MSK Normal Growth & Development Flashcards
What is the sequence of embryological limb bud development?
Mesoderm of embryoblast (3rd week)
4 week buds:
Mesoderm covered with ectoderm
Lateral mesoderm – bone
Somatic mesoderm – muscle
HOX gene – mass and growth
ZPA – AP growth and Apical Ectodermal Ridge (hand developent)
Sonic Hedgehog gene
How to classify congenital growth problems?
*Swanson’s Classification
Failure of formation
Failure of separation (Simple,incomplete/ simple. complete, complex, complicated)
Hypoplasia
Overgrowth
Duplication
Constriction ring syndromes
Skeletal dysplasia
*Describe the process of endochondral ossification, by which most long bones form
- Primary ossification centre (in all long bones by 12/52)
- Secondary ossification centre (distal femur at 36/52)
*Describe the structure of the physis
Diaphysis
Epiphysis
Metaphysis
What are the different ways of measuring skeletal growth?
Lower limb growth:
2nd birthday*2
Menalaus
Moseley charts
Paley multiplier – lower limbs (distal femur grows more compared to proximal femur)
Bone age – G&P chart, Sauvegrain and Nahum
Spine growth:
Scoliosis: End of growth – end of progression?
Menarche (afterwhich 18-24 months left)
Risser (indicator from iliac growth)
What are normal variations in lower limb alignment at different ages?
Babies:
Beiyer’s knees (Valgus)
Flat feet
Classify the problems that can cause growth disturbance
Growth plate injury/arrest
eg. physeal injury (due to trauma, infection, tumor, irradiation, surgery, compression)
Growth plate over stimulation
Lack of nutrition
Vitamin deficiency
Skeletal Dysplasia
Hormonal
What is the Salter-Harris classification?
Classifying growth plate problems after traumatic injury
Achodroplasia
Metaphyseal chondrodysplasia
Osteogenesis imperfecta
Mucopolysaccharidoses (eg. Hurler’s, Hunter’s, Sanfilippo, Morquio’s etc)
