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My2 MSK > orthopaedics: paediatric lower limb + spine > Flashcards

orthopaedics: paediatric lower limb + spine Flashcards

1
Q

what is developmental dysplasia of the hip (DDH)

A

dislocation/ subluxation of the femoral head in the perinatal period and then grow out of proportion together

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2
Q

what happens to the hip joint as a result of DDH

A

head of femur and acetabulum misaligned and acetabulum is shallow/ false one forms

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3
Q

what are the symptoms of DDH

A

unilateral limb shortening and groin skin folds, clinks of the hip, OA at a very young age (20s)

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4
Q

what test is done at birth to identify DDH

A

barlow test –> ortolani test

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5
Q

what investigations are done after birth to identify DDH

A

USS then x-ray after 4-6 months

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6
Q

how do you treat/ manage DDH

A

early diagnosis vital, Palvik harness, THR at young age

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7
Q

which babies tend to get DDH

A

first born girls on left hip, FH, breech, down’s

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8
Q

what is transient synovitis of the hip

A

self-limiting inflam of the synovium joint normaly after a URTI

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9
Q

who normally gets transient synovitis of the hip

A

boys aged 2-10

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10
Q

what are the symptoms of transient synovitis of the hip

A

limp, pain weight-bearing, low grade fever

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11
Q

what investigations of transient synovitis of the hip

A

X ray (exclusion), normal CRP, MRI, hip aspiration of concerns

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12
Q

what is the treatment of transient synovitis of the hip

A

NSAIDs and few weeks rest

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13
Q

what is Perthes disease

A

idiopathic osteochondritis (flattened) of femoral head

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14
Q

what happens as a result of a flattened femoral head in Perthes disease

A

AVN, necrosis, fractures, abnormal growth and remodelling

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15
Q

who normally gets Perthes disease

A

boys aged 4-9

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16
Q

what are the symptoms of Perthes disease (6)

A

pain + limp worse on activity, unilateral, atrophy of leg, loss of internal rotation –> loss of abduction, +ive trendellenberg test, V early OA

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17
Q

how do you investigate perthes disease

A

X ray and MRI

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18
Q

how do you manage Perthes disease

A

can resolve spontaneously, avoid activity, braces, THR

19
Q

what is slipped upper femoral epiphysis (SUFE)

A

femoral head slips down in relation to femoral neck)

20
Q

what causes the femoral head to slip

A

growth plate (physis) cannot support body weight and slips

21
Q

who gets SUFE

A

overweight, prepubertal boys, growth spurt can induce

22
Q

what can predispose SUFE

A

hypothyroidism and renal disease

23
Q

what are symptoms of SUFE

A

pain + limp, pain in groin, can present in knee (obturator nerve), loss of internal rotation

24
Q

what imaging is needed to diagnose SUFE

A

X ray of lateral head

25
Q

how do you manage SUFE

A

surgery to pin femoral head, osteomy, if big slip THR

26
Q

what causes extensor mechanism problems

A

increased body weight and sporting activity in adolescence

27
Q

what is a common extensor mechanism problem

A

patellar tendonitis (jumper’s knee),

28
Q

how do you manage extensor mechanism problems

A

normally self-limiting but can require physio

29
Q

how do you manage meniscal tears in children

A

brace until ages 3/4

30
Q

what is scoliosis

A

lateral curvature of the spine (sometimes rotational), that is idiopathic, mild and pain free

31
Q

when does scoliosis present and who normally gets it

A

female adolescence

32
Q

when would an MRI be done for scoliosis

A

if painful

33
Q

what can scoliosis be secondary to

A

neuromuscular disease, tumour (osteoid osteoma), skeletal dysplasia, infections

34
Q

what are the risks of large curvature in scoliosis

A

compression of lungs and heart

35
Q

what are nonsurgical intervention of scoliosis

A

corrective cast, braces, exercises

36
Q

what are surgical interventions of scoliosis

A

vertebral fusion

37
Q

what is spondylolisthesis

A

slippage of one vertebra over another

38
Q

what level does spondylolisthesis normally occur at

A

L4/L5 or L5,S1

39
Q

what can causes spondylolisthesis

A

increased weight and activity in adolescence, developmental or recurrent fractures

40
Q

what are symptoms of spondylolisthesis

A

lower back pain, radiculopathy (pinched nerves), flat back from muscle spasms, waddling gait

41
Q

how do you treat spondylolisthesis

A

minor: rest + physio.
Severe: stabilisation, maybe reduction

42
Q

what is present in adolescent knee pain

A

softening of hyaline cartilage

43
Q

who normally gets adolescent knee pain

A

girls

44
Q

how do you treat adolescent knee pain

A

physio

My2 MSK (29 decks)

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