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Y2 MSK > Paediatric MSK conditions > Flashcards

Paediatric MSK conditions Flashcards

1
Q

what is developmental dysplasia of the hip?

A

dislocation/subluxation of the femoral head during the perinatal period which affects the development of the hip joint

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2
Q

if DDH is left untreated what can occur?

A

shallow acetabulum, leading to shortened limb and limp

severe arthritis

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3
Q

give 4 risk factors for DDH?

A

Girls > boys
Breech presentation
1st born
Multiple pregnancy

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4
Q

which hip is more likely to be affected in DDH?

A

Left hip

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5
Q

A baby presents with shortening of their left leg, and asymmetrical groin creases, what investigations would you do and what differential diagnosis would you be considering?

A

Ultrasound of hip
Ortolani/Barlows tests
DDH

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6
Q

what are Ortolani and Barlows tests?

A

diagnostic for DDH if a clunk is heard
Ortolani = reducing a dislocated hip with abduction and anterior displacement
Barlows = dislocating hip with adduction and posterior displacement

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7
Q

How is DDH managed?

A

Pavlik’s harness for 6 weeks - holds hips flexed and abducted

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8
Q

What is Perthes disease?

A

idiopathic Osteochondritis of the femoral head - inflammation of the bone/cartilage which leads to the femoral head losing its blood supply, AVN and collapse/fracture as a result

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9
Q

Who is most likely to be affected by Perthes disease?

A

Short boys who are active

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10
Q

How does Perthes disease present?

A

Hip pain
Limp
Loss of internal rotation of the hip

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11
Q

Management of Perthes disease?

A

regular X-rays and no exercise to monitor improvement

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12
Q

what is transient synovitis of hip?

A

self limiting of the synovium of the hip joint, usually following an URTI

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13
Q

How does transient synovitis of the hip present?

A

limp with knee/groin pain
history of URTI
reluctance to weight bear

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14
Q

management of transient synovitis of hip?

A

once more serious causes have been excluded NSAIDs and rest

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15
Q

what does SUFE stand for?

A

Slipped Upper Femoral Epiphysis

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16
Q

What is SUFE?

A

when the femoral head slips inferiorly in relation to the femoral neck

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17
Q

Who is most likely to get SUFE?

A

Overweight pre-pubertal boys

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18
Q

What can develop as a result of SUFE?

A

avascular necrosis of the femoral head

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19
Q

How would SUFE present?

A

pain - can sometimes only be in the knee
loss of internal rotation of the hip
limp

20
Q

Management of SUFE?

A

Pinning of the femoral head to prevent it slipping further

21
Q

What is osteogenesis imperfecta and what is it caused by?

A

Brittle bone disease - autosomal dominant defect in maturation and organisation of type I collagen

22
Q

What are blue sclera, loss of hearing and multiple fragility fractures signs of?

A

Osteogenesis imperfecta

23
Q

What will bones look like on X-Ray in osteogenesis imperfecta?

A

Bones will have thin cortices and be osteopenic

24
Q

What is the difference between proportionate and disproportionate skeletal dysplasias?

A 
proportionate = limbs and spine are proportionately short 
disproportionate = limbs are disproportionately short/long compared to the spine
25
Q

What is the most common type of skeletal dysplasia and what are its typical features?

A

Achondroplasia

Disproportionately short limbs, lax joints & prominent forehead

26
Q

What is Ehlers-Danlos syndrome?

A

autosomal dominant condition where there is abnormal collagen and elastin formation - get joint hypermobility and instability

27
Q

What is Marfans syndrome?

A

autosomal dominant/sporadic condition affecting the fibrillin gene - tall with disproportionately long limbs

28
Q

What is duchenne’s muscular dystrophy?

A

progressive muscular weakness due to a defect in the dystrophin gene

29
Q

what is a sign of duchenne’s muscular dystrophy?

A

Gowers sign - walking hands up legs due to pelvic weakness

30
Q

Who is most likely to be affected by duchenne’s?

A

Boys

31
Q

What is cerebral palsy?

A

neuromuscular condition due to insult to the developing brain before age 3

32
Q

Give 5 causes of cerebral palsy?

A 
Brain malformation
Intrauterine infection
Premature birth
Hypoxia during birth
Menengitis
33
Q

What is ataxic cerebral palsy?

A

When the cerebellum is affected so there is reduced coordination and balance

34
Q

What is athetoid cerebral palsy?

A

when there is uncontrolled writhing motion, sudden changes in tone and difficulty controlling speech

35
Q

Give 3 MSK related complications of cerebral palsy?

A

Joint contractures
Scoliosis
Hip dislocation

36
Q

What is Spina Bifida?

A

a congenital disorder where 2 halves of the posterior vertebral arch fail to fuse in the first 6 weeks of gestation

37
Q

What is poliomyelitis?

A

viral infection affecting the anterior motor horn cells in the spinal cord/brain stem - this results in lower motor neurone deficit (paralysis)

38
Q

What is the most common type of obstetric brachial plexus palsy and which nerve roots are affected in it?

A

Erb’s palsy - injury to C5 & C6 nerve roots

loss of innervation to trapezius, deltoid and some of the rotator cuffs resulting in “waiter tips” pose

39
Q

What is the more rare type of obstetric brachial plexus palsy where C8 and T1 roots are affected?

A

Klumpkes palsy

40
Q

What is talipes equinovarus?

A

clubfoot - congenital deformity where the calcaneus, talus and navicular are misaligned and there are contractors in the surrounding soft tissues

41
Q

Are boys or girls more likely to have clubfoot?

A

boys

42
Q

Give 2 risk factors for the development of clubfoot?

A

Breech presentation

Low amniotic fluid content

43
Q

Management of clubfoot?

A

Ponseti technique

44
Q

What is myositis ossificans?

A

post traumatic calcification of soft tissues - history of trauma with soft tissue swelling, hardness then develops over a couple of weeks

45
Q

What is the best imaging for suspected DDH?

A

Ultrasound

Y2 MSK (35 decks)

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