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Paeds AM > Orthopaedics > Flashcards

Orthopaedics Flashcards

1
Q

What is Perthes?

A

Disruption of blood flow to femoral head causing avascular necrosis

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2
Q

What are the stages of Perthes?

A

Avascular necrosis
Fragmentation (revascularisation)
Reossification
Residual deformity

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3
Q

Who typically gets Perthes?

A

4-8yo

Males >females

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4
Q

What are the risk factors for Perthes?

A

Socioeconomic deprivation

Hypercoagulable states

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5
Q

What is the presentation of Perthes?

A 
Limp
Limited ROM
Short stature
Muscle wasting
Pain- grin, thigh, knee
Systemically well
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6
Q

What is the investigation of Perthes?

A

Bilat hip XR

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7
Q

What is the management of Perths in <6s?

A
  1. Mobilise and monitor

2. operative or non op containment

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8
Q

What is the management of Perthes in >6s?

A

Surgical containment or salvage procedure

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9
Q

What are the complications f Perthes?

A

Osteoarthritis

Limb length inequality

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10
Q

What is SUFE?

A

Slipped upper femoral epiphysis

Posteriomedial displacement of proximal femoral epiphysis in relation to neck

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11
Q

Who is SUFE seen in?

A

9-16yo, typically >11

Associated with growth spurt and obesity

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12
Q

What is the presentation of SUFE?

A 
Pain- groin, thigh, knee
Limited ROM
Limp
Deformity- external rotation, esp on flexion
Possible history of trauma
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13
Q

How is SUFE diagnosed?

A

Frog lateral XR- slipped ice cream cone appearance

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14
Q

What is the management of SUFE?

A

Operative- pin in situ

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15
Q

What are the complications of SUFE?

A

Avascular necrosis
Chrondrolysis
Deformity
Early osteoarthritis

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16
Q

What are the causative organisms of septic arthritis?

A

Usually staph aureus

Consider N. gonorrhoea in sexually active

17
Q

What are the routes of infection of septic arthritis?

A

HAematogenous spread
Dissemination from osteomyelitis
Spread from adjacent soft tissue infection

18
Q

What is the presentation of septic arthritis?

A 
Limping with no weight bearing
Pseudoparalysis, refusal to move joint
Swollen red joint
Pain
Temperature
Unwell
19
Q

What investigations are done for septic arthritis?

A

Bloods- high WCC, CRP and ESR, cultures and CK

US

20
Q

What is the management of septic arthritis?

A

IV antibiotics

Needle aspiration and arthroscopic lavage

21
Q

What is the most common causative organism of osteomyelitis?

A

Staph aureus

22
Q

What is the presentation of osteomyelitis?

A

Pain
ROM better and weight bear more, and more well than septic arthritis
Fever, generally not right

23
Q

What bones are most often affected by osteomyelitis?

A

Long bones of arms and legs

24
Q

What investigations are done for osteomyelitis?

A

Bloods- WCC often normal, CK, CRP, ESR, cultures
MRI
XR

25
Q

What is the management of osteomyelitis?

A

Antibiotics

26
Q

What are the indications for surgery in osteomyelitis?

A

Collection in periosteum
Infection spread into joint
Atypical bacteria
Debridement of dead tissue

27
Q

What is transient synovitis?

A

Infection of hip joint secondary to virus

Most common cause of hip pain in children

28
Q

Who is transient synovitis seen in?

A

2-10yo

29
Q

What is the presentation of transient synovitis?

A

Acute hip pain associated with viral infection
Hobbling limp, will weight bear slightly
No temperature
Usually fairly well

30
Q

How is transient synovitis diagnosed?

A

CLinical

31
Q

What is the management of transient synovitis?

A

Self limiting

Rest and analgesia

32
Q

What is rickets?

A

Defective bone mineralisation due to severe vit D/Ca deficiency

33
Q

What are the risk factors for rickets?

A

Darker skin
Low exposure to sunlight
Colder climates

34
Q

What is the presentation of rickets?

A 
Stunted growth and failure to thrive
Bandy legs
Large abdoman
Large forehead
Wide joints
35
Q

What investigations are done for rickets?

A

XR- radiolucency
Serum 25 hydroxuvitamin D
Serum Ca and phosphate

36
Q

What is the management of rickets?

A

Vit D and Ca supplementation

Paeds AM (28 decks)

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