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Paediatrics > Musculoskeletal > Flashcards

Musculoskeletal Flashcards

1
Q

What is the likely Dx for a teenage girl that has anterior knee pain that is worse on rising after prolonged sitting, and when going up and down stairs?

A

Chondromalacia patellae

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2
Q

What is the likely Dx when a child has medial knee pain and their knee occasionally gives way?

A

Patellar subluxation

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3
Q

What is the likely Dx when a child has pain in their knee after exercise and their knee tends to lock?

A

Osteochondritis dissecans

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4
Q

Where is the tenderness in Osgood-Schlatter disease?

A

Tibial tubercle

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5
Q

What are the RFs for DDH?

A
  1. F
  2. Breech
  3. FHx
  4. First-born
  5. BW >5kg
  6. Oligohydramnios
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6
Q

In which hip is DDH more common?

A

L hip

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7
Q

By what age will DDH probably stabilise?

A

3-6 weeks of age

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8
Q

What are the features of a HxPC of growing pains?

A
  1. Never present on waking
  2. No limp
  3. No limitation of movement
  4. Systemically well
  5. Normal O/E
  6. Motor milestones normal
  7. Sx worse after a day of activity
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9
Q

What are the possible causes of a painful limb?

A
  1. Osteomyelitis
  2. Septic arthritis
  3. Fracture
  4. Sickle cell disease
  5. Bone tumours
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10
Q

Where is the infection in osteomyelitis?

A

Metaphysis of long bones

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11
Q

What are the most common sites of osteomyelitis?

A
  1. Proximal tibia

2. Distal femur

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12
Q

How does osteomyelitis usually spread?

A

Haematogenous spread

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13
Q

What are the causative pathogens of osteomyelitis?

A
  1. S.aureus (mostly)
  2. Streptococcus
  3. H.influenzae
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14
Q

What are the different fracture patterns?

A
  1. Plastic deformation (not technically a fracture)
  2. Buckle fracture
  3. Greenstick frature
  4. Complete fracture
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15
Q

Whom gets plastic deformations?

A

Children, unique to them - bone angulated beyond elastic limit, but energy insufficient to cause a fracture

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16
Q

In what bones may plastic deformations be seen?

A

Ulna, occasionally fibula

17
Q

Where are buckle fractures most commonly seen?

A

At the junction of the metaphysis and the diaphysis in the distal radius, usually caused by fall on an out-stretched hand

18
Q

What are the different types of complete fracture?

A

Spiral - created by rotational force
Transverse
Oblique

19
Q

How are physeal fractures classified?

A

Salter-Harris (SH) classification

20
Q

What is a SH Class I physeal fracture?

A

Transverse fracture through the growth plate, the epiphysis seperating from the metaphysis

21
Q

What is the most common SH classification of a physeal fracture?

A

SH Class II

22
Q

What is a SH Class II fracture?

A

Transverse fracture through the growth plate and an oblique or vertical fracture through the metaphysis

23
Q

What is a SH Class III fracture?

A

Transverse fracture through the growth plate and a vertical fracture through the epiphysis

24
Q

What is a SH Class IV fracture?

A

Vertical fracture through the metaphysis, physis and epiphysis

25
Q

What is a SH Class V fracture?

A

Compression/crushing fracture of the growth plate

26
Q

What are the complications of physeal injury?

A

Majority heal quickly and recover fully. BUT may cause growth disturbance/arrest, which can then result in deformity and impaired function

27
Q

What are the common causes of paediatric fractures?

A
  1. Child abuse
  2. Birth injury
  3. Rickets
  4. Osteomyelitis
  5. Copper deficiency
28
Q

What are the differentials for a limping child?

A
  1. Transient synovitis
  2. CDH
  3. Perthes disease
  4. SCFE
29
Q

What does SCFE stand for?

A

Slipped capital femoral epiphyses

30
Q

What is the most common cause of acute hip pain in children?

A

Transient synovitis

31
Q

What is the HxPC of transient synovitis?

A
  1. Accompanies/follows viral infection frequently
  2. Sudden onset
  3. No pain at rest
  4. Reduced ROM, esp. internal rotation
  5. Pain may be referred to the knee
32
Q

What is Perthes disease?

A

Avascular necrosis of the capital femoral epiphysis

33
Q

What is SCFE?

A

Displacement of the epiphysis of the femoral head posterio-inferiorly

34
Q

When is SCFE most common?

A

During the adolescent growth spurt, esp. in obese boys

35
Q

What is the most common causative organism of septic arthritis?

A

S.aureus (beyond the neonatal period)

36
Q

What are the complications of juvenile idiopathic arthritis (JIA)?

A
  1. Chronic anterior uveitis
  2. Flexion contracture of the joints
  3. Growth failure
  4. Constitutional problems - e.g. anaemia of chronic disease/delayed puberty
  5. Osteoporosis
  6. Amyloidosis

Paediatrics (27 decks)

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