MSK Flashcards
What age is transient synovitis most common?
3-10 yeah olds
Toddlers and young children
What is transient synovitis?
Inflammation of the synovium in the hip following a recent viral infection, may also have joint effusion but this is harmless
How does transient synovitis present differently to septic arthritis?
Trans. Synovitis the child is systemically well and probably afebrile
What are the most common bacteria to cause septic arthritis?
Staph A
Strep Pyogenes
How do bacteria reach the joint capsule in septic arthritis?
Haematogenous spread or through adjacent osteomyelitis
What is arthralgia?
Joint pain
What age group does osteomyelitis tend to present?
Infants and toddlers
Where in the bone does osteomyelitis commonly affect?
Metaphysis
Usually of long bones (femur/tibia)
What condition can predispose to osteomyelitis? What organism may be seen then?
Sickle cell disease
Salmonella
What is perthes disease?
Avascular necrosis of the femoral head
What age group in perthes disease seen in?
6-12 yo
What age group does slipped upper femoral epiphysis seen in?
10-16 yo
Overweight teenagers
What is reactive arthritis?
Sterile Arthritis that occurs after a bacterial or viral infection thought to be autoimmune
What are the two main causes of haemoathrosis in children?
Haemophilia and trauma
How many joints does
- oligoarthritis
- polyarthritis
affect?
Oligo - 4 or less joints
Poly - 5 or more
How longs are symptoms have to last to diagnose JIA?
6 weeks
In septic arthritis of the hip what position is the leg commonly in?
Flexed that the hip, abducted and externally rotated
What is plagiocephaly?
Asymmetry of the skull usually on one side from sleeping position
Resolves in first few years
What antibiotics can be used to treat septic arthritis?
How long is the course?
How long IV?
IV Cephuroxime or IV flucloxacillin
14 days
At least 3 days IV
What are the potential complications of the treatment of developmental dysplasia of the hip?
Necrosis of the femoral head
In JIA oligoarthritis where elbows and knees are affected what eye condition is associated with this?
Anterior uveitis
Which JIA is most likely to be associated with ANA?
Oligoarthritis
Which JIA is more common in girls under the age of 6?
Oligoarthritis
Which JIA is more common in older girls?
Polyarticular
What other symptoms would you see in systemic JIA?
Fever
Salmon pink rash
How long is the fever present in systemic JIA?
2 weeks
What is affected in enthesitis related arthritis?
Inflammation where a tendon or ligament inserts into bone
What joint is usually tender in enthesitis?
Sacroiliac joint
What is the maximum age to be diagnosed with JIA?
16
What is the most common type of JIA?
Oligoarticular
How common is JIA?
1-2/1000
When counting the number of joints affected in JIA what time frame do you use?
Within the first 6 months
What is a quotidian fever? Which type of JIA is is associated with?
A fever that peaks once a day
Is JIA more common in females or males?
Females
Is oligoargicular JIA is it more common the present with stiffness or pain?
Stiffness and reduced movements due to a swollen joint
Apart from systemic JIA what other JIA might you get fever, splenomegaly, hepatomegaly and serositis?
Polyarticular RF positive (5% of JIAs - rf negative is more common)
How is JIA diagnosed?
It is a clinical diagnosis
What is the most common cause of osteomyelitis?
Staph aureus
How longs after the onset of osteomyelitis can an X-ray appear normal for?
1 week
What drug treatment can be given in JIA?
NSAIDs for the pain
Intraarticular steroid injections
Systemic steroids
Methotrexate - for multiple joints
What non pharmacological management can be used in JIA?
Physiotherapy
Physical activity
OT
