- O se iloiloga puupuu lea o nisi o faitioga taua a le tamaititi na feagai i le togafitiga faafomaʻi.
- Faʻalavelave faʻafuaseʻi e aofia ai le ulu o le ulu
- Faʻalavelave faʻafuaseʻi Faʻalavelave i tamaiti (tamaiti faʻamaʻavale)
- Faʻasalaga Musukaloskeletal (Vasega o le Faʻasalaga Faʻasalaga o Tagata, scoliosis,
- Neoplasms masani mo tamaiti (CNS & isi)
- Faʻafitauli
- Maʻi faʻasolosolo
Mataupu
Faʻafitauli ogaoga o le pediatric:
- MANUIA manuaga (eg, paʻu ese le manuki-pa)
- Supracondylar Fx, tulivae. I taimi uma d / t faʻalavelave faʻafuaseʻi. <10-yo
- Faʻaopoopoga Fx
- Gartland le faʻavasegaina o togi na sili atu le soloia ma le faʻaleagaina togafiti na togafitia i le faigofie faigofie le faʻamalosia ma le tosoina o le tulivae tuliloa
- O se tulaga e lamatia ai le faʻataunuʻuina o mea faʻapitoa pe a fai e tolopo le tausiga (Volkmann konekarate)
- E taua tele le faʻataʻitaʻiga ole radiology: saini folau & posterior fat pad sign faʻatasi ai ma le laina humeral i luma na le mafai ona faʻafesoʻotaʻi le ogatotonu / 2/3 o Capitellum.
Fediatric Fx le atoatoa:
- Tele i le <10 yo Greenstick, Torus, Palasitika aka Faʻafefeteina faʻaletonu
- E masani ona faʻamalolo lelei, togafitia ma le le mautonu
- Faʻaletino palasitika pe afai> 20-tikeri manaʻomia tapunia faʻaititia
- Ping pong ulupoo gau e mafai ona atiaʻe mulimuli ane afaina, faʻamalosia le tilivaina ma faʻafitauli o le fanau mai manua. Atonu e manaʻomia le suʻesuʻeina e tamaiti ole neurosurgeo.n
- Salter-Harris ituaiga o mea e afaina ai le eletise faaletino
- Pusa 1-slip. faataitaiga, Slipped Capital Femoral Epiphysis. E masani lava e leai se gau gau
- Pusa 2-M / C ma faʻamatalaga lelei
- Tusa 3-intra-articular, o lea e tauaveina ai le lamatiaga o le vave oʻo osteoarthritis ma e ono manaʻomia le tausiga o le d / t e le maluelue
- Pusa 4- Fx i itu uma e uiga i le masini. Faʻamatalaga leaga ma le faʻapuupuuina o vae
- Pusa 5-e masani lava e leai se faʻamaoniga o le gau moni o le ponaivi. Faʻaleagaina le faʻamaʻi faʻamaʻi manuʻa ma le faʻaleagaina o lapisi ma le faʻapuupuuina o vae
- E taua tele le iloiloga o ata
Faʻaleagaina le faʻaleagaina (NAI) i Tamaiti
- E i ai ituaiga faʻaleagaina o tamaiti. Faʻaleagaina faaletino e mafai ona aʻafia mai manuaga o le paʻu i faʻamaʻi maʻi MSK / faʻapitoa e aʻafia ai ponaivi ma masini mūmū. E taua le faʻataʻitaʻiina ma e mafai ona faʻamaonia ni faʻamatalaga manino e mataala ai i latou e tuʻuina atu fomaʻi ma faʻamalamalamaina le puipuiga o tamaiti ma ofisa o le tulafono e faʻaaogaina tulafono.
- I se pepe: ua luluina le maʻi o le pepe`e ono iai ma faʻailoga CNS o le saei o le matua o le fesoʻotaʻiga o le uaua ma le hematoma subdural lea e ono afaina ai. O le toto toto e masani lava o se faʻailo. Head CT e taua tele.
- MSK Radiological Red Flags:
- 1) ponaivi tele Fx i se tamaitiiti e le o mafaufauina le mafaufau (0-12 mo)
- 2) Nusipepa pito i tua Fx: e masani lava e le tupu se faalavelave i faalavelave faʻafuaseʻi. Masalo faʻaogaina: faʻapipiʻiina ma faʻamaʻi se tamaititi poʻo se lavea tuusao.
