Pediatrics

Question 1

Panner’s disease

Answer 1

Osteochondrosis of the capitellum

• ages 7-12 years old
• dull, achey, lateral elbow pain with activity
• Treatment: Rest from AGG activities

Question 2

What age will you see OCD of the capitellum?

Answer 2

• results from repetitive lateral compression of elbow during overhead motions
• ages 13-17 years old
• dull elbow pain w/ activity
• may have a flexion contracture of 15 degrees or more
• clicking or popping

Question 3

Nursemaid’s elbow

Answer 3

• Dislocation of the radius
• Common in kids under 5
• History of traction MOI

Question 4

Little League elbow syndrome

Answer 4

-Overuse Injury do to valgus overload to the medial elbow

Question 5

Ulnar Collateral Ligament sprain or tear

Answer 5

• similar to little league elbow, however athlete is typically an older teenager

Question 6

Legg Calve Perthes

Answer 6

-Idiopathic AVN of proximal femoral epiphysis in children
- 4-8 years old
-more common in males
- younger age is a GOOD prognostic indicator
Sx:
- painless limp
- intermittent hip, knee, groin or thigh pain

Question 7

What imaging would you order for legg calve perthes?

Answer 7

AP Pelvis
Frog Leg Laterals
- may see cresent sign (represents a subchondral fracture)

Question 8

Slipped Capital Femoral Epiphysis

Answer 8

Slippage of the metaphysis anteriorly & superiorly relative to the epiphysis
Demographics:
- Obese children
- Males
-Average age:  13.4 boys
Sx:
- Groin & thigh pain
-Limp
- Knee pain

Question 9

What imaging would you order for SCFE?

Answer 9

AP & Frog-leg lateral

• Frog leg lateral is most sensitive for detecting a SCFE
• AP Pelvis may demo Klein’s line

Question 10

What fracture needs to be considered in kids 9-15 who have sustained a shoulder injury?

Answer 10

Proximal humeral fracture

Question 11

What is the most common fracture in children?

Answer 11

Supracondylar fractures (distal humerus) comprise 65-75% of all elbow fractures in children
- occurs btwn age 5-10

Question 12

What are the normal ossification centers? (CRMTOL)

Answer 12

Capitellum, Radius, Medial Epicondyle, Trochlea, Olecranon, Lateral Epicondyle

(1,,3,5,9,11 years old)

Question 13

Little Leaguers Shoulder

Answer 13

Sx: tenderness to the LATERAL aspect of the proximal humerus

• Return to play: based on time, 3 months period of rest
• THEN, initiate a throwing program

Question 14

Sever’s Disease

Answer 14

AKA: Calcaneal apophysitis

- inflammation of the growth plate in the calcaneous in growing children

Question 15

Osgood Schlatter’s

Answer 15

AKA: Tibial Tubercle Apophysitis

- pain w/ kneeling

Question 16

Sinding-Larsen Johansson Syndrome

Answer 16

Inferior pole of the patella apophysitis

• typically seen in boys
• age 10-13 years old

Question 17

What are the general guidelines of hours/week of vigorous physical activity by PED athletes?

Answer 17

No more than 16-20 hours/week

Question 18

What are the general guidelines in regards to the limit of overhead sports by PED athletes?

Answer 18

• 1 overhead throwing sport at a time

- avoid playing year round

Question 19

What are the pitching limits for players 9-14 years old?

Answer 19

• 75 pitches per game
• 600 pitches/season
• 2000-3000 pitches/year

Question 20

What are the pitching limits for players 15-18 years old?

Answer 20

• 90 pitches per game

- no more than 2 games per week

Question 21

What is the MOST COMMON cause of hip pain in kids 5-8 years old?

Answer 21

transient synovitis

Question 22

What classification is a fracture through growth plate and metaphysis?

Answer 22

Salter Harris Type II