Morrey and Peterson’s Definition of Osteomyelitis Definite osteomyelitis: Positive bone or adjacent soft tissue culture or histologic evidence Probable osteomyelitis: Positive blood culture + Clinical & radiological evidence of osteomyelitis Likely osteomyelitis: Typical clinical and radiographic features of osteomyelitis responding to antibiotic therapy (in absence of positive culture) Peltola and…
Tag: Pediatrics
Section Editor: Dr. Sujit Kumar Shrestha, MD Pediatrics, Fellowship Neonatology
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Kocher Criteria for Septic Arthritis : Mnemonic
Kocher criteria can help to differentiate between spetic arthritis and transient synovitis in a case of non-traumatic painful hip in a child. A restrospective study in 104 pediatric patients has depicted that meeting 3 out of 4 crtieria would miss 52% cases and is of limited usefulness in detecting septic…
Emergency Medicine 
Pulled elbow reduction
Synonyms: Nursemaid’s elbow, Radial head subuluxation, Elbow subluxation Age: Commonly 1-4 years After 5 years of age, the attachment of the annular ligament to the neck of the radius strengthens Enlargement of the proximal radial epiphysis with growth may also improve stability Presentation: History of pull may be absent in…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
General Principles – Pediatric Fracture Management
Children are not just mini-adults • Higher head to torso ratio: Head injury & Upper C-spine fractures • Light weight – projectile when struck • BSA to Wt. ratio – higher (rapid hypothermia) • Large cardiopulmonary reserves – normal SBP in significant hypovolemia Growth contribution by Proximal & Distal Physes…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Heart Sounds – Murmurs
Murmur is a low, indistinct sound. In terms of medicine, it is the sound produced due to turbulent flow within the heart and great vessels. They are described and named in relation to the normal heart sounds, location, and quality. Please go through these articles before reading further: Heart Sounds…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Appearance and Fusion of Ossification Centers
Upper end of humerus Mnemonic: HGL – 1,3,5 a. Head – by 1 year b. Greater tuberosity – by 3 years c. Lesser tuberosity – by 5 years All 3 centers fuse together by 6 years (1 year after the last center appears) Upper end of femur Mnemonic: HGL –…
Clinical Skills and Approaches 
New Ballard Score: How to use it correctly?
Assessment of gestational age can be made postnatally by either Dubowitz Score or New Ballard Scoring system. In sick infants, examination of Anterior lens canpsule vascularity with a +20D lens can be useful in assessing gestation and it needs to be carried out within 24 hours of birth. Dr Jeanne…
PGMEE, MRCS, USMLE, MBBS, MD/MS 
Amylase and Lipase in Acute Pancreatitis
Test Rise Peak Return to baseline Lipase 4-6 hours 48 8-14 days Amylase 2-4 hours 24-48 5-7 days Serum lipase elevation has a better diagnostic value as compared to serum amylase due to its superior specificity. Amylase has a low molecular weight and as a result can easily pass through…