MDC 1 - Exam 2 1
Diseases & Conditions
• Syndactylism
o Congenital/acquired conditions that cause fingers or toes to be partially or completely
webbed/fused together.
o Can range from slight extension of normal web to complete fusion at the ends of fingers
or toes.
o Affects soft tissue and/or bones of the digits.
o Most common malformation of the limbs
o Half of the cases are bilateral (both hands)
§ Less common in affecting the toes
o Usually treated surgically, only option to separate digits.
• Developmental Dysplasia of the Hip (DHH)
o A condition resulting in improper development of the “ball and socket” joint of the hip in
infants and young children.
§ Diagnostics
• Moving the infant’s legs in a variety of positions to assess.
• Difficult to diagnose right away
• MRI
§ Risk Factors
• Females
• Babies born in breech position
• Babies swaddle tightly with hips and knees straight
• Family history of DDH
§ Symptoms
• Infants
o Asymmetrical gluteal and thigh folds
o Reduced abduction in the hip
o Femoral shortening
• Children
o Walking on tiptoes or with a limp
o Positive Trendelenburg’s Sign
,MDC 1 - Exam 2 2
Diseases & Conditions
• Teens
o Osteoarthritis or hip labral tear
§ Treatments
• 0-6 months
o Pavlik Harness
§ Soft brace that secures ball portion of the joint firmly in socket for
several months.
• 6 months-2 years
o Hip Spica Cast
§ Reduction of bones in place and placement of cast to hold them
together for several months.
• Surgery – last resort
o To fit the joint together, followed by a spica cast.
§ Nursing Education
• Keep skin dry
• Frequent diaper changes to prevent skin breakdown.
• Reposition every 2-4 hours to prevent pressure injuries.
• Teach to wear a layer of clothing under the harness to prevent skin irritation
• Scoliosis
o Abnormal lateral curvature of the spine developed during a child’s growth spurt.
§ Symptoms
• Uneven shoulders, hips, scapula, waist.
• Clothes do not fit properly
• Slight limp
• Complains of a consistent sore back
§ Most cases are mild, child may suffer from
• Strain on heart and lungs
• Chronic back pain
• Appearance issues
§ Diagnostics
,MDC 1 - Exam 2 3
Diseases & Conditions
• Observing and palpating the spine without clothing
o Asymmetry of shoulders and hips
• Bend forward
o Asymmetry or prominence of ribs
• Movement
o Limp, muscle weakness
• X-ray
§ Treatment
• Brace is worn day/night
o More effective the longer worn
o Not a cure, prevents further progression
• Stop using a brace when
o 2 yrs. after menstruation
o When growing stops
• Surgery for severe
o Most common: spinal fusion
§ Connects 2+ bones in spine, wire placed to keep straight.
§ Metal rod at young age
• Adjusted in length as child grows
§ Risk Factors
• Growth spurt to puberty
• Female
• Spinal injuries
• Family history of scoliosis
• Neuromuscular conditions (cerebral palsy)
• Osteogenesis Imperfecta (OI)
o Group of inherited disorders characterized by fragile bones that break easily.
o Caused by defective genes that affect how the body makes collagen to strengthen bones.
§ Symptoms
• Frequent bone fractures
§ Treatment
, MDC 1 - Exam 2 4
Diseases & Conditions
• Cannot be cured
• Achondroplasia
o A genetic condition affecting the protein fibroblast growth factor receptor in the body.
§ Protein begins to function abnormally, slowing down the growth of bone in the
cartilage of the growth plate.
• Paget Disease
o Chronic metabolic disorder that causes bone to become fragile and misshapen.
• Rheumatoid Arthritis (RA)
o The immune system attacks synovium (connective tissue within the joint), mostly
affecting wrists, fingers, and elbows.
o Can also be systemic (fever/anemia)
§ Causes
• Unknown
• Women > Men
• Any age 20-60
§ Testing
• Positive rheumatoid factor
• Increase in erythrocyte sedimentation
• Positive C-reactive protein
• X-ray joint deterioration
§ Symptoms
• Inflammation
• Stiffness (>30min)
• Soft, warm joints
• Fever/redness
§ Nursing Care
• Synovectomy
• Joint fusion
• Steroids
• Osteoarthritis
Diseases & Conditions
• Syndactylism
o Congenital/acquired conditions that cause fingers or toes to be partially or completely
webbed/fused together.
o Can range from slight extension of normal web to complete fusion at the ends of fingers
or toes.
o Affects soft tissue and/or bones of the digits.
o Most common malformation of the limbs
o Half of the cases are bilateral (both hands)
§ Less common in affecting the toes
o Usually treated surgically, only option to separate digits.
