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Paediatrics > MSK > Flashcards

MSK Flashcards

1
Q

Using TIM, which conditions must be excluded before an MSK complaint is discharged?

A

Tumour/trauma

Infection/inflammation

Malignancy/Mechanical/Metabolic

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2
Q

What is the function of osteoblasts?

A

Produce osteoid composed of type 1 collagen, mineralization of matrix

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3
Q

What is the function of osteoclasts?

A

Remove bones tissue by removing mineral matrix and breaking organic bone

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4
Q

How are synovial joints composed?

A

Covered by hyaline cartilage with joint space enclosed by synovium

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5
Q

How does an inflamed synovium affect bone?

A

Excessive fluid with altered cells and increased cytokines = destroys hyaline cartilage then bone

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6
Q

What is an enthesis?

A

Point of insertion of tendon, ligament, fascia or joint capsule into bone, prone to stresses

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7
Q

Give one example of an inflammatory and non-inflammatory primary muscle disease

A

I: dermatomyositis

NI: Muscular dystrophy associated with calf hypertrophy

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8
Q

What is Gower’s sign and which condition is it strongly associated with?

A

Functional weakness seen classically in DMD where pt. uses hands to splint legs to help them rise from sitting

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9
Q

Give 4 MSK history red flags

A
  • Unable to sleep, unremitting pain
  • Deep pain unresponsive to pain relief
  • Loss of function or altered function
  • Unilateral
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10
Q

What are the top 3 organisms implicated in septic arthritis?

A

Staph aureus

Strep. pneumo

Haem influenza

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11
Q

How may a joint appear in septic arthritis?

A 
Hot 
Swollen
Exquisitely painful 
Red
Held immobile
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12
Q

In neonates, what is pseudoparalysis until proven otherwise?

A

Bone/joint sepsis

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13
Q

Give 4 Tx steps in septic arthritis

A
  1. ABC and resus
  2. Urgent aspirate
  3. Blood cultures x2
  4. IV ABX
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14
Q

How does osteomyelitis classically present?

A

Acutely unwell child

Pyrexia

Local erythema + tenderness

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15
Q

Give 3 Tx steps in osteomyelitis

A
  1. Blood cultures
  2. High dose IV ABX
  3. Splintage of limb
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16
Q

Which disease can be cause of insidious onset septic arthritis/osteolitis with vertebral involvement?

A

Tuberculosis

17
Q

What is the cause and Tx of rheumatic fever?

A

Strep. infection

Tx: penicillin

18
Q

What is Reiter’s syndrome?

A

Post enteric/GU infection after gram negative/STI infection

19
Q

How does irritable hip present?

A

Hip pain and limp

Hip flexed and externally rotated

20
Q

How does the self-limiting condition discitis present ?

A

Child refuses to walk
Low grade fever
Lumbar spine tenderness

21
Q

What is Juvenile Idiopathic Arthritis?

A

Group of conditions where investigation aims to rule out other diagnoses

22
Q

Which conditions occurs in JIA patients and can cause blindness?

A

CHRONIC ANTERIOR UVEITIS

23
Q

Name 2 types of vasculitis common in children

A

o Henoch Schonlein purpura (HSP)

o Kawasaki disease

24
Q

Which types of Salter-Harris fractures should always be referred to ortho and why?

A

Type III and IV

Intra-articular with high risk of growth impairment and need for surgery

25
Q

Name 3 types of fractures which occur in children and not adults

A

Greenstick
Buckle
Plastic deformation

26
Q

What is Legg-Calve-Perthes disease?

A

Necrosis of part of femoral capital epiphysis (growth disturbance which can cause degenerative joint disease)

27
Q

How does Legg-Calve-Perthes disease present and what is the Tx?

A

Knee pain, limp, reduced hip abduction and internal rotation

Tx: rest/casts/surgery

28
Q

Which condition can occur when a child rapidly grows or is obese?

A

Slipped upper femoral epiphysis (SUFE

29
Q

Name 3 risks of Developmental dysplasia of the hip

A
  • 1st degree relative
  • Female
  • Breech after 35 weeks
30
Q

How is Developmental dysplasia of the hip treated at birth?

A

Splintage in abduction for 12 weeks

31
Q

Which deformities are seen in Talipes equinovarus (club foot)?

A
  • Downward and inward heel

- Soles point medially

32
Q

What is scoliosis?

A

-Lateral curvature of spine, presenting at time of accelerated growth in puberty

33
Q

Give 4 back pain red flags

A
  1. Under 4y/o
  2. Night pain
  3. Functional disability
  4. Postural shift
34
Q

What are the 5S’s of normal variants in children?

A
  1. Symmetrical deformity
  2. No symptoms underlying systemic disease or skeletal dysplasia
  3. No stiffness on examination
35
Q

Name 3 benign conditions in children

A
  1. Osgood Schlatter’s
  2. Irritable hip
  3. Pulled elbow
36
Q

Name 2 conditions in which muscle enzymes like CK, LDH, AST/ALT may be elevated?

A

Muscular dystrophy

Inflammatory disease

37
Q

What is the significance of ANA in JIA children?

A

Majority of ANA negative

38
Q

Name 2 pathologies which plain X-rays are good at assessing

A

Hip pathology

NAI

39
Q

Which sign is seen in DMD whereby patients use their arms to splint their legs to aid standing?

A

Gower’s sign

Paediatrics (18 decks)

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