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Year 4: Paediatrics > Orthopaedics > Flashcards

Orthopaedics Flashcards

1
Q

most common cause of hip pain in children

A

transient synovitis

- temporary inflammation of the synovial membrane

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2
Q

what precedes transient synovitis

A

URTI

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3
Q

presentation of transient synovitis

A

hip pain/limp/refusal to weight bear in context of viral illness
child otherwise well – no fever, this would suggest septic arthritis

management is symptomatic

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4
Q

what is septic arthritis?

what is the most common cause?

A

infection inside a joint

most commonly caused by staph. aureus

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5
Q

presentation of septic arthritis

A

acute onset red, swollen, hot, painful joint
limited range of movement
fever

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6
Q

ix of septic arthritis

A

joint aspiration

- ABX given once causative organism confirmed

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7
Q

what is Perthes disease

A

avascular necrosis of femoral head

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8
Q

who typically gets Perthes disease

A

boys age 5-8 years

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9
Q

presentation of Perthes

A

slow onset pain in hip/groin
may have referred pain to knee
restricted movements

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10
Q

ix of Perthes

A

XRAY

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11
Q

management of Perthes

A

bed rest + limit physical activity
analgesia
regular XRAYS

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12
Q

what is a SUFE

A

slipped upper femoral epiphysis

- head of femur ‘slips’ along the growth plate

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13
Q

who typically gets a SUFE

A

obese boys 10-15 years old

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14
Q

main clinical sign in SUFE

A

loss of internal rotation

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15
Q

Ix of SUFE

A

Xray

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16
Q

management of SUFE

A

pin in the femoral head

17
Q

what is osteomyelitis

A

infection in the bone + bone marrow

  • typically in the metaphysis of long bones
  • staph. aureus most common cause
18
Q

presentation of osteomyelitis

A

often a risk factor that predisposes the child - open fracture / orthopaedic surgery / immunocompromised
subacute pain, swelling, tenderness

19
Q

Ix of osteomyelitis

A

MRI

blood culture

20
Q

what is DDH

A

developmental dysplasia of the hip

- abnormal development of bones during pregnancy leading to hip instability with tendency to sublux / dislocate

21
Q

signs of DDH

A

different leg lengths
extra thigh skin fold
+ Barlows / Ortolanis test

22
Q

what are Barlows + Ortolani tests

A

Barlows - attempts to dislocate femoral head

Ortolanis - attempts to relocate a dislocated femoral head

23
Q

which infants require USS screening for DDH at 6 weeks?

A

breech > 36 weeks
multiple pregnancy
+ ve frist degree relative with hip problems

24
Q

management of DDH infant < 6 months

A

Pavlik harness

- keeps hips flexed + abducted

25
Q

what is Talipes equinovarus

A

Clubfoot

- fixed abnormal ankle position: plantar flexion + supination

26
Q

tx of talipes equinovarus

A

Ponseti method

- casts used to hold foot in normal position

27
Q

what causes Rickets

A

vitamin D or calcium deficiency

called osteomalacia in adults

28
Q

what is Osgood Slatters disease

A

osteochondritis caused by inflammation at the tibial tuberosity

29
Q

presentation of Osgood Slatters disease

A

palpable tender lump at tibial tuberosity

anterior knee pain exacerbated by physical activity, kneeling or knee extension

30
Q

management of Osgood Slatters disease

A

reduction in physical activity
NSAIDs
Ice

31
Q

what is osteogenesis imperfecta

A

genetic condition that results in brittle bones that are prone to fractures

32
Q

presentation of osteogenesis imperfecta

A

recurrent fractures
blue / grey sclera of the eyes
short stature
early onset deafness

33
Q

management of osteogenesis imperfecta

A

cannot be cured, can only manage symptoms + prevent fractures

  • biphosphonates
  • Vit D supplements
  • physio + occupational therapy
34
Q

knee pain post exercise with intermittent swelling / locking

A

osteochondritis dessicans

35
Q

how should a child < 3 years old with a limp be managed

A

urgent hospital assessment

36
Q

investigation of DDH after 4.5 months old

A

XRAY

Year 4: Paediatrics (16 decks)

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