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PANCE Prep Pearls: 3rd Ed. (2019)
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Lower Extremity Disorders

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PANCE Prep Pearls: 3rd Ed. (2019) | Physician Assistant (PA) School Study Aid

Lower Extremity Disorders
13 Picmonics to Learn | 32 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
Hip Fracture
Assessment
External Rotation
Muscle Spasms
Shortened Leg
Pain
Interventions
Buck's Traction
Analgesics
Surgery
Considerations
Avascular Necrosis
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1 min
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
Baker's Cyst
Pathophysiology
Due To Enlargement of Bursa Between Gastrocnemius and Semimembranosus Muscles
Often Related to Rheumatoid Arthritis or Osteoarthritis
Clinical Manifestations
Often Asymptomatic
Mass or Swelling Behind Knee
Acute Pain If Rupture
Crescent Sign
Diagnosis
Ultrasound
Management
Treat Underlying Condition
Arthrocentesis
Glucocorticoid Injection
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4 mins
MCL Tear
Mechanism
Medial Knee Injury
Unhappy Triad
Football
Skiing
Sign
Valgus Stress Test
Treatment
Conservative Management
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54 secs
ACL Tear
Mechanism
Non-contact
Popping
Sudden Stop
Change in Direction
Unhappy Triad
Sign
Lachman Test
Treatment
Reconstruction if Severe
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1 min
Meniscus Tear
Fibrocartilage Semicircular Band
Traumatic
Unhappy Triad
Degenerative
Symptoms
Clicking and Locking
McMurray Test
Pain on External Rotation
Treatment
Conservative Management
Surgery
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1 min
Unhappy Triad
Lateral Force on Knee with Planted Foot
Anterior Cruciate Ligament
Medial Collateral Ligament
Medial Meniscus
Diagnosis and Treatment
Pain and Swelling of Knee
Knee Instability
MRI
Surgery
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4 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
Plantar Fasciitis
Characteristics
Inflammation of Plantar Fascia
Symptoms
Heel Pain
Worse in Morning and with Dorsiflexion
Treatment
Lifestyle Changes
NSAIDs
Glucocorticoids
Surgery as Last Resort
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2 mins
Salter-Harris Fracture Classification
SMACK
Slipped Across Physis (Type 1)
Metaphysis and Physis (Type 2)
Articular-Epiphyseal (Type 3)
Complete Metaphysis and Epiphysis (Type 4)
Krushed Physis (Type 5)
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2 mins

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