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First Aid for the USMLE Step 1 (2021)
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First Aid for the USMLE Step 1 (2021) | Physician Assistant (PA) School Study Aid

Page 473 -
6 Picmonics to Learn | 18 mins
Nursemaid's Elbow (Radial Head Subluxation)
Pathophysiology
Radial Head Subluxation
Inferiorly Under Annular Ligament
Axial Traction on Forearm
Pulled or Lifted by the Hand or Forearm
Children Aged (1-4 Years Old)
Signs & Symptoms
Extended & Pronated Forearm
Refusal to Bend Elbow
Treatment
Manual Reduction
Hyperpronation of Forearm
Gentle Supination of Elbow at 90 Degrees Flexion
No Immobilization
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3 mins
Osgood-Schlatter Disease (Tibial Tubercle Apophysitis)
Pathophysiology
Apophysitis of Tibial Tubercle
Active, Young Boys
Running and Jumping
Overuse Injury
Recent Growth Spurt
Signs and Symptoms
Diagnosis Made on History
Anterior Knee Pain
Enlarged Tibial Tubercle
Edema
Treatment
Rest
NSAIDs
Activity Restriction
Self-limiting
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2 mins
Patellofemoral Pain Syndrome (PFPS)
Pathophysiology
Young Female Athletes
Runners
Overuse Injury
Idiopathic Patellar & Retinacular Pain
Signs & Symptoms
Chronic Anterior Knee Pain
Increased with Squatting or Running
Increased with Prolonged Sitting or Climbing Stairs
Diagnosis
Patellofemoral Compression Test
Apprehension Sign
Treatment
NSAIDs
Conservative Therapy
Bracing
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3 mins
Developmental Dysplasia of the Hip
Cause
Abnormal Femoral Head in Acetabulum
Newborn Assessment
Positive Barlow Sign
Clicking with Adduction
Positive Ortolani Sign
Clicking with Abduction
Asymmetrical Limb Lengths and Folds (Gluteal and Thigh)
Older Child Assessment
Trendelenburg Sign
Interventions
Abduction Device
Pavlik Harness
Closed Reduction
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3 mins
Legg-Calve-Perthes Disease
Pathophysiology
Idiopathic Avascular Necrosis of Femoral Head
Boys 5-7 Years of Age
Symptoms < 18 Months
Signs & Symptoms
Painless Limp
Limited Range of Motion
Intermittent Anterior Thigh Pain
Insidious Pain in Knee
Atrophy of Upper Thigh
Diagnosis
AP and Frog Leg Lateral X-ray
Compression and Deformity of Femoral Head
Treatment
Bed Rest
NSAIDs
Containment with Brace or Cast
Surgery
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4 mins
Slipped Capital Femoral Epiphysis (SCFE)
Pathophysiology
Separation of Femoral Epiphysis from Femoral Neck
Through Growth Plate (Physeal Plate)
Obesity
Male Adolescents
African American
Growth and Sex Hormone Imbalances
Signs & Symptoms
Thigh or Knee Pain
Inability to Bear Weight
Decreased Internal Rotation of Hip
Obligate External Rotation of Hip with Flexion
Diagnosis
Frog Leg Lateral X-ray
Treatment
Surgical Pinning
Complications
Avascular Necrosis of Femoral Head
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3 mins

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