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Y2 MSK > Paediatric Conditions > Flashcards

Paediatric Conditions Flashcards

1
Q

What happens in developmental dysplasia of the hip (DDH)?

A

Dislocation/subluxation of femoral head during perinatal period

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2
Q

Girls are more commonly affected by DDH than boys. True/False?

A

True

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3
Q

List risk factors for DDH

A

Family history
Breech delivery
First-born
Down’s syndrome

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4
Q

List clinical features of DDH

A

Shortened limbs
Asymmetric groin
Thigh skin creases
Ortolani/Barlow +ve tests

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5
Q

Describe a +ve Ortolani test

A

Click upon reducing a dislocated hip with abduction + anterior displacement

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6
Q

Describe a +ve Barlow test

A

Clunk upon dislocating a hip with flexion + posterior displacement

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7
Q

What is the name of the special harness used to keep hips in comfortable flexion and abduction?

A

Pavlik harness

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8
Q

When does transient synovitis of the hip usually occur?

A

After an URT infection

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9
Q

Boys are less affected by transient synovitis of the hip than girls. True/False?

A

False

More affected

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10
Q

Is transient synovitis the commonest cause of hip pain in childhood?

A

Yes

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11
Q

List clinical features of transient synovitis

A

Limp
Reluctance to weight bear
Restricted motion
Low fever

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12
Q

Outline treatment for transient synovitis

A

NSAIDs and rest

Should resolve, if not seek other diagnosis

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13
Q

What is Perthes disease?

A

Idiopathic osteochondritis of the femoral head, causing necrosis + abnormal growth

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14
Q

What happens to the femoral head as a result of Perthes disease?

A

Loses its blood supply
Necrosis
Abnormal growth
Collapse/fracture

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15
Q

Who usually gets Perthes disease?

A

Boys 5:1 girls

Between age of 4-9

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16
Q

List clinical features of Perthes disease

A 
Pain
Limp
Loss of internal rotation
Loss of abduction
Trendellenburg +ve
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17
Q

In slipper upper femoral epiphysis (SUFE), in which direction does the femoral head epiphysis move?

A

Inferiorly in relation to femoral neck

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18
Q

Who does SUFE typically affect?

A

Overweight, pre-pubertal adolescent boys

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19
Q

List clinical features of SUFE

A

Pain
Limp
PAIN IN THE KNEE (so examine hip!)
Loss of internal rotation of hip

20
Q

How is SUFE treated?

A

Pin the femoral head to prevent further slippage

21
Q

Anterior knee pain in adolescence is common. True/False?

A

True

22
Q

At what age period is dislocation/subluxation of the patella most common?

A

Adolescence

23
Q

What is another name for talipes equinovarus?

A

Clubfoot

24
Q

How does clubfoot arise?

A

In-utero abnormal alignment of joints between talus, calcaneus and navicular

25
Q

List clinical features of clubfoot

A

Ankle equinus (plantarflexion)
Supinated forefoot
Varus forefoot
Contracted soft tissue

26
Q

Girls get clubfoot more than boys. True/False?

A

False

Boys 2:1 girls

27
Q

Outline treatment for clubfoot

A

Splintage (Ponseti technique)

Surgery

28
Q

Back pain in a child/adolescent is a red flag sign. True/False?

A

True

29
Q

In scoliosis, which way does the spine curve?

A

Laterally

30
Q

What is spondylolisthesis?

A

Slippage of one vertebra over another

31
Q

At what spinal region does spondylolisthesis usually occur?

A

L4/L5

L5/S1

32
Q

When is DDH most likely to present?

A

0-18 months

33
Q

When is infection of the hip most likely to present?

A

2-5 years

34
Q

When is SUFE most likely to present?

A

10-16 years

35
Q

How is DDH diagnosed?

A

XR if 3 - 6 months

US if less than 3 months

36
Q

Knees would be expected to be normal alignment by what age?

A

Age 10

37
Q

Which score is used to test for hypermobility?

A

Beightons score

38
Q

What test is used in children to differentiate between fixed and felxible flat feet?

A

Jacks test - In mobile flat feet, medial arch will appear with dorsiflexion of the great toe

39
Q

At birth, children normally have valgus legs. True/False?

A

False

At birth, legs are normally varus (bow-legged) and eventually develop into valgus (knock-knee) at 3yrs old

40
Q

Flat feet can be physiological. True/False?

A

True

41
Q

Describe mobile/flexible flat feet

A

Flatted medial arch forms with dorsiflexion of great toe

42
Q

What can cause flexible flat foot?

A

Ligamentous laxity

Familial trait

43
Q

Flexible flat foot is only present on weight bearing. True/False?

A

True

44
Q

Describe rigid flat foot

A

Medial arch remains flat regardless of weight bearing or dorsiflexion

45
Q

What is the likely underlying abnormality in rigid flat foot?

A

Tarsal coalition, where bones of hindfoot have abnormal connection

Y2 MSK (30 decks)

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