Paediatric normal lower limb Flashcards

1
Q

what leg alignment is normal for newborns

A

varum

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2
Q

what leg alignment is normal for 2.5 year olds

A

valgus

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3
Q

where is longitudinal bone growth at

by what process

A

growth plate

enchondral ossification

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4
Q

where is circumflexual bone growth

by what process

A

periosteum

appositional growth

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5
Q

at what degree does knock kneed/bow legged kids need referral

A

> 16 degrees (more than 2SDs from mean)

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6
Q

reasons for referral of knock kneed/bow legged kids (4)

A

> 16 degrees (more than 2SDs)
asymmetrical
painful
short stature in bow legged

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7
Q

pathological aetiology of knock kneed (4)

A

tumours
rickets
trauma
neurofibromatosis

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8
Q

pathological aetiology of bow legged

A
tumour 
rickets
trauma 
skeletal dysplasia (refer if short stature) 
blounts disease
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9
Q

presentation of blouts disease on xray

A

beak like protrusion

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10
Q

another name for intoeing

A

pigeon toed

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11
Q

presentation of intoeing

when is it worse

A

child walks with feet pointed inwards

worse when running

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12
Q

aetiology of intoeing (3)

A

femoral neck anteversion
internal tibial torsion
metatarsal adductus

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13
Q

what is femoral neck antervsion

A

when child sits in a ‘w’ position

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14
Q

treatment of femoral neck anteversion

A

nothing, will resolve itself

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15
Q

what is internal tibial torsion

A

tibia rotates inward = inverted feet

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16
Q

treatment of internal tibial torsion

A

nothing, will resolve itself <6 years
braces - distressing for patient
surgery if severe

17
Q

what is metatarsal adductus

A

when the bones distal to the metatarsals are internally rotated

18
Q

treatment of metatarsal adductus

A

casting if <1 year

surgery if >8 years

19
Q

which toes are usually affected by ‘curly toes’

A

3rd, 4th, 5th

20
Q

treatment of curly toes if persistent in adolescence

A

surgery

21
Q

are we born with or without an arch in our foot

A

without

22
Q

what happens in people with flexible (not painful) flat feet

A

not arch develops (1 in 5 people)

23
Q

how do you tell if flat feet are fixed or flexible (2)

A

painful = fixed, not painful = flexible

get patient to go onto tip toes, if arch forms = flexible flat foot, if no arch forms = fixed flat foot

24
Q

aetiology of fixed flat feet in kids

A

tarsal coalition (look at paeds foot and ankle conditions for more info)

25
Q

what conditions in kids lower legs should we generally not worry about (just need to reassure parents)

A
varum (bow legged)
valgum (knock kneed)
intoeing 
curly toes 
flexible flat feet