Paeds - normal growth + dev Flashcards
normal knee position: neonate 1.5 yo 2.5 yo older
varus > straight > valgus > 6 degrees valgus
bones grow longitudinally from __ by __
and circumferentially from __ by
long = physis - enchondral ossification circum = periosteum - appositional growth
cant see hip on xray until ___ old as femoral heads are mostly __
6 months
cartilage
at growth plates in kids:
rows of ___ > ___ > die > ___ lay bone > calcification
proliferating cartilage
hypertrophy
osteoblasts
physes that grow most
proximal humeral
distal ulnar and radial
knee
short stature is defined as ___ below mean for age
2SD
normally lose primitive reflexes between ages _-__
1-6months
genu varum is normal in which age group
<2yo
abnormal features of genu varum in children
unilateral (asymmetry >5 degrees)
>2SD/16 degrees from mean
short stature
painful
possible causes of pathological genu varum in children
skeletal dysplasia rickets tumour eg enchondroma Blounts trauma to physis
growth arrest of medial tibial physis that causes genu varum =
Blounts
bird beak protrusion on xray of tibia
Blounts
signs that genu valgum is abnormal
asymmetrical
painful
>2SD from mean
causes of pathological genu valgum
tumours (enchondroma, osteosarcoma)
rickets
neurofibromatosis
idiopathic
4 possible causes of in toeing/ pigeon toed
femoral neck anteversion
internal tibial torsion
metatarsus adductus
combination
sit in W position =
femoral neck anteversion => increased hip internal rotaion
internal tibial torsion usually presents age - and most resolve by __
1-3months
6yo
femoral neck anteversion => increased
hip internal rotation
metatarsus adductus is benign/malig?
if doesnt resolve then Rx option =
benign
serial cast at 6-12m
at birth usually flat footed but develop __ arch as ___ strengthens
medial
tibialis posterior
causes of flexible flat feet
ligament laxity
gastrocsoleus tightness
2 assessments carried out if have flexible flat feet
calf tightness (flex knee to relax gastroc) hypermobility - Beighton score out of 9
cause of rigid flat feet
tarsal coalition
toes most commonly affected by curly toes =
most resolve by age _
3rd and 4th
6yo
anterior knee pain in adolescence is more common in F/M
must check __ and get __
Rx =
F
hips!
radiographs
physio - most resolve
