MSK

Question 1

what is transient synovitis

Answer 1

inflammation of the synovial membrane of the hip joint

Question 2

what age is transient synovitis common in

Answer 2

3-10yrs

Question 3

clinical presentation of transient synovitis

Answer 3

limp
refusal to bear weight
groin or hip pain - no pain at rest
should otherwise be well

Question 4

what is there often a history of in transient synovitis

Answer 4

history of recent URTI

Question 5

management for transient synovitis

Answer 5

analgesia
safety netting
follow up in 48-72hrs

Question 6

what is perthes disease

Answer 6

idiopathic avascular necrosis of the femoral head

Question 7

risk factors for perthes

Answer 7

male
4-12 yrs

Question 8

clinical presentation of perthes disease

Answer 8

limp
hip pain
referred knee pain
restricted hip movement
no hx of trauma

Question 9

investigations for perthes disease

Answer 9

• xray of both hips including frog views
• normal blood tests
• bone scan or MRI

Question 10

management for perthes

Answer 10

bed rest
traction, crutches
analgesia
physio

Question 11

what is osgood- schlatter disease

Answer 11

osteochondritis of the patellar tension insertion at the knee

Question 12

risk factors for osgood-schlatter disease

Answer 12

• m
• 10-15yrs
• athletic

Question 13

clinical presentation for osgood-schlatter disease

Answer 13

gradual onset
visible/ palpable hard and tender lump at the tibial tuberosity
pain in anterior aspect of knee
exacerbation of pain by physical activity, kneeling and extension of knee

Question 14

management of osgood-schlatter disease

Answer 14

self limiting
reduce activity
analgesia

Question 15

what is slipped upper femoral epiphysis (SUFE)

Answer 15

displacement of the proximal femoral epiphysis

Question 16

risk factors for SUFE

Answer 16

• obesity
• endocrine conditions e.g. hypothyroidism
• m

Question 17

typical presentation for SUFE

Answer 17

adolescent, obese male undergoing a growth spurt
with maybe a hc of minor trauma

Question 18

clinical presentation of SUFE

Answer 18

hip, groin, thigh or knee pain
restricted ROM of hip
painful limp

Question 19

investigations for SUFE

Answer 19

• xray
• bloods (normal)
• bone scan

Question 20

management for SUFE

Answer 20

surgery

Question 21

what is osteogenesis imperfecta

Answer 21

genetic condition resulting in brittle bones that are prone to fractures

8 different types which vary in severity

Question 22

clinical presentation for osteogenesis imperfecta

Answer 22

• hypermobility
• blue/ grey sclera
• deafness
• dental problems particularly formation of teeth
• bone pain
• short stature

Question 23

investigations for osteogenesis imperfecta

Answer 23

clinical diagnosis
xray
genetic testing

Question 24

management for osteogenesis imperfecta

Answer 24

• bisphosphonates
• vit d supplements
  MDT

Question 25

common cause of septic arthritis

Answer 25

staph aureus neisseria gonorrhoea in sexually active teens

Question 26

clinical presentation for septic arthritis

Answer 26

hot red swollen painful joint refusing to bear weight stiffness and reduced ROM fever, lethargy

Question 27

investigations for septic arthritis

Answer 27

bloods blood cultures xray- joint effusion, bone erosion joint aspiration - raised wcc, gram stain, culture

Question 28

management for septic arthris

Answer 28

BUFALO consider joint washout

Question 29

septic arthritis vs osteomyelitis

Answer 29

septic arthritis - joint infection osteomyelitis- bone infection

Question 30

what bone is typically affected in osteomyelitis

Answer 30

metaphysis of long bones

Question 31

common cuase of osteomyelitis

Answer 31

staph aureus

Question 32

clinical presentation of osteomyelitis

Answer 32

refusing to use limb or weight bear pain swelling tenderness fever

Question 33

investigations for osteomyelitis

Answer 33

xray blood tests blood cultures

Question 34

what is torticollis

Answer 34

shortening of sternocleidomastoid muscle on one side causing child to rest on one side of their head

Question 35

management for torticollis

Answer 35

physio usually resolves 2-6 months

Question 36

likely cause of torticollis in infants

Answer 36

sternomastoid tumour (causing CMT - congenital muscular torticollis)

Question 37

clinical presentation of torticollis in infants

Answer 37

mobile non-tender nodule on muscle restriction of head turning and tilting of head

Question 38

likely causes of torticollis presenting later in childhood

Answer 38

muscular spasm secondary to ENT infection spinal tumour cervical spine arthritis

Question 39

what is scoliosis

Answer 39

lateral curvature in the frontal plane of the spine

Question 40

management for scoliosis

Answer 40

observation - most dont need treatment bracing surgery

Question 41

complications of scoliosis

Answer 41

cardioresp failure 1

Question 42

causes of scoliosis

Answer 42

idopathuc congental secondary to cp, muscular dystrophy ,