Bone and joint problems in children Flashcards
When are flat and club foot present
At birth
When is Perthe’s disease seen
4-8
When is SUFE seen
11-16
When is toe walking seen
When child starts walking
Why are children prone to musculoskeletal
Skeleton softer, growing, epiphyseal growth plates can slip
Are musculoskeletal conditions seen more in girls or boys
Boys (growth spurts mean bone and cartilage growth isn’t matched)
Do childrens musculoskeletal problems more commonly affect upper or lower limb
Lower
Why may arch not fully develop in the foot
- Mishapen bones can’t form arch
- Muscle imbalance (weak dorsiflexors so arch collapses)
How may flat foot be tended
Surgery to tighten tendons/ ligaments
Orthotics to mould the foot into more normal shape
By what age should toe walking disappear
Age 2
What are the consequences of habitual toe walking
Shortened plantar flexors
What may persistent toe walking be linked to in older children
Cerebral palsy
Nervous system problems
DMD
How may toe walking to treated?
- Put child in braces to cast foot and ankle to stretch out calf muscles
- Physiotherapy
What is the clinical name for club foot
Talipes equinovarus (looks like a horses hoof and points inwards)
How many babies are born with club foot
1 in 1000
Why is club foot thought to happen
Wrong amount of amniotic fluid, so baby can’t move legs and feet are constrained
What presentation in club foot associated with
Breech (baby can’t turn)
How is club foot treated
Ponseti method: manipulative technique to correct clubfoot without invasive surgery
Which sex is congenital hip dysplasia seen in
Female
What skeletal disorders is congenital hip dysplasia seen in
Clubfoot
Scoliosis
What is the Galeazzi sign
Look at the height of the knee- one will be shorter if hip is dislocated
Only works if unilateral
What is the Barlow test
Adduct and push downwards to try and dislocate hip
Diagnostic of ddh
What is the ortolani test
Abduct hips to try and relocate the hip
Fingers push femur forward into acetabulum
How is ultrasound used to interpret developmental dysplasia of the hip
Measure the alpha angle
It should be less than 60
