Term
Painful limp with true leg shortening of the affected lower limb. Some children have only knee pain
Affected limb is externally rotated with limited flexion, abduction and medial rotation |
|
Definition
| SLIPPED CAPITAL FEMORAL EPIPHYSIS |
|
|
Term
There may be referred hip or knee pain
Investigations X-ray of the hip will show varying degrees of downward slippage of the epiphysis of the head of the femur in the frog leg position view. It may be wise to take an x-ray of the other hip as well, since it occurs in the opposite hip 10-20% of the time.
Klein’s line is disrupted and the ice cream falling off the cone sign is present |
|
Definition
| SLIPPED CAPITAL FEMORAL EPIPHYSIS |
|
|
Term
| Painful limp with the pain often referred to the knee; limited abduction and internal rotation of the hip with an antalgic gait. 15% have knee pain only. |
|
Definition
| LEGG-CALVE-PERTHES DISEASE |
|
|
Term
Orthoneuro tests Trendelenburg’s gait may be present in the late neglected phase
Investigations Initially lateral x-rays will show a smaller center of ossification in the head with the surrounding bone may become osteopenic
Later the dense avascular bone is replaced by radiolucent granulation tissue |
|
Definition
| LEGG-CALVE-PERTHES DISEASE |
|
|
Term
| Morning stiffness lasting less than one hour; pain worse with use |
|
Definition
|
|
Term
X-ray of the affected weight bearing joint will show typical findings:
narrowing of the joint space
subchondral sclerosis [aka eburnation]
marginal osteophytes [hallmark sign]
subchondral cysts [aka geodes]
ESR may be elevated indicating a possible inflammatory nature |
|
Definition
|
|
Term
| Senory deficit or hyperesthesia over the lateral aspect of the anterolateral thigh. Traction or compression of the area in hip ROM may increase symptoms |
|
Definition
|
|
Term
| Paresthesia may be produced when tapping over an area along the inguinal ligament 1 inch inferior to the Anterior Superior Iliac Spine |
|
Definition
|
|
Term
| Lateral knee pain that gradually increases over days to weeks, worse with downhill running. Some patients may hear a squeaking sound with movement |
|
Definition
| ILIOTIBIAL BAND SYNDROME (ITB) |
|
|
Term
Investigations Tenderness on palpation of the lateral epicondyle of the femur, especially with knee flexion and extension
Orthoneuro tests: Noble & Ober’s Test [leg does not drop into abduction when the thigh is abducted and extended on side posture] |
|
Definition
| ILIOTIBIAL BAND SYNDROME (ITB) |
|
|
Term
| Painful swelling in the region and the patient is unable to bear weight. The patient may remember hearing a “pop” at the time of injury. Because of the parallel vascular supply, joint swelling develops quickly |
|
Definition
| ANTERIOR CRUCIATE LIGAMENT TEAR (ACL) |
|
|
Term
Lachman test [tibia is moved forward while patient is supine and knee is flexed 0-30 degrees] may be positive with a soft end feel
Anterior Drawer Test [tibia is moved forward while patient is supine and knee is flexed 90 degrees] may be positive if the tibia moves forward more than 6 mm |
|
Definition
| ANTERIOR CRUCIATE LIGAMENT TEAR (ACL) |
|
|
Term
| Swelling is less than ACL due to the rupture of the capsule with drainage down the fascial plane of the lower leg. After a few days there may be discoloration of the back of the calf due to this |
|
Definition
| POSTERIOR CRUCIATE LIGAMENT TEAR (PCL) |
|
|
Term
Posterior Drawer Test [tibia is moved posterior while patient is supine and knee is flexed 90 degrees] may be positive if excessive motion is seen
Look for a “sag-sign”: where the tibial tuberosity is more posterior than the tibial tuberosity of the well leg |
|
Definition
| POSTERIOR CRUCIATE LIGAMENT TEAR (PCL) |
|
|
Term
| Swelling is less than ACL due to the minor blood supply of the meniscus. Patient may notice episodes of knee locking where they experience pain and are unable to move the knee for a few seconds until it is forcefully extended |
|
Definition
|
|
Term
McMurray’s Test [With the patient in the supine position, the examiner fully flexes the knee and then rotates the patient's foot fully outward and then slowly extends the knee. Pain or a palpable or audible "click" during the latter maneuver indicates the possibility of a tear of the medial meniscus of the knee joint. The procedure is repeated with internal rotation of the foot. Pain on extension of the internally rotated knee indicates a tear in the lateral meniscus.] may be positive
Apley’s Compression and Distraction Test [patient is prone and knee is flexed 90 degrees, while the foot is externally and internally rotated, the knee is put into compression and distraction] |
|
Definition
|
|
Term
Pain just below the knee with tenderness over the tibial tuberosity which may be prominent
This should not be confused with Sinding-Larson-Johannson syndrome in which there will be tenderness maximum over the inferior pole of the patella |
|
Definition
| OSGOOD-SCHLATTER’S DISEASE |
|
|
Term
| X-ray may show a large bump [traction apophysitis] |
|
Definition
| OSGOOD-SCHLATTER’S DISEASE |
|
|
Term
| Pain in the sole of the foot on long standing, worse in the morning and improves after moving around, tenderness over the medial calcaneal tubercle especially with dorsiflexion of the toes |
|
Definition
|
|
Term
| X-ray of the foot may show a bone spur from the calcaneus but this is not the source of the pain; Saddle sign is present in 60% of cases of heel pain: radiolucency proximal to the plantar calcaneal spur |
|
Definition
|
|
Term
| Localized tenderness and swelling over the fracture site with increased pain when a vibrating tuning fork is placed over a nearby related bony prominence |
|
Definition
|
|
Term
| Swelling and tenderness on stressing the joint |
|
Definition
|
|
Term
| Tenderness on palpation of the injured muscle or when muscle is actively tested |
|
Definition
|
|
Term
| most common sprain. Trauma to the three components of the lateral collateral ligament (LCL) of the ankle: the anterior and posterior talofibular ligaments and the calcaneofibular ligament |
|
Definition
|
|
Term
Anterior and Posterior Drawer Test [stabilize tibia while pulling the cancaneous anterior and posterior; excess motion is positive]
Varus stress test of the ankle will be positive |
|
Definition
|
|
Term
| Trauma to the deltoid ligament of the medial ankle |
|
Definition
|
|
Term
| Valgus stress test of the ankle will be positive |
|
Definition
|
|
Term
| Pain in the sole of the foot with tenderness between the heads of the third and fourth metatarsals usually. Pain is made worse with dorsiflexion Pain may be relieved on walking barefoot or plantarflexion of the MTP joints |
|
Definition
|
|
Term
| Squeeze Test [Transverse squish of forefoot causes pain] test may be positive |
|
Definition
|
|
Term
| tenderness over the inferior pole of the patella |
|
Definition
| Sinding-Larson-Johannson syndrome |
|
|
