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Paediatric Y4 > Paeds Musculoskeletal > Flashcards

Paeds Musculoskeletal Flashcards

1
Q

Young teenage male with knee pain. Athlete

A

Osgood-Schlatter Disease

Osteochondritis of patellar tendon insertion

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2
Q

Adolescent female

Pain on sitting down or climbing in knees

A

Chondrocalcinosis patellae

inflammation of underside of patella

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3
Q

Blue Sclerae

A

Osteogeneis Imperfecta Type 1

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4
Q

5-10 year old with insidious onset limb pain
+ Progressively worsening
+ Abducted externally rotated limb
(painless limp?)

Flattened femoral head on Xray
Idiopathic Avascular Necrosis of femoral head

A

Perthes Disease

Perthes Primary, so think younger

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5
Q

10-15 year old overweight boy with painful limp
+ shortened externally rotated limb
+ Ice Cream Sign
Frog lateral position on X ray

Fracture through growth plate resulting in slipped head of femur

A

Slipped upper(capital) femoral epiphysis - SUFE

SUFE Secondary, so think older

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6
Q

Gowers sign + dilated cardiomyopathy

A

Duchenne’s Muscular Dystrophy

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7
Q

Tongue Fasciculations + absent deep tendon reflexes

A

Spinal Muscular Atrophy Type 1

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8
Q

Pain on waking at night in 3-12 year old

A

Growth pain/ nocturnal idiopathic pain

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9
Q

Differential dx of pads limp

STARTSS HOTT

A 
Septic joint 
Tumour 
Avascular Necrosis (Perthes)- painLESS
Rheumatoid arthritis/ JIA
Tuberculosis 
Sickle cell disease
SCFE/ SUFE - painFUL 
Hence Schonlein Purpura 
Osteomyelitis 
Trauma 
Toxic/transient synovitis
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10
Q

What is Sever’s Condition

A

Apophysitis of Achilles tendon insertion at heel bone

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11
Q

Four differentials for arthralgia/arthritis and rash

A

Kawasaki Disease
Heuloch Schonlein Purpurs
Acute Rheumatic Fever
Still’s disease - severe juvenile idiopathic arthritis

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12
Q

Kawasaki Disease Presentation

A 
Toddler 
COLOR features + 5 days of fever 
Polymorphous rash 
arthralgia not a big feature 
Watch out for:  coronary disease - Echo at presentation and 6 weeks after
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13
Q

Henloch Schonlein Purpurs Presentation

A

Young child
Purpuric rash on butt/legs
Abdominal pain –> risk of intussusception
Arthralgia
Haematuria
Hypertension
Watch out: renal failure, multi organ failure

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14
Q

Acute Rheumatic Fever Presentation ***

A 
Young child 
Indigenous or immigrant background 
STREP features in Jones major criteria
- Syndham's chorea/ transient migratory arthralgia/ rheumatic subcutaneous nodules / erythema marginatum / pancarditis
Arthralgia migrates 
Erythema marginatum rash 
Watch out for RHD
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15
Q

Still’s Disease or JIA

A 
Toddler 
Fever spikes 
Salmon pink rash 
arthralgia not a big issue 
Potential multi organ 
Watch out for: growth failure
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16
Q

Differentials for arthralgia with NO rash - 4

And what must you rule out?

A

Perthes
SUFE
OSD - osgood Schalter Disease
OCD - osteochondrosis dissecans

must rule out SARCOMAS

17
Q

Perthes presentation

A 
Younger child, 
not obese
with/out prior transient synovitis 
insidious presentation 
XR: flattened femoral head
18
Q

Slipped upper femoral epiphysis presentation

A

Older child
obese
Presents acutely, but also with chronic features
XR: ice-cream slipping off cone

19
Q

Osgood Schalter Disease

A

older child
not obese, very active
acutely presents with tibial tuberosity Sx
XR: fragmentation of tibial tuberosity

20
Q

Osteochondrosis dissecans

A

Older child,
not obese, very active
vague knee pain with activity
XR: fragmentation

21
Q

Four syndromic neuro mimickers

A

Spinal muscular atrophy
Duchenne Muscular Dystrophy
Ataxia telangiectasia
Friederich’s ataxia

22
Q

Spinal muscular atrophy

A 
different types - but infantile 
Autosomal recessive 
Floppy baby 
Respiratory issues 
Paradoxical chest breathing
23
Q

Duchenne muscular dystrophy

A 
Young child 
X-linked recessive (more boys)
Walking issues 
Gower's sign - tripod backward hand walking
Calf pseudo-hypertrophy 
Dilated cardiomyopathy 
with/out ID
24
Q

Ataxia telangiectasia

A 
young child 
Autosomal recessive 
cerebellar signs 
telangiectasia 
recurrent infections 
Associated with leukaemia lymphoma
25
Q

Friederich’s ataxia

A 
Older child 
Autosomal recessive 
Cerebellar 
Motor 
Proprioception loss 
Hypertrophic cardiomyopathy 
Diabetes

Paediatric Y4 (10 decks)

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