Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

3a > Paediatric: Ortho/MSK > Flashcards

Paediatric: Ortho/MSK Flashcards

1
Q

What is another name for growth plates ? what are they ?

A

epiphysial plates
- hyaline cartilage that sits between epiphysis and metaphysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

are there more growth plates in children or adults?

A

only in children
- epiphyseal plates fuse during teenage years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

are growth plates stronger or weaker than bone?

A

growth plates are stronger than bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

differences between child and adult bone ?

A
  • Child bone is more flexible + less strong
  • Child bone has a better blood supply so heal quicker
  • presence of growth plates in child bone
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

which bone fractures are children more prone to ?

A

green stick fractures (one side breaks while other remains intact)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is bone remodelling ? what determines it ?

A

process where bone tissues is taken from areas of low tension and depositied to areas of high tension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What can fractures of the growth plate cause ? what classification ?

A

can causes issues with growth in that bone
- Salter Harris classification (1-5)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Managment of child bone fracture ? (3)

A
  • Mechanical alignment: closed or open (surgical) reduction
  • Relative stability (external casts, screws)
  • Pain management
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

describe the pain ladder in children ? what is avoided ?

A
  • paracetamol or ibuprofen
  • Then morphine
    codeine + tramadol not used in kids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Hip pain presentation (5)

A
  • Limp
  • Refusal to use affected leg
  • Inability to walk
  • Pain
  • Swollen or tender joint
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

joint pain + fever. Watch thinking ?

A

need to exclude septic arthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

0-4 yo presenting with hip pain. differential ? (3)

A
  • Septic arthritis
  • DDH
  • Transient synovitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

5-10 yo presenting with hip pain. differential ? (3)

A
  • Septic arthritis
  • Transient synovitis
  • perthes disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

10-16 yo presenting with hip pain. differential ? (3)

A
  • Septic arthritis
  • Slipped upper femoral epiphysis
  • Juvenile idiopathic arthritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Red flags for child presenting with hip pain ?

A
  • < 3yrs
  • fever
  • waking at night due to pain
  • weight loss
  • Night sweats
    (could be leukaemia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

patient presenting with hip pain plus blood tests show inflam markers. differential ?

A
  • JIA
  • Septic arthritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

why would you do an USS of a joint in a child presenting with hip pain ?

A

if you suspect effusion (fluid) in the joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is septic arthritis ? most common in what age group ?

A

it is infection inside the joint - emergency
- Most common < 4yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

septic arthirits pathophsyiology ? (how could bacteria get to joint ? (3)

A
  • From a bacteraemia (recent UTI, chest infection)
  • direct inoculation
  • Spreading from adjacent osteomyelitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

septic arthritis presentation ?

A

Usually affects single joint (knee, hip)
- Hot, red, swollen + painful joint
- refusal to weight bear
- Stiffness + reduced ROM
- Systemic symptoms (fever, lethargy + sepsis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the most common causative organism of septic arthritis ? in a sexually active teenager ?

A
  • Staphylococcus aureus (most common)
  • Sexually active teenager: Neisseria gonorrhoea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Septic arthritis management ? (3)

A

if suspected, require admission
- Joint aspiration (prior to Abx): send smpale for gram staining, crystal microscopy, culture + abx sensitivities
- Empirical IV Abx (for 3-6 weeks)
- May require surgical drainage + washout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

septic arthritis complications (3)

A
  • Mortality (10%)
  • irreversible articular damage (=> sever osteoarthritis)
  • Osteomyelitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is transient synovitis ? often associated with what ?

A

temporary (transient) irritation + inflammation of the synovial membrane of the joint (synovitis)
- Often associated with recent viral URTI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

transient synovitis presentation ?

A
  • Acute or gradual onset: limp, refusal to weight bear, groin or hip pain, mild low grade temp
  • No signs of systemic illness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

transient synovitis management ?

A

Symptomatic, symptoms will resolve within 1-2 weeks
- Safety net: fever (+septic arthritis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is perthes disease ? leads to what

A

disruption of blood flow to the femoral head => avascular necrosis => affects epiphysis of femur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

perthes disease aetiology ?

A

idiopathic (no clear cause)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

perthes disease disease course ?

A

overtime there is re/neo vascularisation + bone remodelling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

perthes disease complications ?

A

soft + deformed femoral head => osteoarthritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

perthes disease presentaiton ? typical patient ?

A

boy 5-8
- slow onset hip or groin pain
- Limp
- Restricted hip movements
- no Hz of trauma

32
Q

if there is Hx of trauma in a patient presenitng with slow osnet hip or groin pain, what would you consider ?

A

SUFE

33
Q

perthes disease investigations ?

A
  • Xray (can be normal) (first line)
  • Blood tests (typically normal)
  • Technetium bone scan
  • MRI scan
34
Q

Perthes disease management ?

A

conservative (aim to reduce deformity of femoral head)
- bed rest, traction, crutches, analgesia, physio
- Regular xrays
- consider surgery (to improve alignment)

35
Q

What is SUFE ?

A

Slipped upper femoral epiphysis
- it is where the head of the femur is displaced (slips) along the growth plate

36
Q

SUFE presentation ? typical patient (age, Hx)?

A

obese male 8-15 yrs undergoing growth spurt + Hx of minor trauma
- Vague hip/groin/thigh/knee pain
- Restricted ROM
- Painful hip

37
Q

SUFE diagnosis ?

A

Xray
- blood tests (normal)

38
Q

SUFE management ?

