MSK Children - General Assessment Flashcards
(23 cards)
what must be checked for before any child with an MSK complaint leaves a consultation 7
acronym TIM
-Tumour
-Trauma (incld non-accidental injury (NAI))
-Infection
-inflammation
-Mechanical
-Muscle disease
-Metabolic
what must be assessed in an MSK exam 6
joints - as in OSCE REMS examination techniques
also:
Bone palapte for tenderness/ massess
Muscles - weakness (painless or painful), a mass, loss of function
Gait- age approrpiate assessment
-Funcional and dvelopmental assessment
-Nerves -Neuro exam
two main cell types in bone
osteoblasts
osteoclasts
function of osteoblasts 2
-produce a matrix of osteoid composed of type 1 collagen
responsible for mineralisation of the matrix
type of collagen produced by osteoblasts
type 1 collagen
function of osteoclasats
remodel tissue by bone resorption
removes bone tissue by removing mineralised matrix and breaking up organic bone
what do long bones in children consist of 5
shaft
diaphysis
proximal
and
distal metaphysis
(each is separated from the epiphysis by the growth plate(physis) )
how can bone age in a child be assessed
can be estimated by the radiological features on a plain wrist radiograph
-becuase of consistently reproducible squence of ossification of the hand and wrist bones
types of joints 3
fibrous
cartilaginous
synovial
example of fibrous joint 1
sutures of skull
examples of cartilagious joints1
symphysis pubis
examples of synovial joints 1
most skeletal joints
what are synovial joints covered with
hyaline cartilage
what is the joint space in synovial joints covered in
synovium
what do synvoial joints produce
synovial fluid
what does inflammation fo teh synovium cause 3
excessive production of synovial fluid
inreased cellularity
altered cytokines
-this enviroment is destructive of the first hyaline cartilage and then the underlying bone
define the enthesis
point of insertion of a tendon ligament fascia or joint capsule into bone
examples of mechanial stress at the enthesis 2
plantar fascitis
achilles tendonitis
examples of growth related injury to the enthesis 1
osgood schlatters disease
example of inflammatory stress to the enthesis 1
HLA B27 related plantar fascitis
define gowers sign
use of hands to split legs to hem rise from seated
what is gowers sign seen in
shows weakness
-classically in DMD
0can be seen ina ny condition with muscle weakness
MSK features in children 7
pain
stiffness
swelling or mass
warm
deformity
loss of function
developmental delay or regression or loss of milestones previously acheived \
