what is ortolanis sign
elevation and abduction -> hip clunks into place
signs of DDH
leg length discrepancy ortolanis sign barrows sign piston-motion sing hamstring sign
principle of management for childrens fractures
cast for as little time possible
remodel well in plane of joint movement
do not over treat
fixation is not usually required
childrens fracture involving knee/ ankle physes results in
growth arrest
if not caught at birth what can DDH present with
leg length discrepancy
awkward gait
risk factors for DDH
- first born
- oligohydramnios
- breech
- FH
- other lower limb deformities
- increased weight (>10ibs)
risk factors for patella dislocation
- laxity
- femoral anteversion
- tibial external rotation
symptoms Mortons neuroma
- typically affects 3rd, then 2nd webspace. toes
- neuralgic burning pain in the toes
- intermittent
- altered sensation in webspace
most common cause Mortons neuroma
wearing high heels
how is plantar fasciitis diagnosed
mainly clinical
occasionally:
- x-rays
- MRI
- USS
management of ankle #SH1
displaced <3mm - POP6
displaced >3mm - POP6, MUA
define ankle #SH4
- fracture through all 3 elements of bone, growth plate, metaphysics and epiphysis
1st line management JIA
paracetamol
NSAIDs
what is meant by constitutional manifestations
systemic symptoms
size of normal walking base
5-10cm
common compensations of someone with functional leg length discrepancy
- circumduction
- hip hiking
- steppage
- vaulting
non-operative management lesser toe deformities
- altered shoe wear
- activity modification
- orthotics
what is this?
- loss of wrist extension and sensory loss to whole
radial nerve palsy originating in arm
most common cause of acute osteomyelitis in sickle cell patients
salmonella
common acute osteomyelitis organisms in adults
staph aureus
myobacterium
TB
pseudomonas aeroginosa
presentation of gout
single extremely painful and aching joint hot inflamed white under skin nodules appearing. systemically acute, sudden onset
secondary management lumbar disc prolapse
- physio
- strong analgesia
- MRI
- referral after 12 weeks
