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paediatric orthopaedic conditions Flashcards

1
Q

who is patellofemoral dysfunction most commonly seen in?

A

adolescent girls

athletic (increased activity or recent injury)

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2
Q

how does patellofemoral dysfunction present?

A

anterior knee pain walking up stairs

anterior knee pain after prolonged periods of sitting

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3
Q

what is osgood schlatters disease?

A

inflammation of tibial tuberosity - sit of attachment of patellar ligament

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4
Q

who does osgood shclatters disease most commonly present in?

A

boys aged 10-15

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5
Q

what sign indicates osgood shclatters disease?

A

pain worse with straight leg raise - contraction of quadriceps

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6
Q

what is osteochrondritis dissecans?

A

fragment of hyaline cartilage breaks of the surface of the joint

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7
Q

where is osteochondritis dissecans most commonly seen?

A

knee - medial femoral condyle

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8
Q

what symptoms are seen with osteochondritis dissecans?

A

poorly localised pain
effusion
occasionally locking

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9
Q

what features of effusion indicates osteochondritis dissecans?

A

takes hours/days to form

if it does form quickly, will be filled with blood

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10
Q

what imaging is used for osteochondritis dissecans?

A

MRI (difficult to view on x-ray)

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11
Q

what meniscal abnormality can be seen in children?

A

lateral meniscus circular rather than c-shaped

causes pain and popping sensation

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12
Q

what is the fancy name for club foot?

A

talipes equinovarus

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13
Q

what joints are abnormally aligned in club foot?

A

tallus
calcaneus
navicular

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14
Q

what does club foot cause?

A

planter flexion of ankle
supination of forefoot
varus alignment of forefoot

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15
Q

what does club foot increase your chances of?

A

DDH

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16
Q

what technique is used to treat club foot?

A

Ponseti technique - regimen of serial casts started after birth

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17
Q

what is required for club foot after casting?

A

achilles tendonotomy

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18
Q

what is required after full correction for club foot?

A

brace
worn 23 hours a day for 3 months
during sleep until 3-4 years old

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19
Q

what is back pain in children a red flag for?

A

infection - discitis

tumours - osteoid osteoma

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20
Q

what is scoliosis?

A

lateral curvature of the spine

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21
Q

what is the most common cause of scoliosis in females?

A

idiopathic
present as adolescence due to cosmetic appearance
younger children have underlying cause

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22
Q

what are some risks with large curvatures in scoliosis?

A

restrictive lung defect

risk of spinal cord injury

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23
Q

what is spondylolisthesis?

A

slippage of one vertebrae over another

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24
Q

what level does spondyloisthesis commonly occur at?

A

L4/L5 or L5/S1

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25
how does spondyloisthesis present?
in adolescence - increase weight and activity lower back pain flat back due to muscle spasm waddling gait
26
what is syndactyly? where does it most commonly occur? what is polydactyly?
fusion of fingers - most commonly 3rd and 4th | extra finger
27
what is fibular hemimelia? | how does it present?
partial or complete absence of the fibula - shortened limb - bowing of tibia - ankle deformity
28
how is fibular hemimelia treated?
if severe, ankle amputation at 10 months to 2 years and use of below knee prosthetic
29
what does radius deformity cause?
absence of thumb | radius club hand
30
what most commonly causes obstetric brachial plexus palsy's?
``` large babies (macrosomia diabetes) twin deliveries shoulder dystocia ```
31
what its he most common obstetric brachial plexus palsy's?
erb's palsy
32
where is the injury in erb's palsy?
upper nerve roots C5 and C6
33
what posture is there with erb's palsy?
waiter tip posture
34
what muscles are affected with erb's palsy?
loss of motor innervation of - deltoid - supraspinatus - infraspinatus - biceps - brachialis
35
what is the prognosis with erb's palsy?
``` return of bicep function by 6 months good outcomes (90%) ```
36
what is klumpe's palsy?
lower brachial plexus injury - C8 to T1 paralysis of intrinsic hand muscles fingers flexed
37
what may cause klumpe's palsy?
Horner's syndrome
38
what is the prognosis for klumpe's palsy?
bad - less than 50% recover
39
what is osteogenesis imperfecta?
brittle bone disease | defect in the maturation of type 1 collagen
40
what is the most common type of osteogenesis imperfecta?
autosomal dominant
41
what are the symptoms of osteogenesis imperfecta?
``` multiple fractures in childhood short stature multiple deformities blue sclera loss of hearing ```
42
what is seen with osteogenesis imperfecta if autosomal recessive?
very rare fatal in perinatal period spinal deformity
43
what is the outcome of osteogenesis imperfecta?
bones are thin and osteopenic - fractures heal with poor quality callus most adults have scoliosis
44
what is achondroplasia?
disproportionately short limbs prominent forehead widened nose
45
what is the genetic mutation in marfans?
autosomal dominant | sporadic mutation of fibrillin gene
46
what are the symptoms of marfans?
``` high arched palate scoliosis pectus excaratum spontaneous penumonthorax lens dislocation aortic aneurysm arachnodactyly (long fingers and toes) ```
47
what is Ehlers danlos syndrome?
``` autosomal dominant - abnormal collagen and elastin hyper mobility vascular fragility - bruise easily joint instability scoliosis ```
48
what is Down syndrome?
trimosy 21
49
what orthopaedic symptoms are seen in down syndrome?
short stature joint laxity recurrent dislocations - patella atlanto-axial instability of spine - OA
50
who do muscular dystrophies affect and why?
boys - x linked recessive conditions
51
what is Duchenne muscular dystrophy?
defects in dystrophin gene involved in calcium transport
52
what symptoms are seen with Duchenne muscular dystrophy?
difficulty standing/walking up stairs | Gower's sign
53
what is the prognosis for Duchenne muscular dystrophy?
age 10 - no longer walking age 20 - res and cardiac failure death in 20s
54
how is Duchenne muscular dystrophy diagnosed?
raised CK | abnormalities on muscle biopsy
55
how is becker's muscular dystrophy different from duchenne's muscular dystrophy?
milder form boys able to walk into their teens survive until 30/40
56
what is the most common type of cerebral palsy? what are the subtypes?
spastic hemiplegic - leg and arm on same side diplegic - both lower limbs quadraplegic - all 4 limbs
57
what are the symptoms of spastic CP?
increased tone due to damage to UMN
58
what is ataxia CP?
reduced co-ordination and balance due to cerebellar damage
59
what is dyskinetic CP?
damage to basal ganglia and substania nigra uncontrolled writhing motion sudden changes in tone difficulties controlling speech
60
what causes spina bifida?
2 halves on posterior vertebral arch fail to fuse during first 6 weeks of gestation
61
what is spina bifida occulta?
mildest form no associated problems may have tethering of spinal cord - pes cavus, clawing of toe birthmark, skin tag, fatty deposit, dimple, tuft of hair
62
what is spina bifida cystica?
can't walk | contents of vertebral canal herniate through
63
what is meningocele spina bifida?
only meninges herniate through
64
what is myelomeningocle spina bifida?
herniation of meninges with spinal cord/cauda equine | neurological defects - most serious
65
what is polio?
viral infection of anterior horn cells resulting in lower motor neurone deficit
66
what can happen due to polio?
variable degree of paralysis affecting muscles of lower limb in 2-3 days can cause residual paralysis joint deformities and shortening of limb

FINALS (25 decks)

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