Child health- ortho Flashcards
what is juvenile idiopathic arthritis
group of arthritides that affect children and young individuals under the age of 16, where the aetiology is unknown
clinical features of juvenile idiopathic arthritis
systemic signs first-
fevers
generalised malaise
salmon pink rash
joint involvement-
joint pain
joint swelling
morning stiffness
limited range of motion
who do obstetric brachial plexus palsies most commonly occur in
large babies
twin deliveries
shoulder dystocia
most common type of obstetric brachial plexus palsies
erbs palsy
erbs palsy is a result of injury to which nerves
C5 and C6 nerve roots
characteristic posture of erbs palsy
waiter tips posture
klumples palsy is a result of injury to which nerves
lower brachial plexus injury- C8 and T1 roots
clinical features of klumples palsy
paralysis of intrinsic hand muscles +/- finger and wrist flexors
claw hand
what is osteogenesis imperfecta
rare group of genetic disorders mainly affecting bone; aka brittle bone disease
osteogenesis imperfecta aka
brittle bone disease
osteogenesis imperfecta is a defect of the maturation and organisation of which type of collagen
type I collagen
mode of inheritance of osteogenesis imperfecta
most cases autosomal dominant
rarer cases autosomal recessive
clinical features of autosomal dominant osteogenesis imperfecta
multiple fragility fractures of childhood
short stature, multiple deformities
blue sclerae
dentinogenesis imperfecta
loss of hearing
clinical features of autosomal recessive osteogenesis imperfecta
either fatal in the perinatal period or associated with spinal deformity
investigation for osteogenesis imperfecta
XRAY- thin bones
medical term for short stature
skeletal dysplasia
most common type of skeletal dysplasia
achondroplasia
at birth, all feet are flat, true/false?
true
which toe is most frequently affected in curly toes
5th toe
developmental dysplasia of the hip more common in males/females?
females (8:1)
tests carried out for developmental dysplasia of hip
Barlows test
ortolanis test
investigation for developmental dysplasia of the hip before 3 months of age
USS
investigation for developmental dysplasia of the hip after 3 months of age
XRAY
what test is carried out to determine wether a developmental dysplasia of the hip is femoral or tibial
galeazzi test
breech birth is a risk factor for what orthopaedic disease
developmental dysplasia of the hip
management of early developmental dysplasia of the hip
pavlik harness 23-24 hours a day for up to 12 weeks until USS is normal
management of late developmental dysplasia of the hip
surgery- closed reduction spica, open reduction spica
what is transient synovitis
self-limiting inflammation of the synovial of a joint, most commonly the hip
when does transient synovitis commonly occur
after a viral upper respiratory tract infection
typical age of transient synovitis
age 2-10
most common cause of hip pain in childhood
transient synovitis
who does transient synovitis most commonly affect girls/boys?
boys
clinical features of transient synovitis
limp/reluctance to weight bear on affected side
range of motion restricted
may be low grade fever but child is not systemically unwell
management of transient synovitis
NSAIDs and rest
what investigation is carried out to distinguish between septic arthritis and transient synovitis
joint aspiration
what is perthes disease
idiopathic osteochondritis of the femoral head
is perthes disease more common in boys or girls
boys (5:1)
who is most likely to get perthes disease
ages 4-9
boys; particularly very active boys of short stature
mechanism of perthes disease
avascular necrosis of femoral head
differentiating between transient synovitis and perthes disease
transient synovitis- more sudden, following viral illness, fever, resolves
perthes disease- progressive, no fever
who does slipped upper femoral epiphysis most commonly affect
overweight pre-pubertal adolescent boys
aetiology of SUFE
ages 8-18
pubertal growth
overweight
males (80%)
ethnicities- afrocaribbean and hispanic
endocrine- hypothyroidism
investigation for SUFE
XRAY
management of SUFE
urgent surgery
complication of slipped upper femoral epiphysis
avascular necrosis of femoral head
what mode of inheritance is marfans syndrome
autosomal dominant
anterior knee pain, worse going downhill-
patellofemoral dysfcuntion
clinical features of osteochondritis dissecans
knee pain after exercise
intermittent swelling and locking
what is club foot
condition in which a newborns foot or feet appear to be rotated internally at the ankle
how many cases of club foot are bilateral
50%
risk factors for club foot
male
family history
breech presentation
Oligohydramnios
what is the ponsetti technique
splining and casting
80% of club foot cases require what
tenotomy of achilles tendon
