Children

Question 1

What is cerebral palsy?

Answer 1

neuromuscular disease before the age of 2 that is non-progressive damage to the brain before full development of the CNS

Question 2

What are the causes of cerebral palsy?

Answer 2

• genetic problems
• brain malformation
• intrauterine infection
• problems during labour

Question 3

What are the most common bone issue with children?

Answer 3

• hip dislocation: can remove femur head
• spinal problems: can lead to resp problems
  use GMFCS score

Question 4

What does normal motion depend on?

Answer 4

an appropriante and adequate force acting via a rigid layer of appropriate length on a stable joint

Question 5

What are the features of tiptoe walking?

Answer 5

• idiopathic/autism related

- age 3 is when it stops being normal

Question 6

What are the features of clubfeet?

Answer 6

• structural abnormality
• more common in boys
• idiopathic
• treatment is Ponseti plastering

Question 7

What are the features of rocker bottom feet?

Answer 7

• vertical talus

- treat with reverse Ponseti

Question 8

What are red flags for paediatric bone issues?

Answer 8

• short history
• limp
• localisation
• asymmetry

Question 9

What are the extra things to examine with knee or foot issues?

Answer 9

• knee pain? examine hips!

- foot deformity? check spine!

Question 10

What is osteocondritis dissecans?

Answer 10

lack of blood supply to cartilage of the knee

Question 11

What is cavus feet?

Answer 11

hereditary motor and sensory neuropathy

increased arch

Question 12

What is the progression of leg shape in children?

Answer 12

they are born varus but this corrects in adulthood

Question 13

How do bones grow?

Answer 13

• longitudinally from physics by enchondral oddification

- circumferentially from periosteum by appositional growth

Question 14

What are the zones of the growth plate?

Answer 14

Resting zone
Proliferative zone
Columnar zone
Hypertrophic zone
Calcification zone

Question 15

Where does most growth come from in the body?

Answer 15

• upper limb: shoulder and the wrist
• lower limb: knees
  (the bits that stick out of the water when in the bath)

Question 16

What are the factors affecting the growth plate?

Answer 16

• diet/nutrition
• hormones
• illness
• injury
• vitamins and sunlight

Question 17

What is the normal time frame for sitting alone or crawling?

Answer 17

6-9 months

Question 18

What is the normal time frame for standing?

Answer 18

8-12 months

Question 19

What is the normal time frame for walking?

Answer 19

14-17 months

Question 20

What is the normal age for jumping?

Answer 20

24 months

Question 21

What is the normal age for doing stairs alone?

Answer 21

3 years

Question 22

What are some variations of normal relating to children’s feet?

Answer 22

• curly toes
• flat feet
• genu valgum/varum
• intoeing

Question 23

What are the features of Duchenne’s?

Answer 23

• genetic
• X linked dominant
• boys
• shoulder girdle, gluteus mediums and thighs
• push up on legs to stand straight

Question 24

When is varus legs not normal?

Answer 24

abnormal when

• unilateral
• pain

normal when
- familial and <2

Question 25

What are the causes of varus legs?

Answer 25

- skeletal dysplasia - trauma - tumour - rickets - Blounts disease: growth arrest of medial tibial physic and there is a beak-life protrusion on the XR

Question 26

What are the causes of valgus legs?

Answer 26

- rickets - tumours - idiopathic - neurofibromatosis measure while lying down, between maleoli

Question 27

What can intoeing be related to?

Answer 27

- femoral neck anteversion: lie prone, bend knee, rotate leg and there will be a W position - internal tibial torsion: toddlers, most resolve, thigh-foot angle - metatarsus adductus: common, resolves, casting?

Question 28

What are the tests for flatfeet?

Answer 28

- determine if flexible or rigid | - do tip-toe test or check varus/valgus from the back

Question 29

What is skeletal dysplasia?

Answer 29

- dwarfism - abnormal development of bone and connective tissue - proportionate or disproportionate - achondroplasia is short limb, forehead and wide nose

Question 30

What are the features of Marfan's?

Answer 30

- tall - thin - scoliosis - pectus excavatum - eye issues - AA and cardiac valve issues

Question 31

What are the features of Ehlers-Danlos syndrome?

Answer 31

- joint hypermobility - vascular fragility - joint instability - scoliosis

Question 32

What is Erb's palsy?

Answer 32

injury to C5+6 leading to the waiter's tip posture

Question 33

What are the most common paediatric knee issues?

Answer 33

- patellar tendonitis: self-limiting - girls's pain: physio, will disappear - meniscal problems: will heal

Question 34

What is clubfoot?

Answer 34

- ankle equinus, forefoot supination and varus alignment - boys - Fhx - breech - Ponseti splint/cut Achilles for treatment