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MSK > Pediatric MSK disorders > Flashcards

Pediatric MSK disorders Flashcards

1
Q

________= apex of angulation away from midline

A

varus

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2
Q

________ = apex of angulation towards midline

A

valgus

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3
Q

What are three causes of in-toeing in children

A
  1. from the foot: metatarsus adductus
  2. from the tibia: internal tibial torsion
  3. from the femur: femoral anteversion
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4
Q

What is metatarsus adductus?

A

medial angulation of the forefoot present at birth, can usually be corrected with manipulation on exam

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5
Q

When is surgery indicated for metatarsus adductus?

A

feet have enough deformity to cause problems wearing shoes

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6
Q

Though internal tibial torsion is very common at birth, it is usually not detected until ________

A

children begin walking

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7
Q

Internal tibial torsion and femoral anteversion are both likely due to ________ positioning

A

in utero

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8
Q

What is treatment for internal tibial torsion?

A

None, usually deteriorates by about age 5. Braces or bar and shoe devices to not speed up resolution

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9
Q

Children with femoral anteversion have significantly increased ______ rotation of the hip

A

internal

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10
Q

Femoral anteversion usually resolves by about age ____

A

10

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11
Q

When is surgery indicated for internal tibial torsion?

A

continuing to cause tripping after 8 yrs old

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12
Q

When is surgery indicated for femoral anteversion?

A

causes “miserable malalignment syndrome” with anterior knee pain

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13
Q

Describe the normal progression of sagittal plan development of the lower extremities

A
  • varus/ bowlegged at birth
  • valgus/ knock kneed by about 3 years
  • relatively straight adult alignment by about 6 years
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14
Q

Guided growth therapy requires detection of abnormalities before puberty and an open ______

A

physis

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15
Q

Describe guided growth surgery

A

the growth plate is tethered on the convex side, allowing the concave side to continue to grow until the leg is straight

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16
Q

_______ is a pathologic bowing of the lower extremity resulting from varus of the tibia

A

Blount disease

17
Q

What causes Blount disease?

A

compressive forces on the medial portion of the proximal tibia causing inhibition of physeal growth in an asymmetric fashion

18
Q

What children are at risk for Blount disease?

A

heavy toddlers
early walkers
additional internal tibial torsion

19
Q

What is the treatment for Blount disease?

A
  • bracing to attempt to decrease medial tibial forces and promote normal growth
  • may require surgery to re-align tibial and rebalance forces across the growth plate
20
Q

What is the treatment for Blount disease?

A
  • bracing to attempt to decrease medial tibial forces and promote normal growth
  • may require surgery to re-align tibial and rebalance forces across the growth plate
21
Q

How is “adolescent” Blount disease different from the infantile form?

A
  • presents later
  • treated with guided growth, bracing is not effective
  • due to obesity
22
Q

What are two pathologic processes that should be considered in a child with leg bowing?

A

rickets, bone dysplasia

23
Q

Scoliosis is due to asymmetric growth of the ____ spine relative to the _____ spine

A

anterior vs posterior

24
Q

Scoliosis is due to asymmetric growth of the ____ spine relative to the _____ spine

A

anterior vs posterior

25
Q

What are the proposed etiologies of scoliosis?

A

genetics
hormonal influences including melatonin
structural deficiencies- fibrillin, elastin, collagen

26
Q

Left untreated, spinal curves in scoliosis progress at what rate?

A

about 1 degree per month

only the most severe curves continue after skeletal maturity

27
Q

Severe curves in scoliosis can cause _________ compromise

A

cardiorespiratory

28
Q

What is the treatment for scoliosis?

A

bracing

surgical straightening and spinal fusion

29
Q

The risk of _______ of scoliosis is highest in children who develop scoliosis before age 10.

A

progression

30
Q

A foot arch develops in most children by about ____ years old

A

8

31
Q

Are orthotics helpful in development of foot arch in children?

A

NO

actually barefoot is best

32
Q

Clubfoot includes four deformities:

A

metatarsus adductus, cavus (high arch), hindfoot varus and equinus

MSK (25 decks)

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