Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Locomotor > Bones & Joints: paediatrics > Flashcards

Bones & Joints: paediatrics Flashcards

(45 cards)

Start Studying
1
Q

When does the head control milestone usually begin and be complete?

A
  • 1 month

- 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When does the sit milestone usually begin and be complete?

A
  • 6 months

- 9 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

When does the stand milestone usually begin and be complete?

A
  • 9 months

- 12 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

When does the walk milestone usually begin and be complete?

A
  • 12 months

- 20 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the deformities children may have?

A 
Angular plane/ coronal:
-Bow legs
-Knock knees
Rotational plane:
-In/out toeing
=Femoral Torsion
=Tibial Torsion
=In the Foot
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the names for bow legs and knock knees?

A

Genu varum= bow legs

Genu valgum= knock knees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the normal change in coronal alignment in growth?

A

Natural bowed legs when born until walking
Walking= straight
2-3 years knock kneed appearance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

When does the normal gait pattern develop?

A

7 years
Alignment 6/7 degrees of valgus
Adulthood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How might apparent bow/ knock knees be misleading?

A
  • Apparent bowleg occurs when child stands with hips and knees flexed (external rotation)
  • Child lies down and extends hips and knees, legs are straight
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How does pathological forms of genu varum/ valgum present?

A

-Asymmetric
-Resistant to normal change
(rickets)
-Short stature
-Varus > 11 degrees (Blount’s)
-Trauma/ systemic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the treatments for coronal deformities?

A
  • Used to be observational, growth, osteotomy (reshape and plate)
  • Now Eight Plate guides growth, gentle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How does Eight Plates work?

A

Titanium plates, stiff, same stiffness as bone so bend with growth
-Apply to one side of growth plate to slow down on one side, correction in deformity as other side grows

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How does in/ out toeing in the rotational plane present?

A

-Clumsy
-Tripping/ limping
-“deformed”
-From femur, tibia, foot
(how leg rotates in length= foot position)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the angles considered in-toeing and out-toeing?

A

Out-toeing= above 15 degrees

In-toeing below 0 degrees

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is femoral anteversion?

A

-30 degrees
The angle of axis through the condyles
Fit into pelvis, turn hip in, guide to how much hip will internally rotate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How do we measure femoral anteversion?

A

Lie on front to estimate anteversion, leg/knee at 90%, internal hip rotation until feel prominent greater trochanter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the pathological forms of the rotational plane?

A
  • Excessive femoral anteversion

- External tibial torsion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the normal range of foot progression angle?

A

Max: +15
Ideal: +5
Min: -10 (+15/-15)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the normal range of thigh-foot angle?

Study These Flashcards
A

Max: +20-+30
Ideal: -3- +15
Min:-30 to-5
(+15/-15)

20
Q

What is the normal range of external hip rotation?

Study These Flashcards
A

Max: 90 to 55
Ideal: 65 to 38
Min: 45 to 25
(+15/-15)

21
Q

What is the normal range of internal hip rotation?

Study These Flashcards
A

Max: 60 to 55
Ideal: 40 to 43
Min: 15 to 20
(+15/-15)

22
Q

What is persistent in toeing?

Study These Flashcards
A
  • Baby= natural 50 degree anteversion, changes when walking (15 by 7)
  • Persistent femoral anteversion
  • Internal tibial torsion
  • Many resolve with growth/ remain asymptomatic
23
Q

What is miserable malignment?

Study These Flashcards
A

Combination of PFA and ext tib torsion can result in patellar instability
-Symptomatic/ knees

24
Q

What is the pathological form of out toeing?

