Child health- ortho

Question 1

what is juvenile idiopathic arthritis

Answer 1

group of arthritides that affect children and young individuals under the age of 16, where the aetiology is unknown

Question 1

clinical features of juvenile idiopathic arthritis

Answer 1

systemic signs first-
fevers
generalised malaise
salmon pink rash
joint involvement-
joint pain
joint swelling
morning stiffness
limited range of motion

Question 2

who do obstetric brachial plexus palsies most commonly occur in

Answer 2

large babies
twin deliveries
shoulder dystocia

Question 3

most common type of obstetric brachial plexus palsies

Answer 3

erbs palsy

Question 4

erbs palsy is a result of injury to which nerves

Answer 4

C5 and C6 nerve roots

Question 5

characteristic posture of erbs palsy

Answer 5

waiter tips posture

Question 6

klumples palsy is a result of injury to which nerves

Answer 6

lower brachial plexus injury- C8 and T1 roots

Question 7

clinical features of klumples palsy

Answer 7

paralysis of intrinsic hand muscles +/- finger and wrist flexors
claw hand

Question 8

what is osteogenesis imperfecta

Answer 8

rare group of genetic disorders mainly affecting bone; aka brittle bone disease

Question 9

osteogenesis imperfecta aka

Answer 9

brittle bone disease

Question 10

osteogenesis imperfecta is a defect of the maturation and organisation of which type of collagen

Answer 10

type I collagen

Question 11

mode of inheritance of osteogenesis imperfecta

Answer 11

most cases autosomal dominant
rarer cases autosomal recessive

Question 12

clinical features of autosomal dominant osteogenesis imperfecta

Answer 12

multiple fragility fractures of childhood
short stature, multiple deformities
blue sclerae
dentinogenesis imperfecta
loss of hearing

Question 13

clinical features of autosomal recessive osteogenesis imperfecta

Answer 13

either fatal in the perinatal period or associated with spinal deformity

Question 14

investigation for osteogenesis imperfecta

Answer 14

XRAY- thin bones

Question 15

medical term for short stature

Answer 15

skeletal dysplasia

Question 16

most common type of skeletal dysplasia

Answer 16

achondroplasia

Question 17

at birth, all feet are flat, true/false?

Answer 17

true

Question 18

which toe is most frequently affected in curly toes

Answer 18

5th toe

Question 19

developmental dysplasia of the hip more common in males/females?

Answer 19

females (8:1)

Question 20

tests carried out for developmental dysplasia of hip

Answer 20

Barlows test
ortolanis test

Question 21

investigation for developmental dysplasia of the hip before 3 months of age

Answer 21

USS

Question 22

investigation for developmental dysplasia of the hip after 3 months of age

Answer 22

XRAY

Question 23

what test is carried out to determine wether a developmental dysplasia of the hip is femoral or tibial

Answer 23

galeazzi test

Question 24

breech birth is a risk factor for what orthopaedic disease

Answer 24

developmental dysplasia of the hip

Question 25

management of early developmental dysplasia of the hip

Answer 25

pavlik harness 23-24 hours a day for up to 12 weeks until USS is normal

Question 26

management of late developmental dysplasia of the hip

Answer 26

surgery- closed reduction spica, open reduction spica

Question 27

what is transient synovitis

Answer 27

self-limiting inflammation of the synovial of a joint, most commonly the hip

Question 28

when does transient synovitis commonly occur

Answer 28

after a viral upper respiratory tract infection

Question 29

typical age of transient synovitis

Answer 29

age 2-10

Question 30

most common cause of hip pain in childhood

Answer 30

transient synovitis

Question 31

who does transient synovitis most commonly affect girls/boys?

Answer 31

boys

Question 32

clinical features of transient synovitis

Answer 32

limp/reluctance to weight bear on affected side range of motion restricted may be low grade fever but child is not systemically unwell

Question 33

management of transient synovitis

Answer 33

NSAIDs and rest

Question 34

what investigation is carried out to distinguish between septic arthritis and transient synovitis

Answer 34

joint aspiration

Question 35

what is perthes disease

Answer 35

idiopathic osteochondritis of the femoral head

Question 36

is perthes disease more common in boys or girls

Answer 36

boys (5:1)

Question 37

who is most likely to get perthes disease

Answer 37

ages 4-9 boys; particularly very active boys of short stature

Question 38

mechanism of perthes disease

Answer 38

avascular necrosis of femoral head

Question 39

differentiating between transient synovitis and perthes disease

Answer 39

transient synovitis- more sudden, following viral illness, fever, resolves perthes disease- progressive, no fever

Question 40

who does slipped upper femoral epiphysis most commonly affect

Answer 40

overweight pre-pubertal adolescent boys

Question 41

aetiology of SUFE

Answer 41

ages 8-18 pubertal growth overweight males (80%) ethnicities- afrocaribbean and hispanic endocrine- hypothyroidism

Question 42

investigation for SUFE

Answer 42

XRAY

Question 43

management of SUFE

Answer 43

urgent surgery

Question 44

complication of slipped upper femoral epiphysis

Answer 44

avascular necrosis of femoral head

Question 45

what mode of inheritance is marfans syndrome

Answer 45

autosomal dominant

Question 46

anterior knee pain, worse going downhill-

Answer 46

patellofemoral dysfcuntion

Question 47

clinical features of osteochondritis dissecans

Answer 47

knee pain after exercise intermittent swelling and locking

Question 48

what is club foot

Answer 48

condition in which a newborns foot or feet appear to be rotated internally at the ankle

Question 49

how many cases of club foot are bilateral

Answer 49

50%

Question 50

risk factors for club foot

Answer 50

male family history breech presentation Oligohydramnios

Question 51

what is the ponsetti technique

Answer 51

splining and casting

Question 52

80% of club foot cases require what

Answer 52

tenotomy of achilles tendon