Children's Orthopaedics: Normal Growth and Development

Question 1

in what directions do bones grow and where from?

Answer 1

longitudinally from the epiphyseal growth plate OR

circumferentially from the periosteum

Question 2

what is the process of longitudinal bone growth called?

Answer 2

enchondral ossification

Question 3

what is the process of circumferential bone growth called?

Answer 3

appositional growth

Question 4

what factors can contribute to short stature

Answer 4

diet
vitamin d and a
injury
illness
GH
genetics

Question 5

bones with the highest epiphyseal activity

Answer 5

shoulder

wrist

Question 6

common age for a child to stand?

Answer 6

8-12 months

Question 7

what age would a child normally be able to manage stairs alone

Answer 7

3

Question 8

what age is common for children to start saying their first words?

Answer 8

9-12 months

Question 9

what is genu varum

Answer 9

bow legged

Question 10

what is genu valgum

Answer 10

knock knees

Question 11

is it normal for a child under 2 to have genu varum

Answer 11

yes

Question 12

when would a genu varum be considered abnormal?

Answer 12

unilateral
>16 degrees away from normal
short stature
pain

Question 13

differential diagnoses for a pathological genu varum

Answer 13

skeletal dysplasia
rickets
tumour
blounts disease
physeal injury

Question 14

what is blounts disease?

Answer 14

growth arrest of medial tibial physis

Question 15

what does blounts disease show on x ray?

Answer 15

beak like protrusion

Question 16

tumours that may present with genu valgum?

Answer 16

enchondroma

osteochondroma

Question 17

conditions other than cancer that may be associated with genu valgum?

Answer 17

neurofibromatosis

rickets

Question 18

when would you consider surgery in a child with genu valgum?

Answer 18

> 8cm intermalleolar distance

Question 19

what is intoeing?

Answer 19

walking with toes pointed aka pigeon toed

Question 20

possible causes of intoeing?

Answer 20

femoral neck anteversion
internal tibial torsion
metatarsus adductus

Question 21

common clinical finding in femoral neck anteversion

Answer 21

patients can sit in W position

Question 22

what ages is internal tibial torsion common in?

Answer 22

toddlers - 1-3 yrs

Question 23

what should be done for internal tibial torsion

Answer 23

nothing, should resolve by itself by age 6

Question 24

what is metatarsus adductus

Answer 24

foot slants medially

Question 25

how common are flat feet?

Answer 25

1 in 5 adults have it

Question 26

how to tell the difference between fixed flat feet and flexible flat feet?

Answer 26

if you raise the foot and you see an angle its flexible

Question 27

which toes are most commonly affected by curly toes?

Answer 27

3rd and 4th

Question 28

who is most likely to get anterior knee pain

Answer 28

teenage girls

Question 29

why should the hips be checked in anterior knee pain?

Answer 29

hip problems can refer to the knee