Topics Discussed: ankle; ankle fractures; ankle joint; ankle sprains; application of splints to the body and upper extremity; application of splints to the lower extremity; back injuries; back pain, acute; back pain, chronic; back sprain; back strain; elbow injuries; elbow joint; elbow region; examination of elbow joint; examination of knee joint; examination of shoulder; foot fractures; fracture; fracture reduction; hand fractures; knee injuries; knee joint; knee region; knee x-ray; limb fractures, lower; limb fractures, upper; lower extremity cast application; orthopedics; radiography of ankle; salter-harris type i; salter-harris type ii; salter-harris type iii; salter-harris type iv; salter-harris type v; shoulder injury; shoulder joint; shoulder radiography; shoulder region; splint device; sports medicine; sprains and strains.
- Goal of section: The reader will understand common causes of acute ankle, knee, shoulder, back injuries, and chronic back pathology injuries, their diagnoses and management.
- 1%19% of musculoskeletal injuries evaluated in the ED receive proper discharge instructions for optimal management and rehabilitation.
- The mnemonic PRICEMMMS (see treatment section) includes the necessary components for proper care of acute musculoskeletal pain and swelling.
- Most injuries are self-limited.
- 60%80% lifetime prevalence of injury (10% of all sports injuries; peak age 2445 yr).
- Most common causes in pediatric population:
- Back and leg pain: (1) infection, (2) tumor, (3) spondylolisthesis
- Back pain without trauma: (1) spondylolysis, (2) vertebral segmental dysfunction and/or Sacroilitis, (3) ankylosing spondylitis, (4) spondylolisthesis, (5) tumor
- Back pain with trauma: (1) fracture, (2) strain/sprain, (3) ligament injury, (4) herniated disk
- Exam: Acute paraspinal muscle tenderness or spasm painful ROM (active, passive, and resisted) and normal neurologic examination.
- Without treatment: 70% improve <1 wk; 70% asymptomatic <1 month; 90% asymptomatic by 6 wk (Note: Absence of pain is not always indicative..."
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