 48 hrs
Most common cause of polyarticular septic arthritis?
Nisseria gonorrhoeae (gram -)
Is fever Necessary for diagnosis of septic arthritis?
How to differentiate toxic synovitis vs septic arthritis?
Toxic synovitis is?
Irritable hip - unilateral...
- often follows a URI (ie varicella..)
Classic presentaiton of Legg-Calve-Perthes disease
Painless limp (avascular necrosis of femoral head)
differentiates from toxic synovitis!!
-Phy ex:unable to abduct or internally rotate hip
SCFE is the most common orhtopedic hip disorder in
- Obese 14 YOB has pain in the let anterioor thigh for 2 months. On physical exam there is limited passive flexion adn internal rotation of his hip.
Most common cause of chest pain in children?
Costochondritis - inflammation of a rib or the cartilage connecting a rib
- frequently caused by a
- viral illness or by frequent coughing.
Children with arthritis should have routine Ophtho exams to look for?
Iridocyclitis - uvea of the eye suffers inflammation.
Reiters syndrome Triad ?
Can't pee, Can't see, Can't climb a tree
urethritis, uvetis, asymmetirc athritis
Reiters syndrome Biomarker?
HLA-B27 - determinant of disease severity and predictor of reccurance
Bone structure image
- Salter Haris
- I = physis fracture
- II = metaphysis and physis
- III= epiphysis and physis
- IV= meta,epi and physis
- V= Crush the physis
MOST common primary maligant bone cancer?
Scenario: A dull aching pain for several months that has suddenly become more severe think?
Dx = CT scan to rule out metastatic pulmonary disease
Scenario:10 YOB complains of pain in his left leg. On exam htere is localzed swelling and pain in the middle of his left femur. His temperature is 100.8F and ESR is elevated. Further questioning reveals a t-month histor of increasing ftigue and weith loss--- THINK?
- most common metastisis is lungs, spine and bone marrow
Most common bone tumor in children is ?
Scenario: While dooin a physical exam on a 3 monthold female infant, the physician notices that her left knee is lower when her hips are flexed the infant was born toa P1G1 mother via a breech vaginal delivery: THINK?
Developmental dysplasia of the hip DHH
Multiple AND recurrent fractures - THINK?
rare connective tissue disease
Duechenes muscular dystrophy diagnosis:
- axial and proximal weakness (Gowers sign)
- -- elevated CK
3 YOB must use his hands to push himself up when rising from a supine position THINK?
DMD (Gowers sign)
Most worriesome complications of Marfan syndrome?
Aortic dilation, regurgitation and aneurysms
- Fibrillin defect of connective tissue
Screening age for scoliosis?
6-7 years old. Girls 5x more common
Renal Osteodystrophy resembels?
Rickets (vitamin D deficiency)
Bone disease secondary to defective mineralization due to renal failure