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Musculoskeletal > Children's Orthopaedics > Flashcards

Children's Orthopaedics Flashcards

1
Q

What is meant by skeletal dysplasia?

A

Medical term for little person

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2
Q

What is the most common type of skeletal dysplasia?

A

Achondroplasia

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3
Q

Which classification system is used to scale the degree of joint hypermobility of a patient?

A

Wynne-Davies Classification

- common with skeletal dysplasias

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4
Q

What is Duchenne Muscular Dystrophy?

A

X linked recessive

Progressive muscular weakness noticed when boy starts to stand

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5
Q

What is the lifespan of a boy with DMD?

A

~ 20 years

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6
Q

How is DMD diagnosed?

A

Raised serum creatine phosphokinase

Abnormal muscle biopsy

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7
Q

What is cerebral palsy (CP)?

A

Neuromuscular disorder appearing before 3yo

Caused by insult to immature brain before, during or after birth

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8
Q

List 5 causes of CP

A 
Genes
Intrauterine infection
Prematurity
Intra-cranial haemorrhage
Hypoxia during birth
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9
Q

How does CP lead to bone deformity?

5 steps

A 
Brain injury
Increased muscle tone
Abnormal posture
Muscle contracture
Bone deformities
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10
Q

List the 3 features of Lower Motor Neurone inhibition

A

Spasticity
Hyperreflexia clonus
Co-contraction

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11
Q

Define spasticity

A

Condition with abnormally increased muscle tone, affects movement and speech

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12
Q

List 4 features of loss of LMN connection

A

Weakness
Fatigability
Poor balance
Sensory deficits

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13
Q

List 3 treatments for CP

A

Benzodiazapines (acutely)
Botox injections
Dorsal rhizotomy

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14
Q

What is tiptoe walking?

A

Child walking on balls of feet

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15
Q

Up to what age is tiptoe walking regarded as normal?

A

3 years

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16
Q

What are cavus feet?

A

When a person stands and there is a larger than normal gap between the midfoot and ground

17
Q

How do cavus feet normally look?

A

Heel and toes slightly inverted

“claw”/curled toes

18
Q

What is frontal bossing?

A

Prominent forehead

- associated with achondroplasia

19
Q

What is Developmental Dysplasia of the Hip (DDH)?

A

Dislocation/subluxation of the femoral head
During perinatal period
Affects subsequent development of hip joint

20
Q

Which sex is more affected by DDH?

A

Females

21
Q

List 5 risk factors associated with the development of DDH

A 
Family history
Breech position
First borns
Down's syndrome
Talipes etc
22
Q

List 3 clinical signs of DDH

A

Lower limb shortening
Asymmetric groin
Thick skin creases ^

23
Q

Which 2 maneouvres are used to check for the presence of DDH

A

Ortolani test

Barlow test

24
Q

After what age can Xrays be used to detect DDH?

A

4-6 months

- before this, the femoral head is not ossified

25
Q

How may the body compensate for untreated/severe DDH?

A

Develops false acetabulum anterior to the physiological one

- results in shorter limb and severe arthritis

26
Q

What is osteochondrosis?

A

Aseptic ischaemic necrosis

Primarily in centre of ossification on epiphysis

27
Q

What is Perthes disease?

A

Idiopathic osteochondritis of the femoral head

28
Q

Which age group and sex is most commonly affected by Perthes?

A

(active + short) Boys

4-9

29
Q

What is Slipped Upper Femoral Epiphysis (SUFE)?

A 
Femoral physis (growth plate) too weak to support body weight
Epiphysis slips under the strain
1/3 cases bilat.
30
Q

What age group and sex are normally affected by SUFE?

A

Overweight

Pre-pubescent boys

31
Q

Which 2 conditions may predispose a child to developing SUFE?

A

Hypothyroidism

Renal disease

32
Q

What is a strange but common presentation of SUFE?

A

ONLY knee pain

also, loss of internal rotation of hip

33
Q

What is the surgical treatment of SUFE?

A

Pinning of the femoral head

Musculoskeletal (19 decks)

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