A

surgery required to correct femoral position

39
Q

What is osteomyelitis ? typically where ?

A

infection in the bone + bone marrow
- typically in metaphysis of long bones

40
Q

what is the usually causative organism in osteomyelitis ?

A

staphylococcus aureus

41
Q

how can osteomyelitis spread ? (3)

A
  • Direct inoculation
  • Haematogenous
  • Direct psread
  • From nearby infection (septic arthritis)
42
Q

osteomyelitis RF ? typical Hx ?

A
  • Boys <10 yrs with open bone fracutre/surgery
43
Q

osteomyelitis presentation ?

A

can be acute or chronic (acutely unwell child or chronically with more subtle features)
- refusal to weight bear or use limb
- pain, swelling, tenderness
- low grade fever (high grade => spread to septic arthritis)

44
Q

osteomyelitis investigations ?

A

MRI or bone scan
- blood: raised inflam markers + WCC
- Bone marrow aspirate + culture (gold standard)

45
Q

osteomyelitis management ?

A
  • Abx
  • may need surgery for drainage + debridement
46
Q

What is developmental dysplasia of the hips (DDH) ? causes what ?

A

shower there are structural abnormalities of the hips due to abnormal dev of fetal bones during pregnancy => instability of hip => dislocation

47
Q

DDH RF ? (3)

A
  • first degree FHx
  • Breech presentaiton
  • Multiple pregnancy
48
Q

when is DDH usually picked up ?

A

NIPE

49
Q

what manoeuvres check for DDH ? describe

A
  • Ortolani: a dislocated hip
  • Barlow: a dislocatable hip
50
Q

how is DDH diagnosed ?

A

US

51
Q

how is DDH managed ? (2)

A
  • palvik harness
  • consider surgery
52
Q

What is osteogenesis imperfecta ? causes what

A

genetic condition that results in brittle bones => prone to fracture
- affects production of collagen

53
Q

how might osteogenesis perfecta present ? what signs ? (3)

A

recurrent + inappropriate fractures
- hyper mobility
- blue grey sclera (remember this one)
- short stature

54
Q

how is osteogenesis perfecta managed ?

A

clinical diagnoses
- underlying genetic condition cannot be cured
- Meds: bisphophonates, vit D

55
Q

what is rickets ? leads to what ?
(what’s this condition known as in adults)

A

condition affecting children where there is defective bone mineralisation => soft + deformed bones
(same as osteomalacia in adults)

56
Q

what could cause rickets ?

A
  • deficient in vit d or calcium
57
Q

where do you get vit d from ? calcium ?

A
  • Vit D: produced by body in response to sunlight or dietary: egg, oily fish, cereals)
  • Calcium: dairy
58
Q

do darker skinned ppl need more or less sungliht to make the same vit D

A

need more sunlight to make same Vit D

59
Q

from what is Vit D make in the body ? in response to what ? where is it metabolised ? why is this important ?

A

vit D is hormone made form cholesterol in skin in response to UV radiation
- Kidneys metabolic vit D to active form

60
Q

how would CKD affect Vit D levels

A

cause Vt D defieiceny as kidneys are responsible for metabolising it to active state

61
Q

in what absorption is Vit D important in ? what does inadequate vit D then cause ?

A

cit is essentila in calcium + phsophate absorption form intestines + kidneys
- inadequate Cit D => low calcium + low phosphate => defective bone mineralisation

62
Q

what kind of parathryoidsim condition does low vit D or calcium cause ? primary or secondary ?

A

secondary hyperparathyroidism

63
Q

How would rickets present ?

A

may be asymptomattic
- lethargy, bone pain, swollen writs, poor growth, pathological fractures
- howling of legs knock knees

64
Q

What Ix for rickets ? diagnostics ?

A
  • serum 25-hydroxy vitamin D
  • X-ray (diagnostic)
65
Q

rickets management ?

A
  • prevention is best (vit d supplementation)
  • rickets: vit D + calcium supplementation
66
Q

What is Osgood schlatters ? what age group ?

A

inflammation of tibial tuberosity where patella ligament inserts knee pain
- age 10-15 yrs (male)

67
Q

describe the locution of the pain in Osgood schlatters ?

A

usually unilateral anterior knee pain

68
Q

Osgood schlatters pathophys ?

A

stress from running/jumping at same time as growth in epiphyseal plate => inflam on tibial epiphyseal plate => growth + visible lumps just below knee

69
Q

Osgood schlatters presentation ?

A

gradual onset of Sx
- visible or palpable tender lump below knee
- Pain exacerbated by activity

70
Q

Osgood schlatters Mx ?

A
  • reduce physical activity
  • ice
  • NSAIDs
    symptoms usually resolve over time
71
Q

What is juvenile idiopathic arthritis (JIA) ? diagnostic cretira ?

A

autoimmune inflammation in the joints
- diagnosed when there is arthritis with no other cause lasting > 6 weeks, <16 yrs

72
Q

what is the triad of symptoms in JIA ?

A
  • joint pain
  • joint swelling
  • joint stiffness
73
Q

what are the different types of JIA ?

A
  • systemic JIA
  • palyarticular JIA
  • oligoarticular JIA
  • Enthesitic-related arthritis
  • Juvenile psoriatic arthritis
74
Q

Px present with salmon pink rash, fevers + joint pain. what diagnosis ?

A

systemic JIA

75
Q

JIA management ? (3)

A

MDT approach
- NSAIDs
- Steroids
- DMARDs (methotrexate)

3a (43 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions