MSK and rheum Flashcards
Juvenile idiopathic arhrtitis is described as…
Arthritic symptoms <16 for at least 6 weeks with an unknown cause
Transient synovitis is associated with…
Recent viral ilness (typically URTI)
Perthes disease describes…
Avascular necrosis of the femoral epiphysis
Perthes disease typically occurs in children aged..
4-12
Presentation of perthe disease
Commonly unilateral hip pain
Limited hip rotation/ movement
First line investigations for Perthes
Bloods
- ESR and CRP not elevated
- FBC typically normal
Joint aspiration + culture= rule out septic
Pelvic X-ray frog leg is diagnostic
Management of perthes disease
Early stage
- Analgesia, bed rest, physiotherapy
Surgery
- If >50% of femoral head is necrosed
Risk factor of developmental dysplasia of the hip
Born in breech presentation (both C-section and vaginal)
Family history
Macrosomia (>5kg)
Oligohydramnios
______ and _____ test is used to screen for developmental dysplasia of the hip
Barlow= dislocation of the hip
Ortolani = reduction of dislocation
Management of developmental dysplasia of the hip
If born/ presents at breech
= Ultrasound in 6-8 weeks
Confirmed diagnosis
- Harness if <6 months
- Surgery and cast if > 6 months/ harness fails
Management of non-displaced fractures in children typically involves _____
Splinting
Pathophysiology of henoch schonlein purpura
IgA vasculitis
- Typically triggered by infection
- Causes IgA deposits in blood vessels
Presentation of HSP
Skin: Purpuric rash
- Legs and buttocks
MSK
- Arthralgia (knees and ankles)
GI
- Abdominal pain
- GI bleed
Kidneys (IgA nephritis)
- Haematuria
- Hypertension
- Nephrotic syndrome
Investigations findings for HSP
CRP and ESR
- Elevated
Renal function
- haematuria, proteinuria
- Urine protein:creatinine ratio (elevated)
Blood film
- IgA deposits
Criteria for HSP disganosis
EULAR/ PRINTO/ PRES= purpura AND
- Diffuse abdominal pain
- Arthritis/ arthalgia
- IgA deposits on histology
- Proteinuria/ haematuria.
