Peds

Question 1

When Salter Harris III fx involve the anterolateral distal tibial epiphysis this is called what?

Answer 1

• a juvenile tillaux fractures

- AITFL avulsion

Question 2

Supracondylar fractures of humerus are essential diagnosis to make as what artery and nerve can easily occur?

Answer 2

• brachial artery

- anterior interosseous nerve

Question 3

describe what a volkmann contracture is from supracondylar humerus fractures

Answer 3

• When the elbow is splinted in substantial flexion as recommended, the brachial artery can become squeezed and spasm off.
• This results in ischemic necrosis and subsequent scarring of the forearm muscles

Question 4

Mnemonic for elbow ossification centers

Answer 4

“Come Rub My Tree of Love”

• Capitellum
• Radial Head
• Medial epicondyle
• Trochlea
• Olecranon
• Lateral epicondyle
• 1, 3, 5, 7, 9, 11

Question 5

Classification for supracondylar humerus fractures?

Answer 5

Gartland

• type I: Nondisplace
• Type II: Displaced with an intact posterior cortex
• Type III: Completely displaced

Question 6

Describe the Kocher criteria

Answer 6

• used for suspected pediatric septic arthritis of the hip (to differentiate from transient synovitis)
• Non weight bearing
• ESR > 40
• Fever
• WBC > 12k

Question 7

Describe imaging and findings in Legg-Calve-Perthes disease

Answer 7

• need AP pelvis and frog leg laterals
• may depict medial joint space widening
• A “crescent sign” may be noticed indicating seconday subchondral collapse

Question 8

What radiographic finding/line can help determine if there is a slip of the hip (SCFE)

Answer 8

• Klein’s line

- A straight line drawn up the lateral surface of the femoral neck that does not touch the femoral head suggests the dx

Question 9

Persistent genu varum angular deformity into infant and adolescent stages is commonly termed what?

Answer 9

blount’s disease

Question 10

what causes Blount’s disease

Answer 10

disturbed endochondral ossification of the medial proximal tibial growth plate

Question 11

MOst active physes in upper extremity?

Answer 11

• proximal humerus

- distal radius

Question 12

Most active physis in lower extremity

Answer 12

• distal femur

- proximal tibia

Question 13

medial physeal clavicle fx can be difficult to visualize on AP . . what views help?

Answer 13

• Serendipity views (beam at 40 deg cephalic tilt)
• anterior dx . . affected clavicle is above the contralateral clavicle
• Posterior dx (the affected clavicle is below the contralateral

Question 14

along with AP, what additional view could be useful in clavicular SHAFT fx

Answer 14

• ZANCA view (15 deg cephalic tilt) to determine superior/inferior displacement
• may consider having the patient hold 5 to 10 lbs weight in affected hand