Ortho - Paeds Flashcards
what happens in DDH?
dislocation/sublux for femoral head
what hip is more commonly affected in DDH?
left
what can happen if DDH is untreated?
false acetabulum
short limb
arthritis
risk factors for DDH?
FHx
first born
breech
girls
features of DDH?
short limb
assymetric groin crease
clink/clunk
describe ortolani/barlow test?
Ortolani - reduced hip with ab and anterior force
Barlow - dislocation with flexion and posterior force
Ix for DDH?
US (4-6 months as epiphysis not ossified)
XRAY after
Tx for DDH?
observe
pavlik harness
what is transient synovitis?
self limiting inflam of the synovium after URTI
features of transient synovitis?
reluctant to weight bear
reduced range of motion
fever
Tx for transient synovitis?
NSAIDs
rest
Ix for transient synovitis?
CRP (normal)
XRAY
what occurs in perthe’s?
idiopathic osteochondritis of the femoral head
transient loss of blood supply
risk factors for perthe’s?
4-9yrs
male
active
short
features for perthe’s?
pain
limb
loss of IR and abduction
what test can be positive in perthe’s?
trendelenburg
hip drop on opposite to stance leg means stance leg is weak
glut med supplied by gluteal nerve
Ix for perthe’s?
XRAY
Tx for perthe’s?
observe
NSAIDs
physio
avoid physical activity
what happens in a SUFE?
femoral head epiphysis slips inferiorly to the neck
risk factors for SUFE?
overweight
pre pubertal
male
feature of SUFE?
pain in groin/knee
limp
loss of IR
why can hip pain refer to knee?
both supplied by obturator nerve
Ix for SUFE? Tx?
lateral XRAY
surgery
why does a clubfoot occur?
abnormal alignment of talus, calcaneus and navicular
what does a clubfoot look like?
plantarflexion
supinated
Tx for clubfoot?
ponsetti technique (splinting)
what occurs in osteogenesis imperfecta?
problem with maturation of type 1 collagen
features of osteogenesis imperfecta?
blue sclera
deformities
loss of hearing
what is another name for achondroplasia?
dwarfism
inheritance pattern for DMD?
X linked recessive
features of DMD? Ix?
gower’s sign
worsens gradually
CK (raised)
muscle biopsy
what differentiated becker’s to DMD?
milder
can walk into teens
what occurs in spondylothesis?
slippage of one vertebra over another
who gets patellofemoral dysfunction? where is the pain?
young girls
anterior knee pain due to patella being pulled laterally
where is inflamed in osgood schlatter’s?
inflammation of a tubercle (tibial)
what happens in osteochondritis dissecans? features?
fragments of hyaline cartilage and bone break off the joint surface
poorly localised pain
effusion
features of patellofemoral dysfunction?
anterior knee pain
worse downhill
clicking
psuedolocks after sitting (stiff in flexed position)
