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MUSCULOSKELETAL DISORDERS

MUSCULOSKELETAL DISORDERS. THE MUSCULOSKELETAL SYSTEM. Bones and bone growth Epiphyseal plates…bone growth occurs here and when these seal over, there is no more growth Ages 17-18 for males, about 2 years after menarche for females. DISORDERS OF BONE DEVELOPMENT. Flat feet

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MUSCULOSKELETAL DISORDERS

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  1. MUSCULOSKELETAL DISORDERS

  2. THE MUSCULOSKELETAL SYSTEM • Bones and bone growth • Epiphyseal plates…bone growth occurs here and when these seal over, there is no more growth • Ages 17-18 for males, about 2 years after menarche for females

  3. DISORDERS OF BONE DEVELOPMENT • Flat feet • Bowlegs (Genu Varum) • Knock knees (Genu Valgum) • Toeing in • Limps • Growing pains

  4. DISORDERS OF BONE DEVELOPMENT • Osteogenesis imperfecta • Bones are easily broken • May be treated with growth hormone, calcitonin, biphosphonates • Legg-Calve-Perthes disease • Avascular necrosis of the femoral head • More common in boys 4-9 • S/S…limp, possible refusal to walk, and pain. No fever, no obvious signs of inflammation • Treatment • If over six…brace, if under six, observe

  5. DISORDERS OF BONE DEVELOPMENT • Osgood-Schlatter disease • Thickening and swelling of tibial tuberosity • Occurs in adolescence or preadolescence • Sports related • More common in males 10-13 • Treatment usually is limiting activity • Slipped capital femoral epiphysis • Avascular necrosis may occur • Need early detection • More common in males and obese adolescents with sedentary lifestyle • S/S…onset of unilateral hip pain • May need surgery and pinning

  6. INFECTIOUS AND INFLAMMATORY DISORDERS OF THE BONES AND JOINTS • Osteomyelitis • Often caused by staph • Very common after stepping on a nail that goes through a tennis shoe • Very difficult to treat…IV antibiotics, maybe for 6 weeks. Bone cells have little capacity to replace bone destroyed by infection

  7. DISORDER OF SKELETAL STRUCTURE • Scoliosis: functional • Caused by unequal leg length or visual problems • Compensatory mechanism used by child • Scoliosis: structural • Permanent curvature of spine • Peaks age 8-15 • More common in females • Assessment done during PE starting age 10 • Look for… • Shoulder height • Shoulder prominence • Leg lengths • Rib prominence • Treatment is surgery for >40 degree curvature or a brace for >20

  8. DISORDERS OF THE JOINTS AND TENDONS • Juvenile Arthritis • Probably autoimmune • Subtypes pg. 1434 • S/S • Persistent fever and rash • Joint swelling • Treatment • Exercise • Heat • Nutrition • Meds • NSAIDS • DMARDS

  9. DISORDERS OF THE SKELETAL MUSCLES • Muscular Dystrophy • Duchenne’s is the most common form • Sex-linked recessive • Gower’s sign-pressing hand against ankles, knees, and thighs to rise to stand • Calf muscles are hypertrophied, shoulder muscles are weak • Death occurs around age 20 due to heart failure

  10. Fractures • Fractures • Break in the continuity of the bone • Common fractures in childhood • Forearm • Clavicle • Femur • Dislocation of Radial Head • Salter-Harris • Fracture of the growth plate • Graded from I-V

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