Lower Extremity Disorders
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
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