Ortho - Paeds

Question 1

what happens in DDH?

Answer 1

dislocation/sublux for femoral head

Question 2

what hip is more commonly affected in DDH?

Answer 2

left

Question 3

what can happen if DDH is untreated?

Answer 3

false acetabulum
short limb
arthritis

Question 4

risk factors for DDH?

Answer 4

FHx
first born
breech
girls

Question 5

features of DDH?

Answer 5

short limb
assymetric groin crease
clink/clunk

Question 6

describe ortolani/barlow test?

Answer 6

Ortolani - reduced hip with ab and anterior force

Barlow - dislocation with flexion and posterior force

Question 7

Ix for DDH?

Answer 7

US (4-6 months as epiphysis not ossified)

XRAY after

Question 8

Tx for DDH?

Answer 8

observe

pavlik harness

Question 9

what is transient synovitis?

Answer 9

self limiting inflam of the synovium after URTI

Question 10

features of transient synovitis?

Answer 10

reluctant to weight bear
reduced range of motion
fever

Question 11

Tx for transient synovitis?

Answer 11

NSAIDs

rest

Question 12

Ix for transient synovitis?

Answer 12

CRP (normal)

XRAY

Question 13

what occurs in perthe’s?

Answer 13

idiopathic osteochondritis of the femoral head

transient loss of blood supply

Question 14

risk factors for perthe’s?

Answer 14

4-9yrs
male
active
short

Question 15

features for perthe’s?

Answer 15

pain
limb
loss of IR and abduction

Question 16

what test can be positive in perthe’s?

Answer 16

trendelenburg

hip drop on opposite to stance leg means stance leg is weak

glut med supplied by gluteal nerve

Question 17

Ix for perthe’s?

Answer 17

XRAY

Question 18

Tx for perthe’s?

Answer 18

observe
NSAIDs
physio
avoid physical activity

Question 19

what happens in a SUFE?

Answer 19

femoral head epiphysis slips inferiorly to the neck

Question 20

risk factors for SUFE?

Answer 20

overweight
pre pubertal
male

Question 21

feature of SUFE?

Answer 21

pain in groin/knee
limp
loss of IR

Question 22

why can hip pain refer to knee?

Answer 22

both supplied by obturator nerve

Question 23

Ix for SUFE? Tx?

Answer 23

lateral XRAY

surgery

Question 24

why does a clubfoot occur?

Answer 24

abnormal alignment of talus, calcaneus and navicular

Question 25

what does a clubfoot look like?

Answer 25

plantarflexion

supinated

Question 26

Tx for clubfoot?

Answer 26

ponsetti technique (splinting)

Question 27

what occurs in osteogenesis imperfecta?

Answer 27

problem with maturation of type 1 collagen

Question 28

features of osteogenesis imperfecta?

Answer 28

blue sclera

deformities
loss of hearing

Question 29

what is another name for achondroplasia?

Answer 29

dwarfism

Question 30

inheritance pattern for DMD?

Answer 30

X linked recessive

Question 31

features of DMD? Ix?

Answer 31

gower’s sign
worsens gradually

CK (raised)
muscle biopsy

Question 32

what differentiated becker’s to DMD?

Answer 32

milder

can walk into teens

Question 33

what occurs in spondylothesis?

Answer 33

slippage of one vertebra over another

Question 34

who gets patellofemoral dysfunction? where is the pain?

Answer 34

young girls

anterior knee pain due to patella being pulled laterally

Question 35

where is inflamed in osgood schlatter’s?

Answer 35

inflammation of a tubercle (tibial)

Question 36

what happens in osteochondritis dissecans? features?

Answer 36

fragments of hyaline cartilage and bone break off the joint surface

poorly localised pain
effusion

Question 37

features of patellofemoral dysfunction?

Answer 37

anterior knee pain
worse downhill
clicking
psuedolocks after sitting (stiff in flexed position)