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Flashcards in Development Deck (16):

What are the approximate timescales of normal MSK development?

Sits alone, crawls – 6‐9 months
Stands – 8‐12 months
Walks – 14‐17 months
Jumps – 24 months
Manages stairs independently – Age 3


What are the landmarks of neurological development?

Loss of primitive reflexes (Moro reflex, stepping reflex, rooting, grasp reflex, fencing posture etc) by 1‐6 months.
Head control – 2 months
Speaking a few words – 9‐12 months
Eats with fingers, uses spoon – 14 months
Stacks four blocks – 18 months
Understands 200 words, learns around 10 words/day ‐ 18‐20 months
Potty trained – 2‐3 years


At birth what knee alignment disorder do children usually have?

Varus knees (bow legs)


What is the progression of childhood knee alignment from birth to physiological normal?

Varus > neutrally aligned around 14 months, valgus at age 3, gradually to physiological valgus by 7-9


How is pathological varus or valgus defined?

+/- 6' from mean value for age


At what point will genu valgum or varus require surgery?

Possibility after age of 10


What can be some causes of genum varus or valgus?

Can be idiopathic, some familial. Due to underlying skeletal disorder (skeletal dysplasia, Blount's disease), physeal injury with growth arrest (usually unilateral) or biochemical disorder (rickets)


What is in-toeing?

Refers to a child who will have feet that point toward midline when walking or standing


What exaggerates in-toeing, and are some features that make it noticeable?

Exaggerated when running and children are thought of as clumsy and wear through shoes quickly.


What is femoral neck anteversion?

As part of normal anatomy the femoral neck is slightly anteverted (pointing forwards).


What can femoral neck anteversion give the appearance of?

In-toeing, as well knock knees


What are mobile/flexible flat feet?

The flattened medial arch forms with dorsiflexion of the great toe (Jack test)


What can flexible flat footedness be related to?

Ligamentous laxity, familial or idiopathic. Normal variant in children, in adults also may be related to tibialis posterior tendon dysfunction


What are rigid/fixed flat feet?

The arch remains flat regardless of load or great toe dorsiflexion.


What does having rigid/flat feet indicate?

Underlying bony abnormality (tarsal coalition where bones of hindfoot have an abnormal bony or cartilaginous connection) which may require surgery. Also can be inflammatory/neuro disorder


What can OA of the facet joints result in?

Osteophytes impinging on exiting nerve roots, resulting in nerve root symptoms and sciatica as previously discussed