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Int Spec (Ortho) > Paediatric Orthopaedics > Flashcards

Paediatric Orthopaedics Flashcards

1
Q

What investigation is used to diagnose SUFE and Perthes’ disease?

A

Hip x-ray

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2
Q

What is the commonest chronic form of arthritis seen in children?

A

Juvenile idiopathic arthritis

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3
Q

Why are regular slit lamp examinations essential for all children with juvenile idiopathic arthritis?

A

1 in 5 will develop chronic anterior uveitis

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4
Q

A mutation affecting the gene responsible for what protein underlies the pathogenesis of Marfan’s syndrome?

A

Fibrillin

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5
Q

Are boys or girls more likely to be affected by juvenile idiopathic arthritis?

A

Girls

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6
Q

In any child with a high temperature and a swollen, painful joint, what diagnosis should be assumed until proven otherwise?

A

Septic arthritis

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7
Q

What investigation is used to assess for DDH in individuals aged more than 6 months?

A

X-ray

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8
Q

What diagnosis may be suspected if short limbs, particularly short femur length, are seen on an antenatal ultrasound scan relative to abdominal and head circumference measures?

A

Achondroplasia

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9
Q

What respiratory condition is often seen in individual’s with Marfan’s syndrome?

A

Spontaneous pneumothorax

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10
Q

How is osteomyelitis treated?

A

IV antibiotics +/- surgical debridement

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11
Q

What movement of the hip is usually first to be lost in children with Perthes’ disease?

A

Internal rotation

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12
Q

A ‘rib hump’ will be seen in which subtype of scoliosis?

A

Structural scoliosis

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13
Q

Asymmetrical skin creases at the inner upper thigh is suggestive of what condition?

A

DDH

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14
Q

What percentage of children affected by juvenile idiopathic arthritis will have active disease into adulthood?

A

30%

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15
Q

How is SUFE managed?

A

Bilateral screw fixation of the epiphysis

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16
Q

Is DDH more likely to be unilateral or bilateral? Which hip is more likely to be affected?

A

Unilateral, and the left hip

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17
Q

Femoral neck anteversion is caused by an excess of what movement at the hip joint?

A

Internal rotation

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18
Q

How are the vast majority of cases of osteogenesis imperfecta inherited?

A

Autosomal dominant

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19
Q

How is Perthes’ disease managed?

A

Avoidance of activity, mechanical appliances or surgical osteotomy

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20
Q

How does Perthes’ disease typically present?

A

Limp +/- pain in the hip or knee

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21
Q

In talipes equinovarus, the ankle is in what position?

A

Plantarflexed and supinated

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22
Q

What are some features that may be seen in systemic onset juvenile idiopathic arthritis (formerly known as Still’s disease)?

A

Swinging fever, salmon pink macular rash, organomegaly, pericarditis

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23
Q

What are the two main clinical features of Ehler’s Danlos syndrome?

A

Joint hypermobility and vascular fragility (easy bruising)

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24
Q

A baby with DDH presenting before 6 months of age is treated how?

A

Pavlik harness

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25
Q

What investigation is used to confirm scoliosis?

A

Spine radiographs

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26
Q

Juvenile idiopathic arthritis is defined as arthritis starting before what age? To be diagnosed, it must last for at least how long?

A

16 years / 3 months

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27
Q

Klumpke’s palsy involves damage to which nerve roots? In the simplest terms, how does this present?

A

C8 and T1, presents as a claw hand

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28
Q

What is the most significant orthopaedic complication associated with Down’s syndrome?

A

Atlanto-axial joint instability

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29
Q

What investigation is used to assess for DDH in individuals aged less than 6 months?

A

Ultrasound

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30
Q

What is the commonest subtype of juvenile idiopathic arthritis? What joints is this most likely to involve?

A

Oligo-articular, most commonly affecting the knee/ankle/elbow

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31
Q

What medication can be given as prophylaxis against fractures to children with osteogenesis imperfecta?

A

Oral bisphosphonates

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32
Q

Any painful scoliosis warrants what urgent investigation?

A

Spinal MRI

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33
Q

What is the typical demographic of a child affected by Perthes’ disease?

A

Small, hyperactive boy aged 4-10 years

34
Q

Describe the typical demographic of child that will be affected by Osgood-Schlatter’s disease?

A

Active child, more commonly a boy, aged 10-16

35
Q

Which clinical test is this describing: reducing a dislocated hip with abduction and anterior displacement?

A

Ortolani’s test

36
Q

What is meant by the term syndactyly?

A

The fusion of two digits

37
Q

How should transient synovitis of the hip be treated?

A

NSAIDs and rest

38
Q

A Pavlik harness is used to keep a baby’s hips in what position?

A

Flexed and abducted

39
Q

The majority of cases of abnormal knee alignment will resolve by what age?

A

10 years

40
Q

In a child presenting with back pain, what are the two most important pathologies to exclude?

A

Infections and tumours

41
Q

In those who present acutely, an adolescent who cannot weight bear has what condition until proven otherwise?

