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M3 ORTHO > Pediatric Orthopedics > Flashcards

Pediatric Orthopedics Flashcards

1
Q

What is a sternomastoid tumour

A

Congenital muscular torticollis

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2
Q

Describe Osgood-Schlatters Disease+ common management

A

A tibial apophyseal stress lesion, an avulsion of the tibial tubercle due to stress from knee extension, presenting as anterior knee pain with an enlarged tibial tubercle. NSAIDs and activity mod. usually sufficient

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3
Q

How to classify a limping child

A

Painless: DDH
Painful: Perthes, SCFE, Septic arthritis, Transient synovitis

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4
Q

Risk factors for DDH

A

Female
First child
Fetal presentation: Breech
FHx
Fluid inflex: Oligohydramnios

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5
Q

Features of DDH

A

Patient >3/12 old
Limb Length Discrepancy on Galleazzi
Restricted Abduction
Abnormal skin creases
Waddling/Trendelenberg gait

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6
Q

“Packing disorders” a/w DDH

A

Congenital muscular torticollis
Metatarsus Adductus
Talipes Calcaneovalgus

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7
Q

Mx of DDH

A

Conservative: Pavlik Harness: Abduct and flex the hip for reduction

Surgical: Open reduction and soft tissue release

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8
Q

Main ddx for limping child in pre,primary and sec sch

A

Pre: Transient synovitis
Pri: Perthes
Sec: SCFE

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9
Q

What is Perthes disease

A

Idiopathic avascular necrosis of proximal femoral epiphysis in children resulting in remodelling and deformation of femoral head

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10
Q

Radiologic signs of AVN in children

A

Increased radiolucency of bone

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11
Q

Most common demographic for Slipped Capital Femoral Epiphysis

A

Adolescent obese males

Malays at increased risk

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12
Q

PE sign for SCFE

A

Drehmann sign: Obligatory external rotation on flexion of hip

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13
Q

Radiological lines to look for in SCFE

A

Klein line and Trethowan sign

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14
Q

Complication that may be caused by grade 3 SCFE

A

Avascular necrosis

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15
Q

What to suspect in bilateral SCFE

A

Endocrinopathies: Hypothyroidism, Cushing’s, Gigantism, Obesity

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16
Q

Radiological lines to look for in DDH

A

Hilgenreiner’s and Shenton’s line

17
Q

What is Blount’s disease

A

Progressive Pathological Genu Varum of the knee, centered at Tibia

18
Q

Causes of Rickets

A

Nutritional deficiency
Absorption problems?
Renal tubule defects

19
Q

Common description of club foot

A

Forefoot adducted
Midfoot cavus
Hindfoot varus
Heel equinus

20
Q

Mx of club foot

A

Conservative: Ponseti Casting

Surgical: Percutaneous osteotomy

21
Q

Scoring for ligamentous laxity

A

Beighton’s

22
Q

Ddx for positive Galleazzi in infant

A

Congenital: DDH, Perthes, SCFE
Traumatic: fx
Cancer: Osteosarcoma
Infection: Septic arthritis
Syndromes: CP,SMA, Polio

23
Q

Blood supplies to the femoral head

A
  1. Medial femoral circumflex(MAIN)
  2. Ascending branch of lateral circumflex
  3. Branch of obturator artery
24
Q

Important things for Hip XR for perthes

A
  1. Shenton Line
  2. Hilgenreiner line
  3. Perkin line
  4. Acetabular index
25
Q

Order of onset of paeds ortho hip condition

A

DDH earliest, Perthes, SCFE latest

26
Q

Risk factors for SCFE

A
  1. Obesity
  2. Male
  3. FHx
  4. Endocrinopathy
27
Q

Mx of SCFE

A

Percutaneously inserted cannulated screw for epiphyseal fixation

28
Q

Mechanism of SCFE

A

Slippage at the zone of hypertrophy at the femoral head

29
Q

Cx of SCFE

A
  1. Hip AVN
  2. Coxa vara
  3. Femoral acetabular impingement
  4. Early OA of hip
30
Q

Presentations of SCFE

A
  1. Pain at hip or knee
  2. Limping child
  3. Out toeing gait
31
Q

SCFE findings on PE

A
  1. Shortened limb if unilateral
  2. Obilgatory ext rotation during hip flexion
  3. Limited int rotation
  4. Limited int rotation, abduction, flexion
  5. trendelenburg gait
32
Q

Lines and findings on Hip XR for SCFE

A
  1. Klein’s line
  2. Trethowan sign: Klein’s line does not intersect the lateral epiphysis
33
Q

Key Mx of Perthes Disease

A

Petrie casting and surgical osteotomy

34
Q

Mx of Congenital Muscular Torticollis

A

Passive stretching exercises exercises KIV surgical lengthening of SCM (if deformity > 1yr)

35
Q

Mx of SCFE

A

Percutaneously inserted cannulated screw

36
Q

Causes of intoeing gait

A
  1. Metatarsus adductus
  2. Tibial torsion
  3. Femoral anterversion
37
Q
A

M3 ORTHO (10 decks)

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