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Paediatrics > MSK > Flashcards

MSK Flashcards

1
Q

Causes of septic arthritis

A

Common <2 y/o

Usually due to haematogenous spread but also due to puncture wounds

Staph aureus

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2
Q

S+S septic arthritis

A

Red, warm, tender joint Reduced range of movement Joint effusion

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3
Q

Pathology of DDH + which hip is more common, what % is bilateral?

A

Congenital dislocation of the hip

Acetabular dysplasia can cause it

Left more common

20% are bilateral

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4
Q

Test for DDH + when its screened for

A

Barlows (posterior dislocation) Ortolanis (relocation)

Newborn exam + screening at 6-8 weeks

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5
Q

RF for DDH + long term complications

A

Breech

+FHx

Girls

Oligohydraminos

More common in cultures that swaddle

Complications: OA + lower back pain

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6
Q

S+S DDH

A

Asymmetry of skin folds Limp or abnormal gait

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7
Q

Management of DDH + risks of surgery

A

Most stabilise spontaneously by 2-6 weeks - so USS at 6-8 weeks

USS - infant placed in harness/ brace (Pavlik harness) to keep hip flexed + abducted - worn full time for 6 weeks

If over 6 months: need surgery: closed reduction + spica casting

Surgery is 2nd line after bracing

Risks of surgery: re-dislocation, stiffness + avascular necrosis

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8
Q

What is irritable hip?

A

Follows viral infection

Sudden onset pain in hip or limp

Decreased ROM: internal rotation + abduction affected

Child doesn’t appear to be ill

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9
Q

What is reactive arthritis?

A

Caused by enteric bacteria + viral infections

Transient joint swelling of ankles or knees

Usually follows infection

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10
Q

What is juvenile idiopathic arthritis + the types?

A

Persistent joint swelling >6 wks before 16 y/o Polyarthritis >4 joints (any age, symmetrical) Oligoarthritis <4 joints (young children, muscle wasting, antinuclear Ab positive)

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11
Q

S+S JIA

A

Gelling (stiffness after rest) Morning joint stiffness Pain Intermittent limp

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12
Q

What is Stills?

A

Systemic JIA Pre-school children, generally unwell, high fever, splenomegaly + lymphadenopathy Salmon pink rash, high CRP

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13
Q

Complications of JIA

A

Chronic anterior uveitis Growth failure Osteoporosis

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14
Q

Management of JIA

A

NSAIDs Methotrexate weekly Systemic corticosteroids Cytokine modulators

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15
Q

Causes of acute painful limp in 1-3 y/o

A

Septic arthritis Transient synovitis Leukaemia Neuroblastoma

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16
Q

Causes of acute painful limp in 3-10 y/o

A

Transient synovitis Septic arthritis Perthes disease JIA Leukaemia

17
Q

Causes of acute painful limp in 11-16 y/o

A

Slipped capital femoral epiphysis Necrosis of femoral head Reactive arthritis JIA Septic arthritis Bone tumours

18
Q

Causes of chronic/ intermittent limp in 1-3 y/o

A

DDH Talipes JIA Cerebral palsy

19
Q

Causes of chronic/ intermittent limp in 3-10 y/o

A

Perthes Duchenne’s JIA

20
Q

Causes of chronic/ intermittent limp in 11-16 Y/O

A

SIipped femoral epiphysis JIA

21
Q

What is Perthe’s disease?

A

Avascular necrosis of femoral head due to interruption of blood supply

Followed by revascularisation + reossification - abnormal none growth

Misshapen femoral head

Presents with insidious limp

22
Q

What is a slipped femoral epiphysis + how does it present?

A

Displacement of femoral head postero-inferiorly

Presents with acute limp/ hip pain

Can follow minor trauma or be insidious in onset

23
Q

Patient unwell with acute limp: what investigations to do?

A

Bloods

USS or X ray

24
Q

Describe transient synovitis

A

Acute onset hip pain +- refusal to weight bear

No pain at rest

Child otherwise well - commonly toddlers

Preceded by URTI

Treat with rest + analgesia

Resolves in 2 weeks

Effusion + thickening around joint = inflammation

25
Q

RF for Perthe’s

A

Boys

Caucasian

Low birth weight

4-10 y/o

+FHx

26
Q

Presentation + investigations for Perthe’s

A

Hip/ knee pain + effusion

12% bilateral

X ray = joint widening (early) + femoral head collapse (late)

MRI may be needed

27
Q

Management of Perthe’s

A

Children <8 or bone age <6 = conservative (physio + strengthening)

Fails: surgery = proximal varus osteotomy

Surgery if >6y/o

28
Q

Management of slipped femoral ephiphysis + complications

A

Immediate bed rest + analgesia

Surgical closure of epiphysis - percutaneous screws

Complications: chondrolysis + avascular necrosis

29
Q

Types of slipped femoral epiphyseal?

A

Pre slip = wide epiphyseal line, no slippage

Acute = sudden slip, usually spontaneous

Acute on chronic = acute pain on chronic slip

Chronic = progressively worse

30
Q

RF for slipped femoral epiphysis?

A

Obesity

Pelvic RT

Trauma

Hypothyroidism

10-17

Males

31
Q

Describe Osgood Schlatters disease

A

Pain + swelling below knee, worse in active children

Happens during growth spurts - muscle grows faster than bone

32
Q

Describe Marfans disease

A

high arched palate, tall + thin, arachnodactyly (abnormally long fingers + toes), aortic regurg, dilatation + aneurysms

33
Q

What does Reiters syndrome cause?

A

urethritis, conjunctivitis, arthritis

34
Q

Describe rheumatic fever

A

group A strep causing vasculitis (arthritis, carditis, chorea, skin changes, rashes, high CRP + ESR) treat with Pen V

35
Q

Describe osteomyelitis

A

Infection of the bone - commonly long bones

36
Q

Describe osteochondritis

A

Inflammation of cartilage or bone

Paediatrics (19 decks)

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