Study These Flashcards
A

Femoral Retroversion

  • present from birth
  • Osteotomy
25
What are pathological problems in the foot?
Metatarsus Adductus -Medial curve of foot -Resolves completely with growth Club foot (CTEV) -Underdeveloped parts of world badly managed -Corrective surgery if not treated in childhood -Many casts gradually correct deformity (first cast unlocks foot into dorsal flexion), cut Achilles Flat foot (planovalgus) -Tip toes -Symptomatic only treatment= insoles -Subtalar implant (medial weight bearing)
26
Describe limping
- Common presentation in paediatric orthopaedics - Often atraumatic - 180/100,000
27
What is the normal gait in children in early walking?
``` Short stride length Fast cadence (number of steps per min) Low velocity Widened base of support -Until 30-36 months= poor balance and abductor strength so cannot maintain single leg stance -Mature gait age 7 ```
28
What causes a limp?
- Pain - Mechanical problem - Neuromuscular problem
29
Describe the age distribution of limping
``` 0-3= DDH (development dysplasia in hip) 3-6= Transient Synovitis 10-15= SUFE ``` 4-8= Perthes' 0-15= Tumours and Septic Arthritis= neuromuscular
30
What are the pain characteristics of a history of limping?
- Acute= trauma, infection - Constant= malignancy, chronic infection - Morning pain/ pain after inactivity= inflammatory joint disorders - Night pain= malignancy, osteoid osteoma, benign growing pains
31
What do we examine in limping?
- Gait - Spine - Asymmetry - Deformity - Swelling - Tenderness - Examine all joints - Rotational profile
32
What is Transient Synovitis?
Irritable hip Non-specific, short-term inflammatory synovitis with synovial effusion of the hip joint -Aspirate
33
What is the clinical presentation of Transient Synovitis?
- Painful hip/ thigh/ knee - Often associated with viral infection= immune response - Synovial fluid effusion - Hip held in flexion, lateral rotation and abduction - Exclusion of other conditions
34
What are the investigations for Transient Synovitis?
(Excluding Sepsis) - Full blood count - ESR, CRP - X rays- AP and frog lateral - Ultrasound - MRI, bone scan, etc
35
What is Developmental Dysplasia (DDH)?
- 1-5/1000 births - Hereditary influence - Breach after 32 weeks or Caesarean - 1st Born - Oligohydramnios - Female: male= 5:1
36
What do we see on examination in DDH?
-Barlow's= leg in flexion, push down on knee (brutal) until clunk -Ortolani= abduction until clunk (out hips) back into joint DISLOCATED HIPS -Skin crease asymmetry -Leg length discrepancy -Reduced abduction (cant do frog position)
37
How do we treat DDH?
``` Pelvic harness treatment Halter, Stirrups Anterior (Flexor) Stirrup-strap Posterior (Abduction) Stirrup-strap -Allows hip to sit down into position -3 months -Can need surgery ```
38
What is Perthes Disease?
- Avascular osteonecrosis of femoral epiphysis caused by poorly understood non-genetic factors - Boys> girls 4:1 - 4-8 years in majority - Lower social class= increased risk
39
What are the principles of Perthes Treatment?
- Prevention of stiffness - Contain femoral head in acetabulum - Surgical treatment required in certain circumstances - Outcome depends on how well femoral head remodels - Varus osteotomy
40
What is Slipped Upper Femoral Epiphysis (SUFE)?
- Males (3:1) 13-16 years - In females younger, not after menarche - Bilateral in 42% - Obese or tall and slender - Rapid growth - 7% risk of a 2nd family member involved
41
What are the clinical features of SUFE?
- Acute/ chronic/ Acute on Chronic - Pain groin, thigh, knee - Limp - Antalgic gait - Externally rotated and adducted limb
42
What are the red flags of examination?
- Neonate with painful paralysed looking arm or leg= septic arthritis/ infection - Asymmetry of spin or limbs= scoliosis/ DDH - School age child with limp= Perthes disease - Knee pain in adolescent= SUFE or tumour - Back pain= discitis
43
Describe infection
- Cellulitis - Osteomyelitis - Septic arthritis - Usually requires emergent referral for investigation +/- aspiration
44
Describe Discitis
- Presentation can be subtle - MRI usually required - Epidural abscess is surgical emergency
45
What should raise suspicion of non accidental injury?
- Pre-existing disability - Vague history from parents - Injury inconsistent with history - Delay in presentation - Multiple bruises of varying age - Multiple fractures - Burns

Locomotor (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions