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3a > Paeds MSK > Flashcards

Paeds MSK Flashcards

1
Q

What’s the most common cause of hip pain in children aged 3-10?

A

Transient synovitis

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2
Q

What is transient synovitis often associated with?

A

A recent viral URTI

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3
Q

True/false - Perthes disease is more common in boys

A

True

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4
Q

What happens in Perthes disease

A

Disruption of blood supply to the femoral head leading to avascular necrosis of the bone

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5
Q

Will there be a history of trauma in Perthes disease?

A

No

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6
Q

What is the initial management in Perthes disease?

A

Conservative - maintain a healthy position and alignment in the joint to promote healing and prevent damage

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7
Q

What happens in slipped upper femoral epiphysis?

A

The femoral head is displaced along the growth plate

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8
Q

What is the typical profile of a child with SUFE?

A

Adolescent (ages 8-15), obese male undergoing a growth spurt

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9
Q

What condition is indicated by a history of hip pain/restricted ROM and trauma

A

Slipped upper femoral epiphysis

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10
Q

How will a patient with SUFE typically hold their hip?

A

Externally rotated

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11
Q

What is the management of SUFE?

A

Surgery to fix the femoral head in the correct place

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12
Q

What happens in Osgood-Schlatter disease?

A

Inflammation at the tibial tuberosity where the patella ligament inserts

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13
Q

Is Osgood-Schlatter disease usually unilateral or bilateral?

A

Usually unilateral

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14
Q

What is the typical profile of a child with Osgood-Schlatter disease?

A

Sporty male between ages of 10-15

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15
Q

What the the 3 most common causes of joint pain in patients aged 0-3?

A
  • Septic arthritis
  • Developmental dysplasia of the hip
  • Transient synovitis
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16
Q

What are the 3 most common causes of joint pain in patients aged 5-10?

A
  • Septic arthritis
  • Transient synovitis
  • Perthes disease
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17
Q

What the the 3 most common causes of joint pain in patients aged 10-16?

A
  • Septic arthritis
  • Slipped upper femoral epiphysis
  • JIA
18
Q

What is osteomyelitis and what’s the most common cause?

A
  • Infection in the bone and bone marrow
  • Staph aureus
19
Q

How is septic arthritis different to osteomyelitis?

A

Septic arthritis is infection of a joint

20
Q

What’s the best investigation for diagnosing osteomyelitis?

A

MRI

21
Q

What is the management of osteomyelitis?

A
  • Long term antibiotic therapy
  • May need surgery to drain and remove the infected bone
22
Q

Osteosarcoma:
1. Age typically affected
2. Which bone is mos commonly affected
3. What is the main presenting feature

A
  1. 10-20
  2. Femur
  3. Persistent bone pain
23
Q

Osteosarcoma diagnosis:
1. What will XR show
2. What blood test may be raised

A
  1. A poorly defined lesion in the bone, with destruction of the normal bone and a “fluffy” appearance
  2. ALP
24
Q

What is talipes

A

A fixed abnormal ankle position, present at birth

25
Q

What are the two different types of talipes?

A
  • Talipes equinovagus - ankle in plantar flexion and supination
  • Talipes calcaneovalgus - ankle in dorsiflexion and pronation
26
Q

What is the management of talipes?

A

Ponseti method - non surgical correction with physio and casts

27
Q

Give 3 risk factors for developmental dysplasia of the hips

A
  • 1st degree FHx
  • Breech presentation
  • Multiple pregnancy
28
Q

What is the preferred investigation in developmental dysplasia of the hips?

A

USS

29
Q

DDH management:
1. What is first line treatment?
2. How does this keep the hips?
3. How long does it stay on for?

A
  1. Pavlik harness
  2. Flexed and abducted
  3. 6-8 wks
30
Q

When is surgery indicated in DDH?

A

If the pavlik harness fails or the baby is >6months

31
Q

Vitamin D deficiency investigations:
1. What blood test is measured?
2. What value indicates vitamin D deficiency?
3. What investigation is required to diagnose rickets?
4. What might it show?

A
  1. 25-hydroxyvitamin D
  2. <25 mol/L
  3. XR
  4. More radiolucent bones
32
Q

Vitamin D deficiency management:
1. What is the treatment for Vitamin D deficiency
2. What else needs to be replaced in rickets

A
  1. Ergocalciferol
  2. Calcium
33
Q

What’s the likely diagnosis? What differential requires excluding?
- Young child
- Unusual and recurrent fractures
- Blue discolouration to sclera

A
  • Osteogenesis imperfecta
  • NAI
34
Q

What medications are used in osteogenesis imperfecta?

A
  • Bisphosphonates - increase bone density
  • Vit D supplements - prevent deficiency
35
Q

Do you get a painless limb in Perthe’s or SUFE?

A

Perthe’s

36
Q

What is irritable hip?

A

Transient synovitis with joint effusion

37
Q

What do Barlows and Ortolanis tests look for?

A
  • Ortalani - does the hip dislocate anteriorly
  • Barlow - does the femoral head displace posteriorly
38
Q

What is the investigation for hip dysplasia in…
1. Child <4 months
2. Child >4 months

A
  1. USS
  2. XR
39
Q

Give two investigations for Perthes disease

A
  • Roll test - will evoke guarding/spasm
  • XR - joint space widening, crescent sign
40
Q

What criteria can be used for septic arthritis? What is included?

A

Kocher criteria
- Can’t weight bear
- Temp >38.5
- ESR > 40
- WCC > 12

3a (34 decks)

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