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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
What can cause genu varum
``` Blount's disease Growth plate restriction in adolescence Rickets Tumour Physeal injury Skeletal dysplasia ```
26
What is Blount's disease
growth disorder of the medial proximal tibial physis
27
What can cause genu valgus
Rickets Tumour Trauma Neurofibromatosis
28
What is in-toeing
Feet point towards midline when standing Exaggerated when running - appear clumsy Common in children
29
What is femoral neck anteversion
The femoral neck is always slightly anteverted (leans forward) but in some people it can be excessive Leads to in-toeing
30
List common causes of in-toeing
femoral neck anteversion Internal tibial torsion Forefoot adduction
31
What are curly toes
Where there is minor overlapping of the toes | Most common in the 5th toe
32
How do you treat curly toes
Most correct without intervention | May need surgery if persist past childhood
33
How do you treat flat feet
May need surgery if rigid
34
which side is most commonly affected by DDH
Left hip
35
What can occur if DDH is left untreated
Acetabulum is very shallow and in more severe cases a false acetabulum forms Severe arthritis occurs at a young age
36
How do you diagnose DDH
Ultrasound to detect a dislocated hip or shallow acetabulum | X-rays can only be used after 4-6months of age
37
How might you treat DDH
Pavlik harness | Open reduction is persistent past 18 months
38
What is transient synovitis
Self‐limiting inflammation of the synovium of a joint | Most commonly the hip
39
Which ages are typically affected by transient synovitis
Between 2 and 10 years old
40
Who is affected by Perthes disease
Age 4-9 | More common in boys
41
How do you manage Perthes disease
Nothing specific X-ray observation Avoidance of physical activity Occasionally severe cases require osteotomy
42
Which conditions can predispose someone to SUFE
Hypothyroidism | Renal disease
43
SUFE is always unilateral - true or false
FALSE | 1/3 are bilateral
44
Describe patellar tendonitis
Jumper's knee - common in sport Self-limiting Treat with rest and physio
45
What can be the cause of simple anterior knee pain
Muscle imbalance Ligament laxity Subtle skeletal predisposition - e.g. wide hips
46
How might you treat anterior knee pain in adolescents
Usually self-limiting Physio to rebalance muscle Persistent cases may need surgery
47
What is osteochondritis dissecans
Fragment of hyaline cartilage with varying amount of bone fragment breaks off the surface of the joint
48
What joint is most commonly affected by osteochondritis dissecans
Knee | Common in adolescence
49
Describe the treatment of clubfoot
Ponseti splinting ASAP after birth - progressively corrects with several casts 80% get Achilles cut to fully correct
50
What is tarsal coalition
Abnormal bridge between the calcaneus and navicular or talus Can lead to painful, flat foot
51
What are some potential causes of scoliosis
``` Idiopathic - most common Neuromuscular disease Tumours Skeletal dysplasia Infection ```

MSK CORTEXT (13 decks)

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