paeds Flashcards
inheritance osteogenesis imperfecta
autosomal dominant (type 1) // recessive type 2 = death
mutation osteogenesis imperfecta
type 1 collagen
symptoms osteogenesis imperfecta
childhood, fractures, blue sclera, short stature, deafness
invx osteogenesis imperfecta
ca, phosphate, PTH, ALP
what is langerhans cell histiocytosis
abnormal proliferation of histocytes
symptoms langerhans cell histiocytosis
bone pain in skull or femur, nodules, otitid media or mastoiditis
xray langerhans cell histiocytosis
punched out legions
what is normal varus/ valgus alingment at birth
varus
what is normal varus/ valgus alignment as a toddler
valgus
what structural variant causes intoeing
femoral anteversion
what test can used to determine if flat feet are pathological or not
jack’s test –> dorsiflexion of big toe forms an arch
what is curly toes
overlapping and curling of toes
what is developmental dysplasia of the hip (DDH)
dislocation or subluxation of femur head from acetabulum
RF DDH
girls, first born, breech, down syndrome, oligohydramnios, left leg
complications DDH
fake acetabulum forms –> severe OA at young age –> THR
symptoms DDH
short limb, asymmetric groin fold
when is DDH screened for
USS for firs degree relative with hip problems, breech at 36 weeks
invx DDH
barlow –> ortolani test // USS // XRAY 4-6 months
mx DDH
palvik harness, surgery if 18 months+
what is transient synovitis of the hip + what usually causes it
inflammation of synovium joint usually after URTI
symptoms transient synovitis of the hip
limp, pain weight bearing, low grade fever
invx transient synovitis of the hip
Xray, hip aspiration, normal CRP, MRI (diagnosis of exclusion)
what is a red flag in transient synovitis of the hip
fever –> specialist input
which age group get transient synovitis
2-10 girls
what is perthes disease
flattened femoral head –> avascular necrosis
staging for perthes disease
catterall
complications perthes
lack of blood supply –> necrosis –> fracture –> remodelling –> OA
who gets perthes
boys 4-9
symptoms perthes
hip pain and limb worse on exercise // stiffness and atrophy // loss of internal rotation and abduction
invx perthes
Xray + MRI
mx perthes
cast or braces –> surgery (usually conservative mx)
what is slipped upper femoral epiphysis (SUFE)
displacement of femoral head posteriorly
who gets SUFE
overweight boys 10-15, hypothyroid and renal disease
symptoms SUFE
loss of internal rotatin, pain in groin, pain and limp
invx SUFE
lateral Xray
mx SUFE
urgent surgery to pin femoral head
what is juvenile idiopathic arthritis
arthritis at <16 in 4 or less joints - usually medium sized joints
which antibodu can be assoc with juveline idiopathic arthritis
ANA
what is systemic juveline idiopathic arthritis also know as
stills disease
symptoms systemic juveline idiopathic arthritis
pyrexia, rash, lymph, arthritis, uveitis
what is clubfoot assoc with (6)
males, spina bifida, cerebral palsy, edwards (T18), oligohydramnios, breech
mx clubfoot
ponseti casting –> change cast every 5-6 months
what surgery is required for full correction of clubfoot
achilles tendonotomy
secondary causes of scoliosis
neuromuscular disease, skeletal dysplasia,tumour
invx for scoliosis
xray or MRI (if severe pain)
mx scoliosis
casts, braces –> surgical rod stabilisation
what classification is used for growth plate fractures
salter harris: I fracture through physis only –> II physis and metaphysis –> III + IVE metaphysis + epihysis to include joint –> V crush fracture
