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MSK > Paediatric Orthopaedics > Flashcards

Paediatric Orthopaedics Flashcards

1
Q

What is Osteogenisis Imperfecta?

A

brittle bone disease

there is a defect in the maturation and organization of type 1 collagen

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2
Q

multiple fragility childhood fracture, short stature, blue sclerae and loss of hearing

what congenital disorder is this?

A

Osteogenisis Imperfecta

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3
Q

What is Skeletal dysplasias?

A

DWARF!

short stature due to genetic error resulting in abnormal development of bone.

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4
Q

what is the most common type of skeletal dysplasia?

A

achondroplasia

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5
Q

what is achondroplasia like?

A

disproportionately short limbs with prominent forehead and widened nose.

joints are lax and mental development is normal

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6
Q

what do connective tissue disorders usually result in?

A

hypermobility

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7
Q

what is marfan’s syndrome?

A

an autosomal dominant or sporadic mutation of the fibrillin gene resulting in TALL STATURE WITH DISPROPORTIONATELY LONG LIMBS AND LIGAMENTOUS LAXITY

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8
Q

name some features associated with marfan’s syndrome?

A 
glaucoma
lens dislocation
high arch palate in mouth
spontaneous pneumothorax
flattening of chest-pectus excavatum)
heart problems-mitral regurge, aortic aneurysm  and regurg
long arms
scoliosis
long legs
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9
Q

what is Ehlers-Danlos syndrome?

A

abnormal elastin and collagen formation

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10
Q

Name some clinical features of Ehlers-Danlos syndrome?

A

profound joint hypermobility
vascular fragility with ease of bruising
joint instability
scoliosis

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11
Q

what are the MSK manifestations with Downs syndrome?

A

short stature and joint laxity and possible recurrent dislocation

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12
Q

What causes Duchenne Muscular Dystrophy?

A

a defect in the dystrophin gene which is involved in calcium transport

results in muscle weakness

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13
Q

how do you diagnose Duchenne Muscular Dystrophy?

A

raised serum creatinine phosphokinase and abnormalities on muscle biospy.

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14
Q

What is beckers Muscular Dystrophy?

A

similar to DMD but milder and they can live to 30’s/40’s instead of 20’s.

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15
Q

What is cerebral Palsy?

A

a neuromuscular disorder due to an insult to the immature brain before, during or after birth.

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16
Q

what is the most common expression (type) of cerebral Palsy?

A

spastic CP

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17
Q

what spina bifida?

A

2 halves of the posterior vertebral arch fail to fuse (probs in the first 6 weeks of gestation)

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18
Q

what is the mildest form of spina bifida?

A

spina bifida occulta

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19
Q

what is the most severe form of spina bifida?

A

spina bifida cystica

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20
Q

what is Polio?

A

a viral infection which affects motor anterior horn cells in the spinal cord or brain stem resulting in lower motor neurone deficit.

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21
Q

how does the polio virus enter the body?

A

via the Gi tract

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22
Q

When do you get obstetric brachial nerve palsy?

A

mainly in large babies and twins.

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23
Q

what is the most common type of obstetric brachial nerve palsy?

A

Erb’s Palsy

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24
Q

Waiter’s tip posture

A

Erb’s Palsy

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25
Q

what happens in Erb’s Plasy?

A

injury to the upper nerve roots (C5 and 6) resulting in loss of motor innervation of deltoid, supraspinatus, infraspinatus, biceps and brachialis

can lead to internal rotation of the humerus.

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26
Q

what is Klumpke’s Palsy?

A

a rarer type of obstetric brachial nerve palsy

injury to C8 and T1

can result in paralysis of intrinsic hand muscles and horner’s syndrome

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27
Q

when should a baby sit alone/crawl?

A

6-9 months

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28
Q

when should a baby stand?

A

8-12 months

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29
Q

when should a baby walk?

A

14-17 months

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30
Q

when should a baby jump?

A

2 years

31
Q

when should a baby manage stairs by themselves?

A

3 years

32
Q

when should a baby have head control?

A

2 months

33
Q

when should a baby speak a few words?

A

9-12 months

34
Q

when should a baby eat with fingers/ use spoon?

A

14 months

35
Q

when should a baby stack 4 blocks?

A

18 months

36
Q

when should a baby understand 200 words/ learn 10 words a day?

A

18-20 months

37
Q

when should a baby be potty trained?

A

2-3 years

38
Q

what is genu varum

A

bow legs

39
Q

what is genu valgus

A

knock knees

40
Q

what can cause genus valgum?

A

rickets

tumours

41
Q

clumbsy and wear through shoes at an alarming rate

A

in toeing- feet pointing towards midline

42
Q

what is femoral neck anteversion?

A

the femoral neck is slightly averted (pointing forward)

this can give appearance of in toeing and knock knees.

43
Q

what is internal tibia torsion?

A

tibia rotated inward about its vertical axis. but this a normal variation and should be ignored!!

44
Q

what 2 types of flat feet do you get?

A

mobile and fixed

45
Q

which type of flat foot is there tarsal coalition?

A

fixed flat foot

46
Q

what are curly toes?

A

minor overlapping of the toes and curling of the toes.. 5th toe is most affected

47
Q

what is developmental dysplasia of the hip?

A

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

48
Q

which hip is more commonly affected in DDH?

A

left

and girls are more commonly affected that boys

49
Q

risk factors for DDH?

A 
family history of DDH
breech presentation
first born babies
downs syndrome
other congential disorders
50
Q

click or clunk with Ortolani and/or Barlow test?

A

DDH

51
Q

what is Ortolani test?

A

reducing a dislocated hip with abduction and anterior displacement

52
Q

what is Barlow test/

A

dis-locatable hip with flexion and posterior displacement.

53
Q

what can you use to help diagnose DDH?

A

ultrasound

54
Q

what is transient synovitis of the hip?

A

inflammation of the synovium of a joint (hip)

55
Q

when do you commonly get transient synovitis of the hip?

A

after an upper resp tract infection

56
Q

when are mosy children affected by transient synovitis of the hip?

A

2-10 years

57
Q

name some signs/symptoms of transient synovitis of the hip?

A

limp or reluctance to weight bare
range of motion restricted
low grade fever

58
Q

Name some investigations for transient synovitis of the hip?

A

x-ray to exlcude Perthes
CRP- normal
aspiartion
MRI

59
Q

what is the treatment for transient synovitis of the hip?

A

NSAIDS and rest

60
Q

what is Perthes disease?

A

osteochondritis of the femoral head which usually occurs between ages of 4-9 and more common in boys

61
Q

name some signs/symptoms of perthes disease?

A 
pain/limp
usually unilateral
loss of internal rotation (usually first sign)
loss of abduction
positive trendleberg test
62
Q

management of perthes?

A

regular x ray observation and avoid physical activity

63
Q

who is mainly affected by slipped upper femoral epiphysis?

A

FAT pre-pubertal teenage boys

64
Q

what can predispose you to SUFE?

A

hypothyroidism and renal disease

65
Q

signs/symptoms of SUFE?

A

pain and limp
pain may be felt in groin
CAN HAVE KNEE PAIN ONLY!!!
loss of internal rotationmof hip

66
Q

treatment of SUFE?

A

urgent surgery

67
Q

when is dislocation of the patella most common?

A

teenage years

girls more common

68
Q

what is osteochondritis dissecans?

A

fragment of hyaline cartilage with some bone fragments breaks off the surface of the joint

the knee is most commonly affected.

69
Q

patient presentation of osteochondritis dissecans?

A

poorly localised pain
effusion
locking knee (occasionally)

70
Q

what is Talipes Equinovarus?

A

club foot

abnormal alignment of joints between talus, calcaneus and navicular.

boys more affected than girls

71
Q

deformities from club foot/

A

plantarflexion
supination of forefoot
varis alignment of the forefoot

72
Q

treatment for club foot/

A

early splintage!!

73
Q

what is scoliosis?

A

lateral curvature in the spine

74
Q

what is spondylothesis?

A

slippage of one vertebrae over another usually at l4/5 level or l5/s1 level

present with lower back pain!!

MSK (15 decks)

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