MSK

Question 1

what is transient synovitis

Answer 1

acute hip pain following a recent viral infection
typical age 3-8 years

Question 2

features of transient synovitis

Answer 2

limp/refusal to weight bear
groin or hip pain
low grade fever

Question 3

management of transient synovitis

Answer 3

rest and analgesia
refer if child has fever

Question 4

what is perthes’ disease

Answer 4

degenerative condition due to AVN of the femoral head

Question 5

who commonly gets perthes disease

Answer 5

more common in boys
typically 4-8 years old

Question 6

features of perthes disease

Answer 6

hip pain: develops over a few weeks
limp
stiffness and reduced range of hip movement
x-ray: early changes- widening of joint space. later changes- decreased femoral head size/flattening

Question 7

diagnosis of perthes disease

Answer 7

plain x-ray
technetium bone scan or MRI if normal x-ray

Question 8

complications of perthes disease

Answer 8

osteoarthritis
premature fusion of the growth plates

Question 9

staging for perthes

Answer 9

catterall staging

Question 10

management of perthes

Answer 10

keep femoral head within the acetabulum: cast, brace
less than 6 years: observation
older: surgical management with moderate results

Question 11

general management in GP of child < 3 with acute limp

Answer 11

urgent specialist assessment

Question 12

typical age of SUFE

Answer 12

10-15 years

Question 13

features of SUFE

Answer 13

hip, groin, medial thigh or knee pain
loss of internal rotation of the leg in flexion
bilateral in 20%

Question 14

investigations for SUFE

Answer 14

AP and lateral views are diagnostic

Question 15

management of SUFE

Answer 15

internal fixation

Question 16

describe talipes equinovarus

Answer 16

inverted and plantar flexed foot

Question 17

associations with talipes equinovarus

Answer 17

spina bifida
cerebral palsy
edwards syndrome
oligohydramnios
arthrogryposis

Question 18

management of talipes equinovarus

Answer 18

ponseti method

Question 19

predisposing factors for rickets

Answer 19

dietary deficiency of calcium
prolonged breastfeeding
unsupplemented cows milk
lack of sunlight

Question 20

features of rickets

Answer 20

aching bones and joints
lower limb abnormalities (bow legs, knock knees)
rickety rosary- swelling at the costochondral junction
kyphoscoliosis
craniotabes (soft skull)
harrison’s sulcus

Question 21

investigations for rickets

Answer 21

low vit D levels
reduced serum calcium
raised ALP

Question 22

management of rickets

Answer 22

oral vit D

Question 23

what is achondroplasia

Answer 23

autosomal dominant disorder associated with short stature
mutation in fibroblast growth factor receptor 3 gene

Question 24

features of achondroplasia

Answer 24

short limbs with shortened fingers
large head with frontal bossing and narrow foramen magnum
midface hypoplasia with flattened nasal bridge

Question 25

management of osgood schlatter disease

Answer 25

supportive

Question 26

what is oteogenesis imperfecta

Answer 26

group of disorders of collagen metabolism resulting in bone fragility and fractures

Question 27

inheritance of osteogenesis imperfecta

Answer 27

autosomal dominant

Question 28

presentation of osteogenesis imperfecta

Answer 28

presents in childhood fractures following minor trauma blue sclera deafness secondary to otosclerosis dental imperfections