A

SUFE

42
Q

In osteogenesis imperfecta, the defect is in the maturation and organisation of what component of bone?

A

Type I collagen

43
Q

A child with sickle cell anaemia is at particular risk of septic arthritis caused by what organism?

A

Salmonella

44
Q

Pain and swelling at the tibial tuberosity is characteristic of what condition?

A

Osgood-Schlatter’s disease

45
Q

At which spinal levels is spondylolisthesis most likely to occur?

A

L4/L5 or L5/S1

46
Q

What screening is required in individual’s with Marfan’s syndrome?

A

Regular ECHO scans and ophthalmologist review

47
Q

What is the correct term to describe a child who, when walking and standing, will have feet that point towards the midline?

A

Intoeing

48
Q

What is the typical demographic of a child affected by SUFE?

A

A pre-pubertal adolescent boy with obesity/hypothyroidism

49
Q

What is the commonest acute form of arthritis seen in children?

A

Reactive arthritis

50
Q

When is the knee pain associated with Osgood-Schlatter’s disease worse?

A

After repetitive running or jumping activities

51
Q

What surgical procedure is usually required alongside splinting for the correction of talipes equinovarus?

A

Achilles tendon tenotomy

52
Q

What is the commonest type of obstetric brachial plexus palsy? This involves damage to which nerve roots?

A

Erb’s palsy, damage to C5 and C6

53
Q

How often should adolescents with scoliosis be x-rayed to assess for progression of the curve?

A

Every 6-12 month

54
Q

Babies with talipes equinovarus should undergo screening for what other condition?

A

DDH

55
Q

Which babies should always have an ultrasound to screen for DDH, even if clinical tests are normal?

A

Those in breech position or with a positive family history in a first-degree family member

56
Q

How is septic arthritis managed?

A

Joint aspiration, irrigation and IV antibiotics

57
Q

Which clinical test is this describing: dislocating the hip with flexion and posterior displacement?

A

Barlow’s test

58
Q

How may Marfan’s syndrome be inherited?

A

Autosomal dominant or sporadic

59
Q

For juvenile idiopathic arthritis to be classified as a polyarthritis, how many joints must be involved?

A

5 or more

60
Q

A baby born with internal rotation of the shoulder, resulting in the ‘waiter’s tip’ position is suggestive of what diagnosis?

A

Erb’s palsy

61
Q

Other than skeletal abnormalities, what are the most significant clinical features of Marfan’s syndrome?

A

Aortic root dilatation and lens dislocation

62
Q

Is DDH more common in first or later born children? Is it more common in boys or girls?

A

Firstborns, and girls

63
Q

What organism is the most common cause of septic arthritis and osteomyelitis?

A

Staph aureus

64
Q

Other than fragility fractures and bony deformities, what are some other non-bony clinical features of osteogenesis imperfecta?

A

Blue sclera and hearing loss

65
Q

The diagnosis of Osgood-Schlatter’s disease is clinical, however, what investigation is usually performed anyway to exclude other pathology?

A

Knee x-ray

66
Q

Ortolani’s and Barlow’s tests are used to detect what clinical condition?

A

DDH

67
Q

What is the most common type of chondroplasia? How is this most likely to be inherited?

A

Achondroplasia- most likely to be a sporadic mutation

68
Q

How is talipes equinovarus treated?

A

Splinting using the Ponseti technique

69
Q

What condition is this describing: a lack of blood supply to the epiphysis of the femoral head, and consequent avascular necrosis resulting in loss of bone mass and deformity of the femoral head?

A

Perthes’ disease

70
Q

Pain from SUFE is often felt where?

A

In the knee

71
Q

Severe scoliosis can cause what complication?

A

Restrictive lung defects

72
Q

What are some risks associated with osteomyelitis in children?

A

Pathological fractures and growth arrest

73
Q

How is DDH treated if the Pavlik harness doesn’t work or the child presents later than 6 months of age?

A

Surgery (open reduction and femoral osteotomy)

74
Q

How long should it take for pain associated with transient synovitis of the hip to pass?

A

Up to a few weeks

75
Q

What is spondylolisthesis?

A

The slippage of one vertebra over another

76
Q

Growing pains usually cause pain when?

A

Overnight (often wakes the child from sleep)

77
Q

Radiography showing a flattened femoral head with increased bone density is suggestive of what diagnosis?

A

Perthes’ disease

78
Q

Describe the typical phenotype of an individual with Marfan’s syndrome?

A

Tall stature and wide arm span

79
Q

What is the most common cause of non-idiopathic scoliosis?

A

Neuromuscular disease

80
Q

Describe the alignment of the developing knees?

A

Children are born with varus knees which become neutrally aligned at 14 months; they then progress to 10-15 degrees of valgus at 3 years and then regress to the physiological 6 degrees of valgus by 7-9 years

81
Q

Which gender is more likely to be affected by talipes equinovarus?

A

Boys

82
Q

In children, reactive arthritis (including transient synovitis of the hip), most commonly occurs as a result of what infection?

A

URTI

Int Spec (Ortho) (10 decks)

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