Lower Extremity Disorders

Avascular Necrosis

Identify Causes: 

Chronic Steroid or Alcohol use

Fracture

Sickle Cell Disease

Idiopathic

Tx: Depends on age of patient and severity

Developmental Dysplasia

Tx: Pavlik Harness

Kids should NOT have hip pain so slow down and broaden your differential!!

Slipped Capital Femoral Epiphysis (SCFE)

Femoral head slips at the growth plate

MC in obese young adolescent (+/- hypothyroid)

Pain associated with limb

Tx: Surgical Pinning

Legg Calve Perthes Disease

Idiopathic avascular necrosis of femoral head in children

Painless limping

**Limited hip ABDUCTION AND INTERNAL ROTATION**

Xray shows **Crescent Sign**

Tx: Varies

Osgood-Schlatters Disease

Overuse injury causing inflammation at the insertion of the patellar tendon at the tibial tuberosity

**POINT TENDERNESS AT TIBIAL TUBEROSITY**

Tx: Rest, Ice, NSAIDS

Special Tests for Lower Extremities

Ortho Lower Extremity Pearls

Hip Dislocations = MC POSTERIOR

Hip Fractures = Leg is shortened and externally rotated

ACL Injury = non contact injury, pop is heard, LACHMAN TEST IS MOST SENSITIVE

Meniscus Injury = knee giving out, joint line tenderness, worse going DOWN stairs, MCMURRAY TEST IS MOST SENSITIVE

 

Knee Dislocation = Posterior MC, associated arterial injury

Ankle Sprains = MC Inversion injury causing anterior talofibular ligament sprain

Achilles Tendon Rupture = “Gun shot to back of leg”, THOMPSON TEST IS MOST SENSITIVE. Splint in Plantar Flexion

Maisonneuve Fracture = proximal fibula fracture due to severe ankle injury. ANKLE EXAM ALWAYS STARTS AT PROXIMAL FIBULA AND KNEE JOINT

RAPID REVIEW

TEST YOUR KNOWLEDGE NOW

For additional questions and explanations click below!

Disclaimer: There are tons of products and services on the web that relate to medicine. On this website, my focus is to only promote those products or services that I find true value in to make you a better medical professional. The PA School Prescription is a participant in the Amazon Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to amazon.com. I have not been given any free products to advertise on the site and the products I am recommending are the only resources I see value in. If you have any questions or concerns, please don’t hesitate to contact me!

Let me help you make the journey through PA school as stress-free as possible!