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musculoskeletal > growth and development problems > Flashcards

growth and development problems Flashcards

1
Q

what does FAI stand for

A

femoroacetabular impingement syndrome

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2
Q

why does FAI occur

A

hip bones do not form normally during the childhood growing years

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3
Q

what is CAM type FAI

A

asymmetric femoral head with decreased head : neck ratio

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4
Q

who usually presents with CAM type FAI

A

young athletic males

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5
Q

what is a pincer type FAI

A

acetabular overhang

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6
Q

who usually presents with pincer type FAI

A

females

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7
Q

consequences of FAI

A
  • Damage to the labrum and tears
  • Damage to cartilage
  • OA in later life
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8
Q

clinical presentation of FAI

A

activity related pain in the groin
difficulty sitting

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9
Q

clinical signs of FAI

A
  • C sign positive
  • FADIR provocation test positive
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10
Q

management of pincer impingement

A

Peri-acetabular osteotomy

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11
Q

what does SUFE stand for

A

slipped upper femoral epiphysis

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12
Q

what is SUFE

A

femoral head epiphysis slips inferiorly in relation to the femoral neck

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13
Q

who does SUFE usually present in

A

overweight pre‐pubertal adolescent boys

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14
Q

clinical presentation of SUFE

A

Hip, groin, thigh or knee pain with limp
can be bilateral

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15
Q

clinical signs of SUFE

A
  • Antalgic gait
  • lower limb: short, externally rotated, loss of internal rotation, loss of deep flexion
  • pain at extreme hip range of movement
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16
Q

management of SUFE

A

urgent surgery to pin the femoral head

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17
Q

what is perthes disease

A

idiopathic avascular necrosis of the developing femoral head

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18
Q

who usually presents with perthes disease

A

boys 4-9

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19
Q

risk factors for perthes

A

family history, low birth weight, passive smoking, asian

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20
Q

pathophysiology of perthes

A

femoral head transiently loses its blood supply resulting in necrosis with subsequent abnormal growth

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21
Q

clinical presentation of perthes

A

pain and a limp

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22
Q

first clinical sign of perthes

A

loss of internal rotation

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23
Q

what is transient synovitis

A

Self‐limiting inflammation of the synovium of a joint

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24
Q

where does transient synovitis commonly affect

A

the hip

25
Q

what does transient synovitis usually follow

A

viral URTI

26
Q

typical presentation of transient synovitis

A

boys 2-10

27
Q

clinical presentation of transient synovitis

A

limp/reluctance to bear weight
restricted ROM
hip lying flexed/ externally rotated

28
Q

kochers criteria for transient synovitis

A
  • WCC >12
  • inability to bear weight
  • temp >38.5
  • ESR >40 or raised CRP
29
Q

management of transient synovitis

A

NSAIDs and rest

30
Q

what is developmental dysplasia

A

dislocation or subluxation of the femoral head during the perinatal period which affects the subsequent development of the hip joint

31
Q

name some risk factors for developmental dysplasia

A

female, breech, first born, >4kg, multiple pregnancy

32
Q

which hip is more commonly affected by developmental dysplasia

A

left hip

33
Q

clinical signs of developmental dysplasia

A

asymmetry
loss of knee height
crease asymmetry
less abduction in flexion

34
Q

2 examination tests for developmental dysplasia and findings

A

barlows test: hip dislocates posteriorly
ortolanis test: flexion and abduction reduces femoral head into acetabulum

35
Q

investigation of developmental dysplasia

A

USS

36
Q

management of early developmental dysplasia

A

pavlik harness for 23 hrs a day until USS is normal

37
Q

management of late developmental dysplasia

A

closed or open reduction spica

38
Q

what is traction apophysis

A

excessive pull by a large tendon causes damage to the unfused apophysis to which it is attached

39
Q

what is osgood-schlatters disease

A

traction apophysitis at tibial tubercle

40
Q

who gets osgood-schlatters disease

A

adolescent active boys

41
Q

how does osgood-schlatters disease present

A

knee pain + swelling
leaves a prominent bony lump

42
Q

name 2 other sites of traction apophysitis

A

patella
achilles

43
Q

what is osteochondritis dissecans

A

area of the surface of the knee loses its blood supply

44
Q

when is osteochondritis dissecans most common

A

adolescence

45
Q

clinical presentation of osteochondritis dissecans

A

knee pain and recurrent infusions

46
Q

management of osteochondritis dissecans

A

usually heal or resolve spontaneously

47
Q

what is another name for patellofemoral dysfunction

A

anterior knee pain

48
Q

who usually presents with patellofemoral dysfunction

A

adolescent girls

49
Q

what is another name for patellar tendonitis

A

jumpers knee

50
Q

what is another name for club foot

A

congenital talipes equinovarus

51
Q

what is club foot

A

newborn’s feet appear to be rotated internally at the ankle

52
Q

risk factors for club foot

A
  • More common in males
  • Family history
  • Breech presentation
  • Oligohydramnios
53
Q

what causes club foot

A

abnormal alignment of the joints between the talus, calcaneus and navicular results in contractures of the soft tissues

54
Q

management of club feet

A

ponsetti technique: splinting and casting

55
Q

what are rockerbottom feet

A

rigid flat form deformity

56
Q

give 2 examples of conditions that rockerbottom feet feature in

A

patau’s
edwards syndrome

57
Q

clinical presentation of rockerbottom feet

A

feet are gently curved upwards at both ends

58
Q

management of rockerbottom feet

A

vertical talus casting/manipulation

musculoskeletal (30 decks)

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