Paeds pathology

Question 1

What are the three important clinical indication for paed hips?

Answer 1

1. DDH – Developmental Dysplasia of the Hips
   AKA CDH (congenital dislocation of the hip )
2. SUFE – Slipped Upper Femoral Epiphyses
3. Legg-Calve-Perthes: sclerotic & flattened epiphysis

Question 2

Define DDH

Answer 2

Developmental Dysplasia of the Hips
AKA CDH (congenital dislocation of the hip )
Subluxation (partial dislocation) of the hip

Question 3

Define osteochrondosis

Answer 3

decreased blood supply to the epiphysis of bone, resulting in degeneration followed by reossification of one or more ossification centers in children

Question 4

What are a group of diseases primarily affecting the epiphyseal or growth plates of long bones resulting in pain deformities and abnormal bone growth?

Answer 4

• Legg-Calve-Perthes (capital femoral epiphysis)
• Osgood-schlatter (tibial tuberosity)
• Scheuermann (vertebral ring epiphyses)
• Kohlers (tarsal navicular)
• Osteochondritis dissecans

Question 5

What happens during Legg-Calve-Perthes disease?

Answer 5

disintegration of capital femoral epiphysis. It is an idiopathic avascular necrosis (“osteochondritis”) of proximal femoral epiphysis

Question 6

What happens during Osgood-Schloatter’s disease?

Answer 6

Usually occurs in preteen & teenage boys.
It is often an overuse condition or injury of knee that causes pain & swelling distal to patella. inflammation of the patellar ligament at the tibial tuberosity.
Osgood-Schlatter is most common in young athletes who play games or sports that involve running & jumping.

Question 7

Kohler disease define

Answer 7

osteochondrosis of tarsal navicular

Question 8

Scheuermann disease define

Answer 8

decreased disc space, esp. Anteriorly irreg. vertebral endplates, +/- Schmorl nodes
Increased kyphosis
Scheuermann’s disease is considered to be a form of juvenile osteochondrosis of the spine. It is found mostly in teenagers and presents a significantly worse deformity than postural kyphosis. Patients suffering with Scheuermann’s kyphosis cannot consciously correct their posture. The apex of their curve, located in the thoracic vertebrae, is quite rigid

Question 9

osteomalacia

Answer 9

Insufficient mineralization of osteoid due to decreased Vitamin D.
osteopenia
bone softening/deformity: hourglass thorax, bowing of long bones
increased fractures, biconcave vertebral bodies
mottled skull
pseudofractures

Question 10

Osteogenesis Imperfecta

Answer 10

Genetic disorder of Type 1 collagen. Makes too little type 1 collogen -> bones break easily -> osteoporosis

Question 11

Talipes

Answer 11

Congential talipes equinovarus (or club foot) is a birth deformity of the foot (one or both feet), sometimes resulting from crowding in the uterus. In a clubfoot the bones in the front part of the foot are misaligned.

Question 12

3 types of fractures?

Answer 12

Buckle/Torus
Green stick
Fractures of epiphyseal plates are categorised by the Salter–Harris classification system

Question 13

What does SALTR stand for

Answer 13

Slipped, Above, Lower, Thru, Ruined

Question 14

From type 1 to Type 5 what parts of the bones are involved?

Answer 14

Type 1 = Physis (epiphyseal slip)
Type 2 = Metaphysis (fracture of metaphysis including the epiphyseal plate)
Type 3 - Epiphysis (fracture of the epiphysis extending through the epiphyseal plate)
Type 4 - Metaphysis and Epiphysis (fracture extending to both parts of the bone)
Type 5 - damage to the epiphyseal plate

Question 15

Osteochondritis Dissecans

Answer 15

Osteochondritis dissecans is a disorder in which a fragment of cartilage and subchondral bone separates from an articular surface. The knee is most commonly affected, but the elbow and ankle may also be involved