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YR3S2- PM4 > wk 7- radiology paeds > Flashcards

wk 7- radiology paeds Flashcards

1
Q

important to note about the first proximal phalanx

A

the ossification centre is divided into two and can be misinterpreted as a fracture on radiographs

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2
Q

os subfibulare

A

below the lateral mall

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3
Q

os trigonum

A

posterior aspect of talus

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4
Q

accessory navicular or os tibiale externum

A

dorsomedial aspect of navicular and lies within tibial tendon

affects 10-15% of children- most common accessory ossicle

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5
Q

types of accessory navicular

A

type 1- 30%
5mm proximal to navicular tuberosity and 2-4mm in diameter

type 2- 50-60%
attached to navicular tuberosity by fibrocartilage synchondrosis (around 11mm diameter, triangle or heart shaped)

type 3- 10%
prominent navicular tuberosity- fused type 2
can be associated with PT dysfunction

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6
Q

os peroneum

A

in tendon of peroneus longus and seen in the oblique view of the foot

associated with osseous frcition to cuboid and peroneus longus dysfunction

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7
Q

what is clubfoot deformity

A

3 dimension deformity

rearfoot equinas- lateral talocalcaneal angle <35deg

rearfoot varus - talocalcaneal angle <20deg

forefoot metatarsal adductus- talus to first met angle is >15deg

also known as talipes equinovarus

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8
Q

whats the difference between metatarsus adductus and clubfot

A

MA- the talus and calc are normal but there is medial deviation of forefoot

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9
Q

whats the difference between skew foot and club foot

A

skew- ADDuction of forefoot, abduction of midfoot, valgus rearfoot

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10
Q

how is coalitions best viewed on radiograph

A

45deg oblique view

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11
Q

what findings would you have on a radiograph of canceonavicular coalition

A

osseous bar
eburnation or sclerosis
elongation of anterior calc process

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12
Q

what is the most common coalition

A

calcaneonaviuclar

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13
Q

what coalition has worse symptomology

A

talocalcaneal

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14
Q

what is talocalcaneal coalition

A

bar of fibrous, cartilage or osseous tissue between the middle facet of the calc and talus

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15
Q

radiographic findings of talocalcaneal coalition

A

-failure to visualise STJ
-talar beaking
-narrowing of posterior STJ
-concave undersurface of talar neck
-C sign, continuous c shaped arc on lateral ankle graph (however note that this can be seen in flat foot deformity with no coalition)

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16
Q

juvenille hallux valgus what measurements are used to assess

A

3 measurements

1st met angle <20->40 (mild-sev)
line down 1st met and great toe

1-2 intermet angle <11 - >15 (mild-sev)
line down 1st met and 2nd met

seasamoid position/migration 50%0>75% (mild-sev)
across 1st met

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17
Q

what do osteochondroses affect

A

epiphysis- end portion of long bone contributing to the joint
and
apophysis- part of the epiphysis and is the site of tendon or ligament attachment

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18
Q

do osteochondroses include apophysitis/apophysitides

A

yes

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19
Q

underlying pathogenesis of osteochondorses

A

disruption to vasuclar supply of involved area of epiphyseal cartilage
focal ischemia leads to failure in the ossification and abnormal epiphysis

20
Q

classifying osteochondroses through

A

non articular (tension)
articular (compression)
and physeal

21
Q

what classification is kohlers

A

articular/compression

22
Q

what classification is freibergs

A

articular, compression

met head collapse (typically the 2nd met)

23
Q

what classification is os goods schlatters

what is it and who is it common in

A

non articular, tension

traction apophysitis of tibial tubercle

common in jumping/high impact shorts for kids going through growth spurt

24
Q

what classification is legg calve perthes

A

articular, compression

lack of blood supply to head of femur

25
Q

what classification is slipped capital epiphysis

what is it and who does it present in

A

articular, compression

damage to growth plate which causes head of femor to slip

can present as a limp in children

26
Q

diaz/ mouchets site is (OC)

A

talus/talar dome

27
Q

treves/ ilfleds site is (OC)

A

sesamoids

28
Q

thiemann’s site is ( osteochondroses)

A

phallanges

29
Q

are osteochondroses self limiting

A

yes, immobilise to allow for healing

30
Q

kohler affects what bone, what age, symptoms, feature on x ray

A

navicular around age 5

symptoms:tenderness, swelling, decreased ROM, redness

gait with limp or refusal to weight bear

navicular is small on radiograph due to AVN

31
Q

treatment for kohlers

A

resolves over time usually

NSAIDS to manage pain
short period of non weight bearing cast or CAM walker immobilisation

32
Q

sever’s disease is, what age range is it common in

A

calcaneal apophysis

most common OC in children, presents typically in boys
8-14 years

heel pain

33
Q

treatment for severes disease

A

linear heel raise to reduce tensile stress

34
Q

freiberg is

A

met head (2-4th)

35
Q

siffert, arkin is

A

distal tibial epiphysis

36
Q

lesson, weiner is

A

cuneiforms ossification

37
Q

what causes osteochondroses

A

multifactorial

trauma
hereditary
diet / bone health
growth plate timing
anatomy of area
biomechanical function
vascular events

38
Q

what do u need to rule out with OC

A

stress fractures/reactions
tumours
infections

39
Q

iselins disease is what
common in what age

A

traction of apophysitis at the base of the 5th met

age 10-14 years

x ray usually required to rule out accessory bones or frature/avulsion

40
Q

treatment for iselins disease

A

rest

NSAIDS for pain relief at the start

stretching of calf and lateral shin muscles

heel raise to reduce stress

if these dont work than immobilisation in CAM for short period until pain has decreased

41
Q

friebergs infarction

A

AVN due to trauma, compressive

age 12-15 years

42
Q

radiography of friebergs infarction

A

flattening of articular head (most commonly 2nd)

43
Q

friebergs classification (bragard staging)

A

stage 1- met head flattening decreased bone density

2- met head sclerosis, fragmentation, deformation, cortical thickening

3- MTP OA with loose bodies

44
Q

treatment for friebergs infarction

A

rest
NSAIDs

immbolisation if hasnt decreased pain

surgery may be considered in advanced stages

45
Q

vertical talus

A

talipes convex pas valgus

rearfoot valgus and equinas, midfoot dorsiflexion and forefoot abduction due to fixed dorsal dislocation of the navicular on the talar head

bulbous heel morphology

looks similar to club foot

46
Q

treatment for vertical talus

A

stretching/manipulation
bracing/ serial casting

surgery of bones moved/pinned in correct place and tendons and ligaments lengthened where appropriate

YR3S2- PM4 (12 decks)

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