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MSK SOH > Childhood pathologies > Flashcards

Childhood pathologies Flashcards

(81 cards)

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1
Q

Genu Varum - defintion

A

Bow legged (large gap between knees when feet are together)

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2
Q

Can genu varum be a normal finding?

A

Yes

Children less than 2

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3
Q

When to suspect that genu varum is abnormal

A

Severe (+/- 6 degrees from the mean value for that age)
Painful
Unilateral

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4
Q

Genu valgum - definition

A

Knocked knees

ankles are too Lateral

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5
Q

Can genu valgum be a normal finding?

A

Yes

Children around 3

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6
Q

When to suspect that genu valgum is abnormal?

A

Severe (+/- 6 degrees from the mean value for that age)

Painful

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7
Q

Intoeing - definition

A

When a child walks with the toes pointed inwards

AKA pigeon toe

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8
Q

Intoeing - clinical features

A

“child wears through shoes at an alarming rate”

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9
Q

Intoeing - causes

A

Internal tibial torsion
Femoral neck anteversion
Metatarsus adductus

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10
Q

Intoeing - management

A

Most resolve spontaneously

May need to put a plaster cast on

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11
Q

Flat feet - definition

A

It is normal to be born with flat feet but most people should develop a medial arch once at walking stage

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12
Q

Skeletal dysplasia - definition

A

Abnormal development of bone and connective tissue

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13
Q

Skeletal dysplasia - clinical features

A 
Short stature 
Disproportionately short limbs 
Prominent forehead 
Widened nose 
Mental development normal
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14
Q

Generalised joint laxity

A

Hyper mobility of joints

“double jointed”

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15
Q

Marfans syndrome - definition

A

Mutation of fibrillin gene (gene which is required for the formation of elastin)

