Paeds - normal growth + dev

Question 1

normal knee position:
neonate
1.5 yo
2.5 yo
older

Answer 1

varus > straight > valgus > 6 degrees valgus

Question 2

bones grow longitudinally from __ by __

and circumferentially from __ by

Answer 2

long = physis - enchondral ossification
circum = periosteum - appositional growth

Question 3

cant see hip on xray until ___ old as femoral heads are mostly __

Answer 3

6 months

cartilage

Question 4

at growth plates in kids:

rows of ___ > ___ > die > ___ lay bone > calcification

Answer 4

proliferating cartilage
hypertrophy
osteoblasts

Question 5

physes that grow most

Answer 5

proximal humeral
distal ulnar and radial
knee

Question 6

short stature is defined as ___ below mean for age

Answer 6

2SD

Question 7

normally lose primitive reflexes between ages _-__

Answer 7

1-6months

Question 8

genu varum is normal in which age group

Answer 8

<2yo

Question 9

abnormal features of genu varum in children

Answer 9

unilateral (asymmetry >5 degrees)
>2SD/16 degrees from mean
short stature
painful

Question 10

possible causes of pathological genu varum in children

Answer 10

skeletal dysplasia
rickets
tumour eg enchondroma
Blounts
trauma to physis

Question 11

growth arrest of medial tibial physis that causes genu varum =

Answer 11

Blounts

Question 12

bird beak protrusion on xray of tibia

Answer 12

Blounts

Question 13

signs that genu valgum is abnormal

Answer 13

asymmetrical
painful
>2SD from mean

Question 14

causes of pathological genu valgum

Answer 14

tumours (enchondroma, osteosarcoma)
rickets
neurofibromatosis
idiopathic

Question 15

4 possible causes of in toeing/ pigeon toed

Answer 15

femoral neck anteversion
internal tibial torsion
metatarsus adductus
combination

Question 16

sit in W position =

Answer 16

femoral neck anteversion => increased hip internal rotaion

Question 17

internal tibial torsion usually presents age - and most resolve by __

Answer 17

1-3months

6yo

Question 18

femoral neck anteversion => increased

Answer 18

hip internal rotation

Question 19

metatarsus adductus is benign/malig?

if doesnt resolve then Rx option =

Answer 19

benign

serial cast at 6-12m

Question 20

at birth usually flat footed but develop __ arch as ___ strengthens

Answer 20

medial

tibialis posterior

Question 21

causes of flexible flat feet

Answer 21

ligament laxity

gastrocsoleus tightness

Question 22

2 assessments carried out if have flexible flat feet

Answer 22

calf tightness (flex knee to relax gastroc)
hypermobility - Beighton score out of 9

Question 23

cause of rigid flat feet

Answer 23

tarsal coalition

Question 24

toes most commonly affected by curly toes =

most resolve by age _

Answer 24

3rd and 4th

6yo

Question 25

anterior knee pain in adolescence is more common in F/M
must check __ and get __
Rx =

Answer 25

F
hips!
radiographs
physio - most resolve