Paeds MSK Flashcards
What is osteogenesis imperfecta?
No collagen being formed in the bones (brittle bone disease)
How is OI inherited?
Autosomal dominant
What are the clinical features of OI?
Presents in childhood
Multiple fractures
Blue/grey sclera
Bones with altered shape
Results of calcium, phosphate and PTH for OI>
Usually within the normal range
Management of OI?
Physio when symptoms occur
Pamidronate
Zoledronic acid
What is rickets?
Severe vitamin D deficiency resulting in failure of mineralisation of bone at the growth plates of long bones
Clinical features of rickets in toddlers?
Delayed growth
Bone pain
Bone deformity
leg bowing in toddlers
What do blood tests show in rickets?
Decreased: Calcium, phosphorus, calcidiol, calcitriol and urinary calcium
Increased: PTH, ALP and urinary phosphorus
Management of rickets?
If patient is hypocalcaemic give IV calcium infusion.
Oral calcium and vit D supplementation until levels return to normal
What are the risk factors for DDH?
Breech after 32 weeks
Oligohydramnios
Female
Family history
Which tests are used to look for DDH?
Barlows and Ortolani’s
When does a baby require an USS for DDH?
Breech after 36 weeks no matter delivery
Multiple pregnancy
First degree FHx of hip problems
Or positive Barlows and Ortolani’s
What is the management of DDH over 4-5 months?
Pavlik harness (dynamic flexion abduction orthosis)
What is perthes disease?
Avascular necrosis of the proximal femoral epiphysis in children
When does perthes most commonly occur?
Ages 4-10
Loss of what movements of the hip is characteristic of perthes?
Internal rotation
Abduction
What are the clinical features of perthes disease?
Limp
Hip stiffness (loss of internal rotation and abduction)
Pain
Antalgic gait
Muscle spasms
Leg length discrepancy
What are the investigations for Perthes disease?
Bilateral AP pelvic X-ray
What is the management of Perthes?
Typically conservative:
Observation
Casting
Activity limitation
Analgesia
If over 8 then surgery.
What age does slipped capital femoral epiphysis tend to affect?
10-15 years
Which movements are restricted in SCFE?
Loss of internal rotation in FLEXIOn
What settings does SCFE present?
May present following trauma or could present chronically with persistent symptoms
What is the management of SCFE?
Internal fixation
A single cannulated screw places in the centre of the epiphysis
What is transient synovitis?
Intermittent inflammatory disorder of the synovium of the hip
