MSK Children - General Assessment

Question 1

what must be checked for before any child with an MSK complaint leaves a consultation 7

Answer 1

acronym TIM

-Tumour
-Trauma (incld non-accidental injury (NAI))

-Infection
-inflammation

-Mechanical
-Muscle disease
-Metabolic

Question 2

what must be assessed in an MSK exam 6

Answer 2

joints - as in OSCE REMS examination techniques

also:
Bone palapte for tenderness/ massess

Muscles - weakness (painless or painful), a mass, loss of function

Gait- age approrpiate assessment

-Funcional and dvelopmental assessment

-Nerves -Neuro exam

Question 3

two main cell types in bone

Answer 3

osteoblasts

osteoclasts

Question 4

function of osteoblasts 2

Answer 4

-produce a matrix of osteoid composed of type 1 collagen

responsible for mineralisation of the matrix

Question 5

type of collagen produced by osteoblasts

Answer 5

type 1 collagen

Question 6

function of osteoclasats

Answer 6

remodel tissue by bone resorption

removes bone tissue by removing mineralised matrix and breaking up organic bone

Question 7

what do long bones in children consist of 5

Answer 7

shaft

diaphysis

proximal
and
distal metaphysis
(each is separated from the epiphysis by the growth plate(physis) )

Question 8

how can bone age in a child be assessed

Answer 8

can be estimated by the radiological features on a plain wrist radiograph

-becuase of consistently reproducible squence of ossification of the hand and wrist bones

Question 9

types of joints 3

Answer 9

fibrous

cartilaginous

synovial

Question 10

example of fibrous joint 1

Answer 10

sutures of skull

Question 11

examples of cartilagious joints1

Answer 11

symphysis pubis

Question 12

examples of synovial joints 1

Answer 12

most skeletal joints

Question 13

what are synovial joints covered with

Answer 13

hyaline cartilage

Question 14

what is the joint space in synovial joints covered in

Answer 14

synovium

Question 15

what do synvoial joints produce

Answer 15

synovial fluid

Question 16

what does inflammation fo teh synovium cause 3

Answer 16

excessive production of synovial fluid

inreased cellularity

altered cytokines

-this enviroment is destructive of the first hyaline cartilage and then the underlying bone

Question 17

define the enthesis

Answer 17

point of insertion of a tendon ligament fascia or joint capsule into bone

Question 18

examples of mechanial stress at the enthesis 2

Answer 18

plantar fascitis

achilles tendonitis

Question 19

examples of growth related injury to the enthesis 1

Answer 19

osgood schlatters disease

Question 20

example of inflammatory stress to the enthesis 1

Answer 20

HLA B27 related plantar fascitis

Question 21

define gowers sign

Answer 21

use of hands to split legs to hem rise from seated

Question 22

what is gowers sign seen in

Answer 22

shows weakness
-classically in DMD

0can be seen ina ny condition with muscle weakness

Question 23

MSK features in children 7

Answer 23

pain

stiffness

swelling or mass

warm

deformity

loss of function

developmental delay or regression or loss of milestones previously acheived \