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MSK CORTEXT > 3- Paediatric orthopedics > Flashcards

3- Paediatric orthopedics Flashcards

1
Q

What makes up most of the organic composition of bone

A

Type 1 collagen

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2
Q

What is the medical term for brittle bone disease

A

Osteogenesis imperfecta

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3
Q

Describe the appearance of bones in osteogenesis imperfecta

A

Thin
Thin cortices
Osteopenia
Mild cases may have normal x-ray

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4
Q

What is the general cause of skeletal dysplasia

A

Genetic error

Leads to abnormal development of bone and connective tissue

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5
Q

What is generalised joint laxity

A

Hypermobility of joints that run in families
May describe selves as double jointed and be able to pop joints out
More prone to soft tissue injury and dislocation

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6
Q

What pattern of inheritance does Ehlers-Danlos syndrome follow

A

Autosomal dominant

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7
Q

What are the MSK manifestations of Down’s syndrome

A

Short stature

Joint laxity - possible recurrent dislocation

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8
Q

What are the general symptoms of muscular dystrophies

A

Progressive muscle weakness and wasting

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9
Q

How can Duchenne muscular dystrophy be managed

A

Physiotherapy, splintage and deformity correction may prolong mobility
Severe scoliosis may get surgery

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10
Q

What causes neuromuscular disorders

A

Due to abnormal or deficient motor neuron signals to skeletal muscle
Can be due to a defect in either the brain, spinal cord, peripheral nerve, neuromuscular junction or muscle

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11
Q

What determines the severity of cerebral palsy

A

The area of the brain affected

This also affects the expression of the disease

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12
Q

What are the MSK problems that can occur in cerebral palsy

A

Spasticity
Joint contractures
Scoliosis
Hip dislocation

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13
Q

What is spina bifida

A

Congenital disorder where the 2 halves of posterior vertebral arch fail to fuse
Leads to neurological symptoms

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14
Q

What is polio

A

a viral infection which affects motor anterior horn cells in the spinal cord or brainstem resulting in a lower motor neurone deficit

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15
Q

List the common types of limb malformation

A

Extra bones
Absent bones
Short bones
And fusion of bones and/or soft tissue

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16
Q

What is syndactyly

A

Commonest congenital malformation

Fusion of digits

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17
Q

What can cause limb malformations

A

Genetics

Insult to the developing limb bud during gestation

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18
Q

What is the results of Erb’s palsy

A

Injury to C5 and 6
Loss of motor innervation to deltoid, supraspinatus, infraspinatus, biceps and brachialis
Leads to internal rotation of the humerus and waiter’s tip posture

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19
Q

What is more common, Erb’s or Klumpke’s palsy

A

Erb’s

Also has better prognosis

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20
Q

What causes Klumpke’s palsy

A

Forceful adduction of arm

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21
Q

List the normal milestones of MSK development

A 
Sits alone, crawls – 6‐9 months
Stands – 8‐12 months
Walks – 14‐17 months
Jumps – 24 months
Manages stairs independently – Age 3
22
Q

Describe the normal progression of knee alignment in kids

A

Birth - varus knees
14 months - neutral alignment
3 y/o - valgus
7-9 y/o - physiological slight valgus (normal)

23
Q

What is a valgus deformity

A

‘Knocked kneed’

Larger gap than normal between feet/ankles

24
Q

What is a varum deformity

A

‘Bow-legged’

Larger gap between the knees

25
Q

What can cause genu varum

A 
Blount's disease 
Growth plate restriction in adolescence 
Rickets 
Tumour 
Physeal injury 
Skeletal dysplasia
26
Q

What is Blount’s disease

A

growth disorder of the medial proximal tibial physis

27
Q

What can cause genu valgus

A

Rickets
Tumour
Trauma
Neurofibromatosis

28
Q

What is in-toeing

A

Feet point towards midline when standing
Exaggerated when running - appear clumsy
Common in children

29
Q

What is femoral neck anteversion

A

The femoral neck is always slightly anteverted (leans forward) but in some people it can be excessive
Leads to in-toeing

30
Q

List common causes of in-toeing

A

femoral neck anteversion
Internal tibial torsion
Forefoot adduction

31
Q

What are curly toes

A

Where there is minor overlapping of the toes

Most common in the 5th toe

32
Q

How do you treat curly toes

A

Most correct without intervention

May need surgery if persist past childhood

33
Q

How do you treat flat feet

A

May need surgery if rigid

34
Q

which side is most commonly affected by DDH

A

Left hip

35
Q

What can occur if DDH is left untreated

A

Acetabulum is very shallow and in more severe cases a false acetabulum forms
Severe arthritis occurs at a young age

36
Q

How do you diagnose DDH

A

Ultrasound to detect a dislocated hip or shallow acetabulum

X-rays can only be used after 4-6months of age

37
Q

How might you treat DDH

A

Pavlik harness

Open reduction is persistent past 18 months

38
Q

What is transient synovitis

A

Self‐limiting inflammation of the synovium of a joint

Most commonly the hip

39
Q

Which ages are typically affected by transient synovitis

A

Between 2 and 10 years old

40
Q

Who is affected by Perthes disease

A

Age 4-9

More common in boys

41
Q

How do you manage Perthes disease

A

Nothing specific
X-ray observation
Avoidance of physical activity
Occasionally severe cases require osteotomy

42
Q

Which conditions can predispose someone to SUFE

A

Hypothyroidism

Renal disease

43
Q

SUFE is always unilateral - true or false

A

FALSE

1/3 are bilateral

44
Q

Describe patellar tendonitis

A

Jumper’s knee - common in sport
Self-limiting
Treat with rest and physio

45
Q

What can be the cause of simple anterior knee pain

A

Muscle imbalance
Ligament laxity
Subtle skeletal predisposition - e.g. wide hips

46
Q

How might you treat anterior knee pain in adolescents

A

Usually self-limiting
Physio to rebalance muscle
Persistent cases may need surgery

47
Q

What is osteochondritis dissecans

A

Fragment of hyaline cartilage with varying amount of bone fragment breaks off the surface of the joint

48
Q

What joint is most commonly affected by osteochondritis dissecans

A

Knee

Common in adolescence

49
Q

Describe the treatment of clubfoot

A

Ponseti splinting ASAP after birth - progressively corrects with several casts
80% get Achilles cut to fully correct

50
Q

What is tarsal coalition

A

Abnormal bridge between the calcaneus and navicular or talus
Can lead to painful, flat foot

51
Q

What are some potential causes of scoliosis

A 
Idiopathic - most common 
Neuromuscular disease 
Tumours 
Skeletal dysplasia 
Infection

MSK CORTEXT (13 decks)

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