22 - Bone and Joint Problems of Children Flashcards
(55 cards)
How do children with a musculoskeletal problem usually present
With a limp
usually the lower limb
What usually causes problems with musculoskeletal in children
They are still growing
bones can bend
epiphyseal growth plates open
What does the fat pad develop into as an infant grown
Medial longitudinal arch
What is flat feet
when the medial longitudinal arch does not develop
What are the reasons for flat foot
Misshapen bones
Muscle imbalance - dorsiflexors are weak
How does a child with flat foot present
Ankles look like they are ‘weak’ as they turn inwards
Treatment for flat foot
Orthodics - insoles to reshape the growing bones
Surgery - to reshape bone
What can habitual toe walking lead to
Shortening of the muscles of plantar flexors
By what age to infants usually grow out of toe walking
Age 2
What can be a cause for persistant toe walking in older children
Cerebral palsy
DMD
NS problems
Treatment for toe walking
Casting the foot + ankle for 6 weeks to stretch the calf muscle Physiotherapy Surgery (to stretch the tight plantarflexors)
What is club foot know as
Talipes equinovarus
What is the cause of club foot
Calf underdevelopment
Too much/too little amniotic fluid constraining the baby into that position in utero
What would happen to the infant if not treated for club foot
As the sole of the foot is inverted the child would walk on the side of their foot
What is club foot associated with
Breech position
Ehlers Danlos
Genetic syndromes ie edward’s
Treatment of club foot
Ponseti method - uses a cast to correct as bone is still mouldable
How long do you use the ponseti method for club foot
use the brace for 12 weeks
every night till 4 y/o
What can cause Congenital Hip Dysplasia
Breech postion
Sign of CHD in a baby
Extra creases as the head of the femur is not in the acetabulum - higher in the illiac crest
Clinical implication of CHD
Shortens the leg
What is the Galeazzi sign
Bend the knees to see which is shorter
Barlow test
Adduct and push down the baby to try and dislocate the hip
Ortolani test
Abduct hip to try relocate the hip
Push femur into acetabulum
What would you see in an ultrasound of a baby with CHD
The gluteal muscles are pushed more vertically (look like they’re standing)
