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MSK (mine) > hip, spine, foot (paeds) > Flashcards

hip, spine, foot (paeds) Flashcards

1
Q

what is in-toeing, what is it also known as

A

feet pointing towards the midline

aka pigeon toeing

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2
Q

what causes in-toeing

A

(in order of frequency)

metatarsal adductus
internal tibial torsion
femoral neck anteversion
a combo of the above

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3
Q

what is genu valgum

A

knock-knees

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4
Q

when does genu valgum peak?

A

3 1/2yrs

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5
Q

when would you suspect genu valgum is abnormal

A

unilateral/asymmetric
painful
severe
if intermalleolar distance >8cm by 11yrs

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6
Q

what are the pathological causes of genu valgum

A

tumours
rickets
neurofibromatosis

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7
Q

what is genu varum

A

bowed legs

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8
Q

at what age is genu varum normal

A

<2yrs

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9
Q

when would you suspect genu varum is abnormal

A

unilateral/asymmetrical
severe
short stature
painful

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10
Q

what are the pathological causes of genu varum

A

skeletal dysplasia
rickets
tumor
Blout’s disease

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11
Q

what is Blout’s disease

A

growth arrest of medial tibial of physics, aetiology unknown

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12
Q

what is the buzzword for Blout’s disease

A

beak-like protrusion

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13
Q

what is spondylolisthesis

A

slippage of one vertebra over another

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14
Q

at what spinal level does spondylolisthesis usually occur

A

L4/5

L5/S1

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15
Q

what are the causes of spondylolisthesis

A

developmental defect

recurrent stress fracture of posterior elements which fail to heal

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16
Q

what are the symptoms of spondylolisthesis? when do they present

A

present in adolescence

lower back pain
nerve pinching is slippage is severe
flat back = due t muscle spasm
waddling gait

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17
Q

what is the treatment of spondylolisthesis

A

minor = rest + physio

more severe = stabilisation +/- reduction

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18
Q

what is scoliosis

A

lateral curvature of the spine

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19
Q

what are the causes of scoliosis

A 
idiopathic (most common)
secondary to neuromuscular disease
tumour
skeletal dysplasia
infection
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20
Q

investigations of scoliosis

A

X-ray

MRI but only if painful

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21
Q

treatment of scoliosis

A

mild/ non-progressive = nothing

large curve/progressive = surgery

22
Q

what is Hallux valgus

A

a bunion

23
Q

when/where does Hallux valgus occur

A

late in adolescence

on the foot

24
Q

what is tarsal coalition

A

abnormal bridge (bony, fibrous, or cartilaginous) between the calcareous and navicular or between the talus and calcaneus leading to a fixed, flat foot deformity

25
Q

what is talipes equinovarus

A

club foor

26
Q

what are the risk factors of talipes equinovarus

A 
make
FM 
breech presentation
low amniotic fluid content
skeletal dysplasia
27
Q

symptoms of talipes equinovarus

A

50% are bilateral
ankle equines (plantar flexion)
supination of foot
varus alignment of forefoot

28
Q

treatment of talipes equinovarus

A

early splintage = Ponseti technique

late presentation = surgery

29
Q

what is development dysplasia of the hip (DDH)

A

dislocation or subluxation of the femoral head during the perinatal period

30
Q

what hip is more commonly affected in development dysplasia of the hip (DDH)

A

Left

31
Q

what are the risk factors of development dysplasia of the hip (DDH)

A 
female
FH
first born
breech presentation
down's syndrome 
lack of uterine fluid
other congenital disorders
32
Q

symptoms of development dysplasia of the hip (DDH)

A 
shortening, asymmetric groin/thigh creases
uneven leg lengths
clicl/clunk in manoeuvres
positive ortolani manoeuvre
posotove Barlow manoeuvre
33
Q

what is the Barlow manoeuvre

A

hip dislocated with flexion and posterior displacement

B for putting it Back/ posterior

34
Q

what is the ortolani manoeuvre

A

dislocated hip can be reduced with abduction and anterior displacement

35
Q

what are the investigations of development dysplasia of the hip (DDH)

A

<6 months = ultrasound

>6months = X-ray

36
Q

what is the treatment of development dysplasia of the hip (DDH)

A

pavilik harness for 23hrs daily for 6 weeks = maintains correct position serial Ultrasound to document improvement

persistent dislocation >18motnhs = open or closed reduction + spica cast

if reducible = reduce then monitor

37
Q

what is transient synovitis of the hip

A

self-limiting inflammation of the hip joint

38
Q

what usually precedes transient synovitis of the hip

A

URT infection

39
Q

who does transient synovitis of the hip most commonly affect

A

girls, 2-10yrs

40
Q

what are the symptoms of transient synovitis of the hip

A

limp
reluctance to bear weight
restricted range of motion
low grade fever but NOT systemically unwell

41
Q

what are the investigations of transient synovitis of the hip, what are their purpose

A

X-ray = exclude earths
CRP = exclude septic arthritis
aspirate hip
MRI = exclude osteomyelitis

42
Q

what is the treatment of transient synovitis of the hip

A

shot course of NSAIDs + rest

43
Q

what is perthes disease, what does it lead to

A

idiopathic osteochondritis of the femoral head which leads to avascular necrosis of the hip

44
Q

who most commonly gets perthes disease

A

active boys with short stature

45
Q

at what age does perthes disease occur

A

occurs between 4-9

46
Q

what are the symptoms of perthes disease

A 
pain
gradual onset of painless limp
unilateral 
loss of internal rotation
loss of abduction
postive trendelenburg test = gluteal weakness
47
Q

what is the treatment of perthes disease

A

regular X-ray observation

avoid physical activity

48
Q

what is slipped upper femoral epiphysis (SUFE)

A

Occurs when the proximal femoral head epiphysis slips inferiorly in relation the femoral neck

49
Q

who is at risk of slipped upper femoral epiphysis (SUFE)

A 
pre-pubertal, adolescent boys
obese
hypothyroidism
renal disease
growth spurt may preclude onset
50
Q

what are the symptoms of slipped upper femoral epiphysis (SUFE)

A

1/3 bilateral
pain in knee and/or groin
loss of internal rotation of the hip
limp due to externally rotated foot

51
Q

what are the investigations of slipped upper femoral epiphysis (SUFE), what would these show

A

lateral X-ray = ice cream fallen off it’s cone

52
Q

what is the treatment of slipped upper femoral epiphysis (SUFE)

A

urgent surgery to pin femoral head in order to prevent further slips

MSK (mine) (17 decks)

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