15.11.2 Common paediatric conditions

Question 1

Explain what exactly the spectrum of disease referred to as “Developmental Dysplasia of the Hip” entails.

Question 2

Define Developmental dysplasia of the hip (DDH)?

Question 3

Discuss the aetiology of Developmental dysplasia of the hip (DDH.)

Question 4

List associated conditions that commonly occur together with of Developmental dysplasia of the hip (DDH).

Question 5

Discuss the epidemiology of Legg Calve Perthes disease.

Question 6

Discuss the pathogenesis of Legg Calve Perthes disease.

Question 7

Tabulate the pathological stages (Waldenström) of Legg Calve Perthes disease.

Question 8

Name the typical clinical features of Legg Calve Perthes disease.

Question 9

Tabulate the classic radiological features of Legg Calve Perthes disease.

Question 10

Describe the applied anatomy that is relevant for Slipped Upper Femoral Epiphysis (SUFE).

Question 11

Explain the concept of the disease entity of Slipped Upper Femoral Epiphysis (SUFE).

Question 12

Identify the patient at risk for Slipped Upper Femoral Epiphysis (SUFE).

Question 13

Describe the presenting signs and symptoms of a child with Slipped Upper Femoral Epiphysis (SUFE).

Question 14

Classify Slipped Upper Femoral Epiphysis (SUFE).

Question 15

Explain why we need to classify a child presenting with Slipped Upper Femoral Epiphysis (SUFE).

Question 16

Describe the X-ray features of Slipped Upper Femoral Epiphysis (SUFE).

Question 17

Rotational variations

Answer 17

Vary widely

Generally not pathological

Foot position during walking relative to the body’s line of movement during the gait cycle

Question 18

Rotation is until which age and why.

Answer 18

Varies up to the age of 5 (mature gait)

Question 19

Variation is dependent on torsion, what do we mean by torsion?, and it is due to:

Answer 19

Internal/external/neutral=0 degrees
Picture on PowerPoint
Due to: the below-mentioned being twisted
Femur
Tibia
Foot

Question 20

What factors fall under Torsion? Explain them.

Answer 20

-version of the bones
Bones are twisted.
-capsular pliability
The ability of a joint capsule to stretch and allow movement in different directions.
Influenced by factors such as bone shape, muscle control and body posture.
-muscle control
The ability to contract and relax mm. voluntarily and selectively.
Comprises of controlling muscles in: isolation, combination, and sequences.

Question 21

Rotational variation assessment

Answer 21

Static and dynamic
- For both assessments the patients should lie on their tummy.
-Internal and external seat
Static:
-Femoral interversion: femur neck in which direction it is facing ,hips range of motion

Question 22

Static Assessment

Answer 22

Available range of rotational motion
Prone position

Question 23

Dynamic Assessment

Answer 23

Effect of various torsional

-Child should be able to walk alone
-Shoes and barefoot
-Foot and knee position should be observed over several cycles of gait.

Question 24

Thigh Foot angle

Answer 24

Degree of tibial torsion

Foot deformities may contribute to rotational abnormalities.
-Longitudinal axis of the thigh and foot, in relation to the tibia (see picture on the PowerPoint)
-Lot of variation, esp. in young children.

Question 25

The average TFA

Answer 25

5 degrees internal in infants (range, -30 to +20 degrees)
10 degrees external by 8 years of age (range, -5 to +30 degrees)

Question 26

TFA changes very little after which age?

Answer 26

12 years of age

Question 27

Differential diagnosis of in-toeing

Answer 27

Metatarsus adductus
Internal tibial torsion
Excessive femoral anteversion

Question 28

Metatarsus adductus

Answer 28

The foot itself: The shape is abnormal.

Question 29

Internal tibial torsion

Answer 29

-The twisting of the shinbone (tibia) inward
-causing a pigeon-toed appearance.
- It is common in young children
- usually corrects by itself over time
-There is no specific treatment for it, unless it is severe or associated with other problems.

Question 30

Excessive femoral anteversion