- 3) Faʻalavelave faʻalavelave faʻapitoa i fuataga o togafitiga faʻasolosolo taimi, o lona uiga, o faila o le ponaivi o loʻo faʻaalia ai le faʻaleagaina faifai pea o le tino
- 4) Metaphyseal tulimanu Fx lima Faʻatau Manua Fx, e masani ona faʻamaonia mo le NAI i tamaiti. E tupu pe afai e taofiofia le ita ma le feusuaʻi.
- 5) Ole vaeluaga o ponaivi uumi i se tamaititi o se isi faʻataʻitaʻiga o le NAI.
- Isi faʻataʻitaʻiga taua o le NAI. Tusia le talafaasolopito e saunia e leoleo / tausi maʻi. E leai se faʻamaoniga o ni mea e le masani ai / gasegase o ponaivi pei o Osteogenesis Imperfecta poʻo Rickets / osteomalacia ma isi.
- NB Pe a taʻua e le au vaʻavaʻaia se talaʻaga o loʻo lipotia ai le paʻu ma faʻalavelave i totonu o le fale, E taua le iloa o le tele o faʻalavelave / paʻu i totonu o le fale e seasea maua pe faʻapea e oʻo i ni ponaivi tetele.
- Lipotiina le sauaina o tamaiti i Ilinoi:
- www2.illinois.gov/dcfs/safekids/reporting/pages/index.aspx
MSK Faʻamatalaga Faʻamatalaga ile Pediatrics
- Juvenile Idiopathic Arthritis (JIA)-Faʻaalia M / C faʻamaʻi tumau o le tamaitiiti. Fomaʻi Dx: soʻoga tiga / fulafula mo 6-vaiaso pe sili atu i se tamaititi <16-yo Eseese fomu o loʻo i ai: Early Dx e taua e puipuia ai le tuai faʻalavelave
- Le tele o ituaiga masani o le JIA:
- 1) Pauciarticular faʻamaʻi (40%) - m / c ituaiga o JIA. E sili atu le lamatiaga o teine. O loʻo avea ma gugu ile <4 soʻoga: tulivae, tapuvae, tapulima. Eluga. Lenei ituaiga faʻaalia maualuga fesoʻotaʻiga ma ocular aofia ai pei iridocyclitis (25%) e ono ono taitai atu ai i le tauaso. Labs: RF-ve, ANA lelei.
- 2) Polyarticular disease (25%): RF-ve. O teine e sili atu ona lamatia. E afaina ai sooga laiti ma le tele e masani ona aʻafia ai le tui o le Cervical
- 3) Faiga faʻapitoa o le JIA (20%): e masani ona maua mai ai faʻamatalaga faʻapitoa e pei o le feversing o fevers, arthralgia, myalgias, lymphadeno [ala, hepatosplenomegaly, polyserositis (pericardial / pleural effusion). O mea taua o le Dx o loʻo faʻaalia ai le fuga o le lanu mama i luga o pito ma ogalaau. O le Faiga faʻavae e leai se faʻafitauli o le tino. O sooga e masani ona seevae e leai ni paʻu pe a faatusatusa i isi ituaiga. O lona uiga, o le faʻatafunaina faʻatasi e le masani ona vaaia
Ata i le JIA
- O le ponaivi o le faʻasosolo e sili atu i le faʻamalosi o le patella cartilage / le ponaivi DJD
- Uʻamea ma ponaivi uumi vave tapunia o le kesi / faʻapuupuuga lima
- Rad DDx tulivae / tapuvae: Hemophilic arthropathy Rx: DMARD.
- O faʻalavelave e mafai ona oʻo mai faʻaumatiaga faʻapitoa, faʻalavelave tuputupu aʻe / limite lima, tauaso, faʻalavelave faʻafitauli, le atoatoa.
Le tele o le faʻaleagaina o le pepe Neoplasms
- Osteosarcoma (OSA) & Ewing's sarkoma (ES) o le 1 st ma le 2nd M / C o le ponaivi mumusu matua o le pepe (pito i luga i le 10-20 yo) Falemaʻi: paʻu o le ponaivi, suiga i le gaioiga, masini muamua masima ma faʻapipiʻi pulumu. Poloaʻi faʻataʻitaʻi
- Ewing`s ono iai ma ponaivi tiga, fiva ma maualuga ESR / CRP mimicking faʻamaʻi. Vave Dx ma faʻataʻitaʻiga ma faʻavasegaina e taua tele.
