Week 6 discussion

Case Scenario 1: Brenda is a 13-year-old brought into the clinic by her mother for a left leg limp she developed last week. Brenda’s BMI is >95%. She reports no history of injury and her past medical history is unremarkable. She can bear weight on her left leg but complains of left hip, groin, and knee pain when she does.

• What more should you know about Brenda? • What specific exam techniques should you perform and why? • What diagnostic tests should you order and why?

Case Scenario 2: Jim is a 17-year-old who was brought into the clinic today for a headache. He reports nausea and an increase in stress from school and after-school activities (basketball practice and debate team). His vital signs are within normal limits and his BMI is 24.

• What more should you know about Jim? • What information in your history and exam would be red flags suggestive of

secondary or pathologic headaches • What education would you provide for Jim and his parents?

Case Scenario 3: Robert is a 14-year-old undergoing a rapid growth spurt who complains of a tender mass over the anterior tubercle of one knee. He says the pain improves with rest and worsens with activities like squatting, kneeling, jumping, and climbing stairs.

• What does the evidence suggest about the etiology of his condition? • How should you manage this condition? • What type of anticipatory guidance should you share with Robert and his parents?

Week 6 Discussion Part I

Table 1 Differential Diagnosis Pediatric Limp

Complete the table. CC limp

Condition Age Pain (+ or -)

Historical Findings

Clinical Findings

Causative Factors

Management

Developmen tal Dysplasia of Hip

Leg-length Inequality

Juvenile Arthritis

Slipped capital femoral epiphysis (SCFE) Legg-Calve- Perthes disease

Transient synovitis

Trauma

Neoplasm

Septic arthritis Acute hematogeno us osteomyelitis

Table 2 Differential Diagnosis Pediatric Headaches

Complete the table.

Common Types Diagnostic Criteria Based on History

Treatment/Management

Pediatric Migraine Headache

Tension Headache

Chronic Tension Headache

Other Differentials: List 3 additional differentials for headache

Characteristics Management

1.

2.

3.

Table 3 Musculoskeletal Disorders and Sports-Related Injuries

Complete the table.

Adolesce nt Idiopathic Scoliosis

Osgood - Schlatte r

Meniscal Tear

Quadricep s Contusion

Sprain of MCL

Osteochondriti s dissecans

Description

Screening Test?

How do you perform the screening test? Imaging?

Treatment Plan