MSK Flashcards
ddx for limp by age group`
toddler 1-4yrs
- DDH
- Transient synovitis
- toddlers fracture
- child abuse
child 4-10yrs
- transient synovitis
- Perthes disease
adolescent >10yrs
- SUFE
- over use/stress #
- osgood schlatter
all ages
- septic arthritis
- osteomyelitis
- trauma
- NAI
- malignancy
- arthritis
- functional limp
ix for limp
not ususally indicated if <3days - FBC - CRP - ESR - BC xray uss if ?sepsis bone scan ?osteomylitis, Perthes
what is transient synovitis
dx of exclusion
ddx septic arthritis
most common cause of limp in 1-4yrs also 3-8yrs
child can walk but painful
afebrile and well
preceeding URTI
decreased him movement and internal rotation
mx bed rest alangesia - nsaid and paracetamol reveiw by gp in 3 days safety net
what is developmental dysplasia of the hip
RFs - F - female, first child, feet first, fam hx CF - limp - limited abduction ix <6mo USS >6mo xray
mx
splint
closed reduction and plaster cast
open reduction
what is perthes disease
avascular necrosis of femoral head idiopathic more common in boys RF: trauma, enodcrine, coagulopathy CF painless limp antalgic gait effusion ix xray bone scan
what is SUFE
dispalcement of upper femoral head on metaphysis through growth plate
RF: obesity, puberty, boys, fam hx
CF
pain in knee or hip
flexed and externally rotated hip
ix xray
risk of avascular necrosis or osteonecrosis
what is osgood schlatter
inflammation of patella tendon insertion to tibial tuberosity
over use syndrome
pain and swelling over tibial tuberosity
mx - RICER
what is osteomyelitis
infection of any bone joint commonyl lower limn staph aureus CF - subacute onset - localised pain on movement - tenderness - no erythema - no fever
Ix fbc, esr, bc, xray, bone scan mx abx orthoid input
what is septic arthritis
GAS - acute onset - pain on movement and rest - decreased or no ROM - erythema - fever ix fbc, esr, crp bc aspirate mx abx, aspiration, abx washout
what is craniosyntosis
premature fusion of cranial sutures
distorted head growth
surgical corrected required if numerous sutures involved
what is plagiocephaly
common
asymmetry of skull
normal head circumference
usually improves in a couple of years
what is VACTERL
group of birth defects V - vertebral anomalies A - anal atresia C - cardiac defects T - tracheosophageal fistual E - oesophageals atresia R- renal and radial abnormalitites L - limba abnormalitites
can be asosciated with single umbilical artery
what is genu varum
bow legged
common 12-18mo
usually self resolves
if severe can be rickets
what is genu valgum
knock knees
common 3-8yrs
often self resolves
what is talipes equinovaurs
can be severe - muscle wasting, short foot or postural deformity due to restriction in uterus requires physio normal sized foot
