Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Paeds > Joints > Flashcards

Joints Flashcards

1
Q

What is juvenile idiopathic arthritis

A

Arthritis occuring in someone who is less than 16 years old and lasts for more than 6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which joints does juvenile idiopathic arthritis tend to occur in

A

Medium sized- ankles, knees and elbows

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How does pauciarticular juvenile idiopathic arthritis present

A

Joint pain and swelling of medium sized joints
Limp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the different types of juvenile idiopathic arthritis

A

Pauciarticular- 4 joints or less
Polyarticular- more than 5
Systemic- with systemic symptoms like fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What antibody can be positive in JIA

A

ANA
Risk factor is SLE fhx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Pathophysiology of congenital hip dysplasia

A

When the femoral head does not sit within the acetabulum, as such they grow out of proportion to one another. If femoral head not in the acetabulum get hypertorphy of the ligaments. Caused by an excess of force on hip from various origins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Risk factors for congenital hip dysplasia

A

Anything which causes too much force on hip
- breech position
- first born child
- female
- oligohydramnios

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Symptoms of congenital hip dysplasia in newborns

A

Different length legs in children
Asymmetrical skin folds over the hip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Symptoms of congenital hip dysplasia in older children

A

Painless limping
Waddling gait
Painful osteoarthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How to visualise congenital hip dysplasia

A

Under 4.5 months- ultrasound
Over 4.5 months- X-ray

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How is CHD screened for

A

Barlow and ortolani test

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does barlow and ortolani test diagnose CHD

A

Barlow test initially- adduct hip whilst keeping knee straight
Ortolani test- flexing babies hip and adducting it will put femoral head back in place

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How to treat CHD

A

Under 6 months- pavlik harness for 1-2 months which holds femoral head in place
Over- surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What should be done in all children under 2 with an acute limp

A

Refer urgently

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is slipped upper femoral epiphysis

A

When the head of the femur (ball) slips off the neck of the femur at the growth plate
It slips postero-inferiorly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Risk factors for slipped upper femoral epiphysis

A

Obese
Males
Aged 10-15
Hypothyroidism
Hypogonadism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How can slipped upper femoral epihysis present

A

Can be acutely following trauma or more commonly with chronic symptoms
These include gradual onset pain (can be anywhere) and limp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How is slipped upper femoral epiphysis diagnosed

A

AP and lateral (frog legs) X-ray on BOTH legs
SUFE can be bilateral in 20% of cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What movement is lost in SUFE

A

internal rotation when flexed as such on examination the leg is often shortened and extenrally rotated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the management for superior upper femoral epiphysis

A

Internal fixation- single cannulated screw placed in the centre of epiphysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is transient synovitis

A

Acute synovitis which in children typically occurs a few weeks after an infection- be careful when diagnosing as should exclude all other causes first

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Factors which indicate can keep transient synovitis care at the GP

A

Afebrile
Can bear weight
No swelling
Redness
Between 3-9 (rare in under 3s)
Not obese

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is perthes disease

A

Avascular necrosis of the femoral head
Can be bilateral

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Presentation of perthes disease