• Developmental Dysplasia of the Hip (DHH)
o A condition resulting in improper development of the “ball and socket” joint of the hip in
infants and young children.
§ Diagnostics
• Moving the infant’s legs in a variety of positions to assess.
• Difficult to diagnose right away
• MRI
§ Risk Factors
• Females
• Babies born in breech position
• Babies swaddle tightly with hips and knees straight
• Family history of DDH
§ Symptoms
• Infants
o Asymmetrical gluteal and thigh folds
o Reduced abduction in the hip
o Femoral shortening
• Children
o Walking on tiptoes or with a limp
o Positive Trendelenburg’s Sign
,MDC 1 - Exam 2 2
Diseases & Conditions
• Teens
o Osteoarthritis or hip labral tear
§ Treatments
• 0-6 months
o Pavlik Harness
§ Soft brace that secures ball portion of the joint firmly in socket for
several months.
• 6 months-2 years
o Hip Spica Cast
§ Reduction of bones in place and placement of cast to hold them
together for several months.
• Surgery – last resort
o To fit the joint together, followed by a spica cast.
§ Nursing Education
• Keep skin dry
• Frequent diaper changes to prevent skin breakdown.
• Reposition every 2-4 hours to prevent pressure injuries.
• Teach to wear a layer of clothing under the harness to prevent skin irritation
• Scoliosis
o Abnormal lateral curvature of the spine developed during a child’s growth spurt.
§ Symptoms
• Uneven shoulders, hips, scapula, waist.
• Clothes do not fit properly
• Slight limp
• Complains of a consistent sore back
§ Most cases are mild, child may suffer from
• Strain on heart and lungs
• Chronic back pain
• Appearance issues
§ Diagnostics
,MDC 1 - Exam 2 3
Diseases & Conditions
• Observing and palpating the spine without clothing
o Asymmetry of shoulders and hips
• Bend forward
o Asymmetry or prominence of ribs
• Movement
o Limp, muscle weakness
• X-ray
§ Treatment
• Brace is worn day/night
o More effective the longer worn
o Not a cure, prevents further progression
• Stop using a brace when
o 2 yrs. after menstruation
o When growing stops
• Surgery for severe
o Most common: spinal fusion
§ Connects 2+ bones in spine, wire placed to keep straight.
§ Metal rod at young age
• Adjusted in length as child grows
§ Risk Factors
• Growth spurt to puberty
• Female
• Spinal injuries
• Family history of scoliosis
• Neuromuscular conditions (cerebral palsy)
• Osteogenesis Imperfecta (OI)
o Group of inherited disorders characterized by fragile bones that break easily.
o Caused by defective genes that affect how the body makes collagen to strengthen bones.
§ Symptoms
• Frequent bone fractures
§ Treatment
, MDC 1 - Exam 2 4
Diseases & Conditions
• Cannot be cured
• Achondroplasia
o A genetic condition affecting the protein fibroblast growth factor receptor in the body.
§ Protein begins to function abnormally, slowing down the growth of bone in the
cartilage of the growth plate.
• Paget Disease
o Chronic metabolic disorder that causes bone to become fragile and misshapen.
• Rheumatoid Arthritis (RA)
o The immune system attacks synovium (connective tissue within the joint), mostly
affecting wrists, fingers, and elbows.
o Can also be systemic (fever/anemia)
§ Causes
• Unknown
• Women > Men
• Any age 20-60
§ Testing
• Positive rheumatoid factor
• Increase in erythrocyte sedimentation
• Positive C-reactive protein
• X-ray joint deterioration
§ Symptoms
• Inflammation
• Stiffness (>30min)
• Soft, warm joints
• Fever/redness
§ Nursing Care
• Synovectomy
• Joint fusion
• Steroids
• Osteoarthritis