- Ata o OSA & ES: x-ray, sosoʻo ai ma le MRI, pusa CT, PET / CT. I x-ave: OSA ono afaina ai soʻo se ponaivi ae sili ona i ai nei o le malosi o ponaivi fausia neoplasms e uiga i le tulivae (50% mataupu) aemaise lava pei osteoid fausiaina se faʻamaʻi mataʻutia i le metaphysis ma speculated / sunburst periostitis & Codman tafatolu. Faʻailogaina le susulu o aano o manu.
- E mafai e le ES ona tuʻu i totonu o le paʻu ma faʻaali vave le gasologa o le susu. E taua tele le MRI e faʻaalia ai le tele o le ponaivi ma le ST osofaiga, MRI manaʻomia mo le taotoga
- OSA & ES Rx: O se tuʻufaʻatasiga o taotoga, radiation, chemo. O isi auala e faʻaalu ai le faʻasaoina o le tino. Le lelei le vavalo pe a fai e iloa tuai.
- Ata o le Ewing's sarcoma
- Faʻasaʻo le ponaivi i le faʻamalosi
- Uluai osofaʻiga vaivai
- Faʻalavelave faʻasolosolo agavaʻa ma le faʻalanu (lanu o le sisi)
- Faʻamamāina o le ponaivi oona (fuga moli)
- O le Lesion e masani ona faʻaaoga faʻasolitulafono ma se faʻaopoopoga faʻafaʻatusa
- Faʻailoaina o le Round cell tumo faʻatasi ai ma Multiple Myeloma ma Lymphoma
Faʻasalaga Faʻatasi o Tamaiti
- Neuroblastoma (NBL) M / C leaga o le pepe. E afua mai i neura crest cells aka PNET tumors (eg, ganglia alofa). Tele tupu i tamaiti <24-masina. O nisi faʻaalia lelei prognosis ae> 50% mataupu o loʻo iai ma faʻamaʻi alualu i luma. 70-80% i le tausaga 18-masina pe sili atu o loʻo iai nei ma metastasis alualu i luma. NBL ono tupu i le adrenal medulla, agaalofa ganglia ma isi nofoaga. Faʻaalia o se manava tele, puaʻi. > 50% meaalofa ma ponaivi tiga d / t metastasis. Togafitiga: suʻega faʻaletino, fale suʻesuʻe, faʻataʻitaʻiga: fatafata ma ave x-ave, CT manava ma le pusa e taua tele ia Dx. MRI ono fesoasoani. NBL mafai metastasize i le ulupoo ma faʻapipiʻi sutures ma se faʻalauiloaina faʻaaliga pei pathological sutural diastasis.
- Leukemia Lisi Lymphoblastic o le m / c faʻamaoni o le tamaitiiti. Faʻasologa: faʻasologa o le lekikemiki le gaʻo o le ponaivi e oʻo atu ai i le ponaivi o le ponaivi ma suia ai isi fualaʻau masani o le suālaʻau i le anemia, thrombocytopenia, neutropenia ma aʻafiaga e aʻafia ai. Leukemic sela e ono mafai ona faʻaaogaina isi nofoaga e aofia ai le CNS, vaʻa, ponaivi ma isi itulagi. Dx: CBC, maualuga lactate dehydrogenase level, O le suamalie o le suga suamalie o le koko o le ki. E mafai ona fesoasoani faʻataʻitaʻiga ae le taua i le siama. I luga o le leitio, o le lekekemiki o le fausiaina o le ponaivi e masani lava ona foliga mai o ni laina eletise i luga o le eletise o le tuputupu ae o le physeal. Rx: chemotherapy ma togafitiga faʻafitauli
- Medulloblastoma: M / C faʻaleagaina CNS neoplasm i tamaiti
- Faateleina le atinaʻe i luma ole 10-yo
- M / C nofoaga: cerebellum ma fossa
- Faʻaalia i le talafaasolopito le tino o le tumo o le PNET e le o se glioma e pei ona muai mafaufauina
- MBL, faʻapea foi Ependymoma ma le CNS lymphoma, e mafai ona taʻitaʻia ai gasegase e ala i le CSF ma faʻaalia ai se tulaga uiga ese e le pei o isi tumutumu o le CNS e faʻaalia ai le masini lautele i fafo atu ole CNS, m / c i le ponaivi
- 50% o le MBL e mafai ona faʻatino lelei atoatoa
- Afai o le Dx ma togafitiga e amata i luma o metasisi, 5-tausaga e ola ai 80%
- E taua le faʻataʻitaʻiina: E mafai ona faʻaaogaina le CT numera ae o le ata faataitai o le filifiliga o le MRI lea o le a faʻaopoopoina ai se maualuga o le iloiloga o le neuraxis atoa mo metastisi.
