Paediatrics Flashcards

1
Q

how to bones grow?

A

longitudinally from the growth plate by enchondral ossification

circumferentially from the periosteum by appositional growth

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

when do the limb buds start to develop?

A

four weeks gestation

these are made of mesoderm, covered in ectoderm

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

when does the primary ossification centre form in long bones?

A

by week 12 gestation

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

how can bone age be calculated?

A

by doing XRs of the hand and wrist

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

what can cause problems with the growth plate?

A
trauma
infection
tumours
radiation
surgery
compression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what condition can be diagnosed upon infant hip scanning?

A

developmental dysplasia of the hip (DDH)

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

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

A

females

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

which hip is most commonly affected by DDH?

A

left hip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is DDH a risk factor for?

A

early onset OA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

name some risk factors for DDH

A
breech 
family history 
oligohydramnios 
first born 
larger babies
multiple pregnancy babies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

when is USS done for suspected DDH?

A

breech
first degree family history
moulded baby

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

when is screening done for DDH?

A

neonatal check before sent home

6-8 week GP check

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what can be seen on inspection in DDH?

A

asymmetry
loss of knee height
less abduction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what specific tests are done to screen for DDH?

A

barlow’s maneouvre - if dislocates = DDH

ortolani maneouvre

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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
what causes perthes disease?
idiopathic
26
who is most commonly affected by perthes disease?
males 4-8 years old lower socioeconomic groups
27
how is perthes disease managed?
conservative management
28
what is a possible complication after perthes disease heals?
trochanteric overgrowth
29
what is cerebral palsy?
a persistent motor disorrder due to non progressive damage to the brain before the CNS is complete
30
when does cerebral palsy present?
before the age of three
31
what does brain injury cause in cerebral palsy?
increased tone, abnormal posture - causing contracture of bone and bone deformity also cause spasticity of muscles
32
what orthopaedic issue is there an increased risk of in patients with cerebral palsy?
dislocations
33
what is the GMFCS, and what does this mean for a cerebral palsy patients dislocation risk?
gross motor functional classification score higher score = higher risk
34
what spinal issue is common in patients with cerebral palsy?
scoliosis
35
when can tip toe walking be normal?
up til age of three
36
what are some possible pathological causes of tiptoe walking?
cerebral palsy PNS problems muscular dystrophy idiopathic
37
how is idiopathic tiptoe walking managed?
physio casting stretches rarely surgery
38
which direction of curve in scoliosis is more concerning and why?
to the left can affect the heart