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Y2 Musculoskeletal > Paediatrics > Flashcards

Paediatrics Flashcards

1
Q

how to bones grow?

A

longitudinally from the growth plate by enchondral ossification

circumferentially from the periosteum by appositional growth

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2
Q

when do the limb buds start to develop?

A

four weeks gestation

these are made of mesoderm, covered in ectoderm

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3
Q

when does the primary ossification centre form in long bones?

A

by week 12 gestation

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4
Q

how can bone age be calculated?

A

by doing XRs of the hand and wrist

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5
Q

what can cause problems with the growth plate?

A 
trauma
infection
tumours
radiation
surgery
compression
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6
Q

what condition can be diagnosed upon infant hip scanning?

A

developmental dysplasia of the hip (DDH)

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7
Q

who is more likely to have DDH - females or males?

A

females

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8
Q

which hip is most commonly affected by DDH?

A

left hip

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9
Q

what is DDH a risk factor for?

A

early onset OA

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10
Q

name some risk factors for DDH

A 
breech 
family history 
oligohydramnios 
first born 
larger babies
multiple pregnancy babies
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11
Q

when is USS done for suspected DDH?

A

breech
first degree family history
moulded baby

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12
Q

when is screening done for DDH?

A

neonatal check before sent home

6-8 week GP check

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13
Q

what can be seen on inspection in DDH?

A

asymmetry
loss of knee height
less abduction

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14
Q

what specific tests are done to screen for DDH?

A

barlow’s maneouvre - if dislocates = DDH

ortolani maneouvre

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15
Q

what is the treatment for DDH if caught early?

A

pavlik harness for up to 12 weeks until USS normal, followed by night time splinting for a few weeks

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16
Q

when can late DDH be caught?

A

not until the patient starts walking

17
Q

how is late DDH managed?

A

surgery

hip will not be normal, often need further surgery

18
Q

what is SUFE?

A

slipped upper femoral epiphyses

when the ball of the hip starts to slip off of the growth plate

19
Q

what are some risk factors for SUFE?

A

rapid pubertal growth

over weight or under weight

20
Q

how does SUFE present?

A

hip, groin, thigh or knee pain
antalgic gait
lower limb is short and externally rotated
if severe, can’t walk

21
Q

how is SUFE diagnosed?

A

2 x-rays at 90 degrees to each other

22
Q

what is transient synovitis and what causes it?

A

inflammation of the synovium

often secondary to a viral illness

23
Q

how does transient synovitis present?

A

history of viral infection
mild limp
fever

24
Q

what is perthes disease?

A

AVN of the hip in children

25
Q

what causes perthes disease?

A

idiopathic

26
Q

who is most commonly affected by perthes disease?

A

males

4-8 years old

lower socioeconomic groups

27
Q

how is perthes disease managed?

A

conservative management

28
Q

what is a possible complication after perthes disease heals?

A

trochanteric overgrowth

29
Q

what is cerebral palsy?

A

a persistent motor disorrder due to non progressive damage to the brain before the CNS is complete

30
Q

when does cerebral palsy present?

A

before the age of three

31
Q

what does brain injury cause in cerebral palsy?

A

increased tone, abnormal posture - causing contracture of bone and bone deformity

also cause spasticity of muscles

32
Q

what orthopaedic issue is there an increased risk of in patients with cerebral palsy?

A

dislocations

33
Q

what is the GMFCS, and what does this mean for a cerebral palsy patients dislocation risk?

A

gross motor functional classification score

higher score = higher risk

34
Q

what spinal issue is common in patients with cerebral palsy?

A

scoliosis

35
Q

when can tip toe walking be normal?

A

up til age of three

36
Q

what are some possible pathological causes of tiptoe walking?

A

cerebral palsy
PNS problems
muscular dystrophy
idiopathic

37
Q

how is idiopathic tiptoe walking managed?

A

physio
casting
stretches
rarely surgery

38
Q

which direction of curve in scoliosis is more concerning and why?

A

to the left

can affect the heart

Y2 Musculoskeletal (37 decks)

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