- MBL e masani ona aliali mai o hytetetete hypo, leʻo ma le hyperintense lion i T1, T2 ma le FLAIR sikola (ata pito i luga) pe a faʻatusatusa i le mafaufau o le mafaufau. E masani ona faʻaosoina le ventricle 4th ma le faʻalavelave hydrocephalus. Ole tino e masani ona faʻaalia le faʻaleleia atili o le T1 + C gad (pito i lalo tauagavale). Faʻasologa o metastasis mai le MBL ma le T1 + C faʻalautele le liona i le maea
Telefoni Faʻasoifua Pediatric
- I le neonate / pepe <1month: fiva> 100.4 (38C) ono faʻaalia siama ma nisi siama siama. Strep B, Listeria, E. Coli ono taitai atu i sepsis, meningitis. Faʻalatalata: pusa x-ray, lumbar puncture ma aganuu, toto aganuu, CBC, urinalysis.
- I tamaiti laiti, o le Hemophilus influenza type B (HIB) e ono oʻo atu ai i le Epiglottitis se mea e seasea ae faigata. O le tui nei o loʻo fesoasoani e faʻaititia le numera o mataupu o Epiglottitis ma isi maʻi e aʻafia ai le HIB.
- Parainfluenza poʻo le RSV siama e mafai ona taʻitaʻi atu i le Croup poo le Laryngotracheobronchitis.
- Epiglottitis ma Croup o Dx clinically but AP and lateral soft muscle neck x-ave e aoga tele
- O le Epiglottitis o loʻo iai ma se faʻailoga 'Thumbumb' e ogatusa ma le mafiafia ole epiglottis d / t epiglottic edema. Ole mea lea e ono avea ma faʻalavelave faʻafuaseʻi e afaina ai vaʻalele (tauagavale i luga)
- Croup e mafai ona faʻaali mai le ―stepeple sign poʻo le bottlewine fagu faʻailoga ma le faʻaletonu o le hypopharynx e pei o le faʻaititia o subglottic airway i le AP ma le itu o le ua ivi ivi itu gofie (taumatau i luga)
- Sini o le Syncytia Virus (RSV) ma le influenza e mafai ona oʻo atu ai i le vailaau vailaau e mafai ona i ai i faʻafitauli o le ola i faʻalavelave faʻafuaseʻi, matua laiti ma tamaiti faʻatasi ai ma le faʻamalosia. E taua tele le CXR (ogatotonu pito i luga)
- Streptococcal pharyngitis ma le faʻamaʻi GABHS e ono iʻu ai i ni faʻalavelave faigata pe tuai foi (eg, Fiva Rheumatic)
- Paʻu peritonsillar (i luga taumatau taumatau) e mafai ona atiae i nisi tulaga ma faigata ona o le faasalalauina o vaalele vaivai i totonu o le ua e mafai ona taitai atu ai ile faasalalauina i vaega ole lua / submondibular (Ludwig Angina) pe a manaʻomia le pulea o le ea i le gagana edema
- O le atinaʻeina o le faʻaogalave o le faʻavavega o le tino e mafai ona oʻo atu ai i le salalau o le faʻamaʻi e ala i le faʻatalanoaina o le neck fascia lea e mafua ai le faʻataʻitaʻiina o le mediastinitis, Lemmier syndrome ma le osofaʻiga o avanoa vavalalata (o mea uma lava e lamatia ai le ola)
- Griesel syndrome- (pito i luga i lalo) seʻi faʻalavelave faʻalavelave faʻamaʻi pipisi i le itulagi o le itulagi e mafai ona faʻasalalau i le vaeluaga o le vaʻaia e oʻo atu i le laxity o le C1-2 ma le le mautonu
- O isi faʻamaʻi pipisi i tamaiti o siama faʻapitoa (Pneumococcal) pneumonia, siama o le Urinary ma Putelonephritis (aemaise i tamaʻitaʻi) ma Meningococcal Meningitis
- Pediatric Metabolic Disease
- Rickets: le mafaufau o le osteomalacia i le skeletal matua. O le faʻasologa o faʻatulagaga faʻatulagaina o le epiphyseal growth plate o loʻo afaina tele
- Falemaʻi faʻapitoa ile tuputupu aʻe o le tuputupu aʻe, pito i lalo o le ifo, rosary rachitic, pusa lupe, afaina faʻalavelave, tapulima lautele ma fulafula, ma tapuvaevaevae
- Faʻamatalaga: O le Vit D ma le mea e le o le tino o le calcium o le m / c lea. Le lava o le la susulu esp. paʻu paʻu-paʻu, lavalava faʻasaʻo e malamalama lelei, umi ole susu ole susu, veganism, syndromes malabsorption o le faʻaoga, faʻaleagaina tele ma isi
- Faʻataʻitaʻiga: faʻasolosolo faʻasolosolo faʻasolosolo faʻasolosolo faʻasolosolo faʻamalositino ma faʻamalo, faʻalauteleina o le meaola tuputupu aʻe, faʻasalaga costochondral pulu e pei o le rosary rachitic, pito i lalo ifo
- Rx: togafitia mafuaʻaga autu, saʻo lelei le soifua maloloina, ma isi.