A

Limp
Reduced movement as stiff
Progressive hip pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
X-ray finding of perthes disease
Loss of joint space initially then loss of femoral head
26
How to image perthes disease and if symptoms persist but no changes
X-ray If persist MRI or technetium
27
Management of perthes disease
If under 6 and not severe collapse of the head- observation, physio and serial x-rays If over 6 surgical management
28
What is osgood schlatters disease demogrpahic
Sporty teens
29
Presentation of osgood schlatters
Pain after excerise in sporty teens Anterior tibia
30
Management of osgood schlatters
Pain relief- paracetamol or NSAIDS Lifestyle advice- reduce activity, wear knee brace, ice packs on tuberosities
31
Complication of juvenile idiopathic arthritis
Anterior uveitis Damage to joint Osteoporosis Growth failure
32
Management of juvenile idiopathic arthritis
NSAIDS or paracetamol Can use intra-articular or oral corticosteroids IF Fail to respond to these 1st line- oral methotrexate 2nd line- sulfasalazine Cn use inflammatory cytokine block agents too
33
What is systemic JIA also known as
STILLS disease S- spiking fever (mainly in evening) T- there could be arthralgia I- increase in size of liver and spleen L- lose weight,anaemia L- looks like cancer S- salmon pink rash that comes and goes with fever
34
What are types of osteogenesis imperfecta
T1- mildest and most common T2- lethal T3- severely progressive and deforming T4- moderately progressive
35
Features of osteogenesis imperfecta
Multiple fractures Blue sclera Discoloured teeth Aortic root dilatation Aortic regurg Mitral valve prolapse
36
What is osteogenesis imperfecta
Group of collagen metabolism disordersleading to increased bone fragility and thinning of the sclera
37
Complications of pavlik splinting
Avascular necrosis Temporary femoral nerve palsy
38
What causes anterior knee pain on exercise or climibing stairs with a grating sound or crepitus on examination
Chondromalacia patellae
39
Management of chondromalacia patellae
Physio
40
What are the 3 types of spina bifida and what are they
Spina bifida occurs when there is a failure of the vertebral arch to fuse Spina bifida occulta- just failure to fuse Meningocele- herniation of the meninges through the arch causing a sac Myelomingocele- herniation of meninges containing neural tissue
41
What presents with dimple, tuft of hair or lipoma over spine
Spina bifidia
42
Difference in presentation of the spina bifidas
Occulta- can be incidental or through tethered chord syndrome Meningocele- no abnormal neurology but sac can burst causing meningitis or hydrocepahlus Myelomeningocele- severe abnormal neurology like bladder/bowel dysfunction, club foot or paresis
43
What is tethered chord syndrome
When inelastic tissue of caudal spine fuses to local area Can present with pain on exercise, gait issues and neurological dysfunction
44
Inheritance of muscular dystrophies
X-linked
45
How does duchenne muscular dystrophy present
1-3 years of age Delayed walking and waddling gait Difficulty to walk stairs Bulky calfs (pseudohypertrophy as muscle replaced by fibrotic tissue)
46
Prognosis and complications of duchenne muscular dystrophy
Cant walk at 12 Get cardiomyopathy and resp muscular issues Die by 20-30
47
Presentation of reactive arthritis
GI infection, throat or UTI 3 weeks later triad of - conjunctivitis - arthritis - urethritis normally first symptoms
48
How does reactive arthritis arthritis present
Oligoathritis of large joints Ethesitis like plantar fasciitis
49
Rarer symptoms of reactive arthritis
Keratoderm blenhoragicum- hard nodules on feet Balanitis- swelling of glans of penis
50
What type of condition is reactive arthritis
Seronegative spondyloarthropathy- associated with HLA-B27 and RF negative
51
Risk factors for perthes disease
Hyperactivity Short stature
52
What organism is associated with septic arthritis in SCD
Salmonella
53
X-ray findings of septic arthritis
Joint widening Ill defined articular margins
54
Most common site of septic arthritis
Hip
55
If patient deteriorates rapidly in osteomyeltis despite IV abx what do
Surgical debridement
56
Most common site of osteomyelitis
Upper tibia or lower femur
57
What is trendelenburg test in DDH
Positive- as hip tilts to one side
58
What is a greenstick fracture
When bone breaks and bends - common in at wrist when children fall forwards
59
What is a greenstick fracture
When bone breaks and bends - common in at wrist when children fall forwards - no complications
60
Management of greenstick fractures
Manipulation plaster immobilisation
61
What is chondromalacia patella
Wearing away of cartilage in the patella
62
What do if suspect transient synovitis but feverish
Admit
63
Management of stills disease
1st line- NSAIDS, steroids 2nd line DMARDS like steroids 3rd line- toclizimumab
64
How do gRowing pains present
Pain worse in joints at night
65
Up until when is bowed legs normal
3 years
66
What is pes planus
Flat feet
67
Up until when is pes planus normal
4-8 years
68
How does osteosarcoma present
Swelling around a joint Painless most often Reduced mobility
69
What is osteochondritis dissecans pathophysiology
Get reduced blood flow to patella- leads to fragmentation of bone and cartilage
70
Presentation of osteochondritis dissecans
Pain after exercise Locking and catching of knee Gives way easily
71
How is reactive arthritis managed
Pain relief
72
Long term complications of perthes disease
Short leg Osteoarthritis
73
What rfx require USS for breech detection
Breech delivey FHx
74
Investigations for osteomyelitis
Blood cultures X-ray but wont show anything til 7 days when will see bone destruction, osteopenia
75
Management of osteomyelitis and septic arthritis abx wise
IV flucloxacillin (clindamycin if pen allergic) Vancomycin if MRSA
76
Osteomyelitis presentation
Leg swelling Immobile Tender and erythematous Onset insidious
77
Septic arthritis presentation
Acute limb pain Swelling Not mobilising limb Red
78
Management of septic arthritis
IV fluclox Joint washout
79
What is gowers sign and what seen in
When getting up walk hands up legs and body Duchenne muscular dystrophy
80
What investigations done for duchenne muscular dystrophy
CK initially If elevated gold standard now is genetic testing
81
What infections can precede reactive arthritis
UTI GI Throat
82
What is trethowans sign seen in and what is it
SUFE Where the line of klein passess above the femoral head and does not line up with one on other side
83
What is irritable hip
Transient synovitis
84
How are growing pains managed
Heat packs Pain relief if needed
85
What causes joint pain and hyperextension of joints
Hypermobile joints
86
Recurrent broken bones including bones broken in utero
Osteogenesis imperfecta
87
Management if positive barlow and ortolani
USS at 6 weeks to assess
88
Differences between becker and duchenne muscle dystrophy
Becker presents at around 10 but duchenne between 1 and 6 Becker far less severe Becker rarer
89
How does spinal muscle atrophy present
Difficulty to maintain head Breathing difficulties Weak cough and cry Proximal muscle weakness Hypotonia
90
Inheritance of spinal muscular atrophy
Autosomal recessive
91
Abdo mass with limp
Neuoblastoma Metastasies to bones quickly and evidence of metastatic disease most common presentation
92
What do first; joint aspirate or IV abx
Joint aspirate
93
How is positional talipes differentiated from talipes equinovirus
In positional talipes the foot van be easily moved from position and isnt fixed
94
How does dislocated knee present
Severe knee pain and swelling Feeling it pop Wanting to flex the knee
95
Blood findings of osteogenesis imperfecta
All normal
96
Presentation of meningocele
Protrusion of meninges through vertebrae with no abnormal neurology but are at risk of meningitis and hydrocephalus
97
What is differnece between anencephaly and encephalocele
Anencephaly- failure of fusion of cranial neural tube which presents with with stillbirth Enancephalocele- herniation of brain and meninges through midline skull defect
98
What test is used to determine if leg shortening is tibial or femoral
Galleazis
99
Gold standard for duchenne
Genetic testing
100
Where do Ewings sarcomas appear vs osteosarcoma
Ewings- middle of long bones Osteosarcoma- around knee
101
How do Ewings sarcomas present
Like an infection with a fever

Paeds (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions