MSK Synap

Question 1

how does spondilolithesis present?

Answer 1

lower back pain (as it usually occurs at L4/L5 or L5/S1)
radiculopathy (if severe)
flat back (due to muscle spasm)
waddling gait

Question 2

how is spondilolithesis managed?

Answer 2

rest
physio
stabilisation and reduction in severe cases

Question 3

what is spondilolithesis associated with?

Answer 3

usually in adolescents

associated with increased body weight and physical activity

Question 4

back pain in children is a red flag, what 3 things can it signify?

Answer 4

infection
tumours
spondilolisthesis

Question 5

what is perthes disease and who does it usually occur in?

Answer 5

idiopathic osteochondritis of the femoral head leading to avascular necrosis. This affects bone growth and development
usually occurs in boys aged 4-9

Question 6

how does perthes disease characteristically present?

Answer 6

unilateral groin and knee pain with a limp in young active boys

Question 7

how is perthes disease managed?

Answer 7

rest
activity modification
bracing
potentially surgery

Question 8

what are the 4 stages in perthes?

Answer 8

necrosis/sclerosis
fragmentation
reossification
remodelling

Question 9

any painful scoliosis requires what urgent investigation?

Answer 9

urgent MRI to rule out tumour or infection

Question 10

what is the most common cause of painful fixed flat foot deformity and how is this managed?

Answer 10

tarsal coalition

splintage, orthotics or surgery

Question 11

what are the 3 main features of ehlers danlos syndrome?

Answer 11

ligamentous laxity, hypermobile joints
vascular instability and bruising
scoliosis

Question 12

Osgood schlatters vs sinding Larsen johanssen disease?

Answer 12

Osgood schlatters = tibial tubercle
sinding = inferior pole of patella
both managed with rest and physio

Question 13

how is DDH managed?

Answer 13

pavlik harness in children up to 4-6 months old
- constantly for first 6 weeks
- only at night for following 6 weeks
if older than 4-6 months
- reduction with dye or open reduction

Question 14

3 features of talipes equinovarus?

Answer 14

ankle equinus (plantarflexion)
supination of the forefoot
varus alignment of the forefoot

Question 15

talipes equinovarus is due to a deformity between what 3 bones?

Answer 15

calcaneous
navicular
talus

Question 16

what causes waiters tip posture?

Answer 16

erbs palsy

C5, C6

Question 17

how is talipes equinovarus managed?

Answer 17

ponsetti technique
serial casts with 5-6 weekly changes
once correction is achieved, brace must be worn 23 hrs a day for 3 months, then only at night until age 3-4

Question 18

what can cause pes cavus and claw toes?

Answer 18

spina bifida occulta

Question 19

what is spina bifida oculta?

Answer 19

milder form of spina bifida

due to tethering of spinal cord at vertebral arch defect