mau faasino
Faʻataʻitaʻiga Tomai o Faʻataʻitaʻiga
O faʻamatalaga o loʻo i luga "Faiga Faʻapitoa Pediatric Faʻamatalaga Faʻamatalaga Mataʻituina | El Paso, TX."E le o fa'amoemoe e sui ai se mafutaga ta'ito'atasi ma se fa'apolofesa fa'alesoifua maloloina agava'a po'o se foma'i laiseneina ma e le o se fautuaga fa'afoma'i. Matou te fa'amalosia oe e fai fa'ai'uga fa'alesoifua maloloina e fa'atatau i au su'esu'ega ma faiga fa'apaaga ma se tagata tomai fa'apitoa tau soifua maloloina.
Blog Fa'amatalaga & Va'aiga Talanoaga
O matou fa'amatalaga lautele e fa'atapula'a ile Chiropractic, musculoskeletal, vaila'au fa'aletino, soifua maloloina, fa'asoa etiological fa'alavelave viscerosomatic i totonu o fa'ata'ita'iga fa'apitoa, somatovisceral reflex fa'ata'ita'iga fa'amanino, fa'alavelave fa'aletonu, fa'afitauli ma'ale'ale o le soifua maloloina, ma/po'o tala fa'afoma'i aoga, autu, ma talanoaga.
Matou te tuuina atu ma tuuina atu felagolagomai falema'i faatasi ai ma tagata tomai faapitoa mai matata eseese. O fa'apitoa ta'ito'atasi e fa'atonutonuina e la latou fa'apolofesa lautele o fa'ata'ita'iga ma a latou pulega fa'atulafonoina. Matou te fa'aogaina tulafono fa'alesoifua maloloina ma le soifua manuia e togafitia ma lagolago ai le tausiga o manu'a po'o fa'aletonu o le musculoskeletal system.
O a matou vitiō, pou, mataupu, mataupu, ma malamalamaga e aofia ai mataupu tau falemaʻi, mataupu, ma mataupu e fesoʻotaʻi ma tuusaʻo pe le tuusaʻo le lagolagoina o la matou faʻataʻitaʻiga masani.*
O lo matou ofisa sa taumafai lava e tu'uina atu fa'amatalaga lagolago ma ua fa'ailoa mai su'esu'ega su'esu'ega talafeagai po'o su'esu'ega e lagolagoina a matou pou. Matou te saunia ni kopi o lagolagoina suʻesuʻega suʻesuʻega avanoa i tulafono faʻatonutonu laupapa ma tagata lautele pe a talosagaina.
Matou te malamalama o matou aofia ai mataupu e manaʻomia se faʻaopopo faʻamatalaga o le auala e ono fesoasoani ai i se faʻapitoa tausiga fuafuaga poʻo togafitiga togafitiga; o lea, ia toe talanoaina le mataupu mataupu i luga, faʻamolemole lagona le saoloto e fesili Dr. Alex Jimenez, DC, pe faʻafesoʻotaʻi i matou 915-850-0900.
Ua matou o mai e fesoasoani ia oe ma lou aiga.
faamanuiaga
Dr. Alex Jimenez D.C., MSACP, RN*, CCST, IFMCP*, CIFM*, atn*
imeli: faiaoga@elpasofunctionalmedicine.com
Laisene o se Fomaʻi o Chiropractic (DC) i Texas & New Mexico*
Texas DC Laisene # TX5807, New Mexico DC Laisene # NM-DC2182
Laisene ose Tausima'i Resitala (RN*) in Florida
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Tulaga Fa'atasi: Laisene Tele-Setete: Fa'atagaina e Fa'ata'ita'i i totonu 40 States*
Dr. Alex Jimenez DC, MSACP, RN* CIFM*, IFMCP*, ATN*, CCST
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