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16
Q

Marfans syndrome - clinical features

A

Hypermobility
Tall
Disproportionately long limbs and fingers
High arched palate

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17
Q

Duchene muscular dystrophy - definition

A

Defect in calcium transport so muscles don’t move as normal

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18
Q

Duchene muscular dystrophy - genetics

A

X-linked recessive

only affects males

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19
Q

Duchene muscular dystrophy - clinical features

A

Progressive muscle weakness
Heart failure
Respiratory failure

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20
Q

Duchene muscular dystrophy - investigations

A

Increased serum creatinine phosphokinase

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21
Q

Duchene muscular dystrophy - management

A

Physio

Splintage

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22
Q

Ehlers danlos syndrome - definition

A

Abnormal elastin and collagen formation

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23
Q

Ehlers danlos syndrome - genetics

A

autosomal dominant

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24
Q

Ehlers danlos syndrome - clinical features

A

very stretchy skin
Easy bruising
Joint hyper mobility
Dislocations

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25
Ehlers danlos syndrome - management
Surgery | - but skin healing is poor after surgery
26
Upper motor neurone problems arise from
Brain | Spinal cord
27
Upper motor neurone problems result in
Weakness | Spasticity
28
Lower motor neurone problems arise from
Peripheral nerve Nerve roots Anterior horn
29
Lower motor neurone problems result in
Reduced tone | Weakness
30
Cerebral palsy - definition
insult to the immature brain either before, during or after birth
31
Spina bifida - definition
2 halves of the posterior vertebral arch fail to fuse
32
Spina bifida - mild form
Occulta - high arched foot (pes cavus) - clawing of toes - tuft of hair in skin overlying defect
33
Spina bifida - severe form
Cystica | - excess CSF which raises ICP
34
Polio - definition
Viral infection which affects the motor anterior horn cells in the spinal cord or brainstem resulting in a LMN defecit
35
Polio - clinical features
flu like illness -> paralysis of muscles -> shortening of limbs
36
Syndactyly
2 digits fused together
37
Polydactyly
Extra digit is formed
38
Tarsal coalition
Fusion between 2 tarsal bones
39
Erbs palsy - definition
Injury to the upper nerve roots during delivery of baby resulting in loss of motor innervation, deltoid, supraspinatous, biceps and brachialis muscle
40
Erbs palsy - nerve roots affected
C5, C6
41
Erbs palsy - clinical features
Internally rotated humerus
42
Kerlumpke's palsy - definition
Injury to the lower nerve roots during delivery of baby caused by forceful adduction resulting in paralysis of intrinsic hand muscles
43
Kerlumpke's palsy - nerve roots affected
C8-T1
44
Kerlumpke's palsy - clinical features
Fingers are flexed
45
Talipes equinovarus - definition
AKA club foot | Congenital deformity of the foot due to abnormal alignment in utero
46
Talipes equinovarus - clinical features
Varus alignment | Supination of forefoot
47
DDH - definition
Developmental dysplasia of the hip | Dislocation or subluxation of the femoral head which affects the subsequent development of the hip
48
DDH - who gets it
More common in girls | Immediately before or after birth
49
DDH - Which hip (left or right) is more commonly affected?
Left
50
DDH - risk factors
First born babies FHx Breech position in utero
51
DDH - clinical features/examination
Look: shortening, asymmetric skin creases Feel: clink/clunk on specific manoeuvres (barlow test, ortolani test) Move: affected hip abducts more
52
DDH - investigations
Ultrasound - detect dislocated or unstable hip
53
DDH - management
Pavlik harness - if diagnosed early enough | Open reduction - open hip and release soft tissues
54
Transient synovitis - definition
Inflammation of the synovium of the hip joint
55
Transient synovitis - who gets it
Age: 2-10 | more common in boys
56
Transient synovitis - risk factors
Previous URTI
57
Transient synovitis - clinical features
``` Patient with a limp Reluctance to weight bear on affected side Hip pain Restricted range of motion No signs of infection ```
58
Transient synovitis - investigations
Must exclude other serious potential conditions Bloods - CRP (should be normal) US - effusion
59
Transient synovitis - management
NSAIDs and rest
60
Perthes - definition
Osteochondritis of the femoral head. | Femoral head looses its blood supply resulting in AVN with subsequent abnormal growth
61
Perthes - who gets it
Children aged 4-9 Boys more than girls Children who are very active Children with short stature
62
Perthes - clinical features
Pain Loss of internal rotation of the hip Loss of abduction
63
Perthes - investigations
+ve Trendelenburg test | X-ray
64
Perthes - management
Avoid physical activity
65
SUFE - definition
Slipped Upper Femoral Epiphysis Femoral head epiphysis slips inferiorly in relation to the femoral neck Growth plate is not strong enough to support body weight
66
SUFE - who gets it
age 10-16 (adolescents going through puberty) more common in boys Obesity
67
SUFE - clinical features
Pain in the knee (due to the obturator nerve) Pain in the groin area Can't weight bear Loss of internal rotation of the hip
68
SUFE - investigations
X-ray (lateral x-ray)
69
SUFE - management
Urgent surgery to pin the femoral head to prevent further slippage
70
SUFE - complications
Avascular necrosis
71
Skeletal dysplasia - genetics
Achondroplasia
72
Generalised joint laxity - genetics
Autosomal dominant
73
Cerebral palsy - causes
``` Intrauterine infection Genetic problems Brain malformation Prematurity Intra-cranial haemorrhage Hypoxia during birth ```
74
Cerebral palsy - monoplegic
One limb affected
75
Cerebral palsy - hemiplegic
One ipsilateral upper and lower limb affected
76
Cerebral palsy - diplegic
Both legs affected
77
Cerebral palsy - clinical features
Delayed developmental milestones Scolisosis Hip dislocations
78
Cerebral palsy - management
``` Physio Splintage Balcofen Botox injection to spastic muscles Surgery ```
79
Cerebral palsy - spastic
Most common | Injurry to motor cortex, UMN or corticospinal tract
80
Cerebral palsy - ataxic
Affects cerebellum so coordination and balance are affected
81
Duchene muscular dystrophy - what sign is common in patients
Gower's sign (patient walks hands up their body)

MSK SOH (24 decks)

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