Paediatrics - Rheumatology

Question 1

How would a joint with septic arthritis examine?

Answer 1

Effusion, tender, warm, localized swelling
Severe pain on passive movement

Systemic illness

Question 2

What is transient synovitis and how would an affected joint examine?

Answer 2

Infection of synovium

Mild-moderate restricition of internal rotation

Question 3

What are some risk factors of developmental hip dysplasia?

Answer 3

Breech
Family history
>98 centile birth weight
Multiple pregnancies

Question 4

What are some symptoms of slipped upper femoral epiphysis? How would an affected joint examine?

Answer 4

Groin, thigh and knee pain that develops over weeks-months
limp
decreased hip range of movement

Question 5

What is Perthes disease and how would it examine?

Answer 5

necrosis of the femoral head

- hip stiffness and leg length discrepency

Question 6

What are the common pathogens that cause septic arthritis?

Answer 6

Neonates - Group B strep
> 2 year - staph aureus
adolescents - neissera gonnorhea

Question 7

What does vitamin D do?

Answer 7

Vitamin D makes calcium available by increasing calcium absoprtion in gut and increasing calcium release from bone
Also has a role in immune function

Question 8

Name 3 symptoms of rickets

Answer 8

meaphyseal swelling, bowing deformities, slow linear growth, motor delay, hypotonia, fractures, respiratory distress

Question 9

Name 3 treatments of osteogensis imperfecta

Answer 9

Bisphosphonates
cyclical administration of IV pamidronate
surgery
MDT

Question 10

What are some symptoms of osteogensis imperfecta?

Answer 10

fractures, deformities, blue sclera, hypermobility, hearing problems, bone pain, poor growth, hernias, valve prolapse

Question 11

How do you treat rickets?

Answer 11

Vitamin D and calcium - if giving IV calcium give it slowly to prevent thrombosis

Question 12

How do you treat JIA?

Answer 12

Analgesia
DMARDs e.g. methotrexate
Steroids
Biologicals e.g. tocilizumab

Question 13

What are 5 symptoms of JIA?

Answer 13

Early morning stiffness 
Struggle on stairs
Swelling 
loss range of movement 
warmth 
colour change 
pain 
joint deformity 
Uveitis

Question 14

When do you refer JIA and to who?

Answer 14

< 16 years old
6 weeks of symptoms
To rheumatologist and opthalmologist (for uveitis)

Question 15

What is reactive arthritis?

Answer 15

Responds well to pain meds

often follows URTI 1-2 weeks after, usually affecting large weight bearing joints