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Muskuloskeletal Flashcards

(46 cards)

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1
Q

Are there any risk factors for developing developmental dysplasia of the hip?

A
  • Family history

- Breech position

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2
Q

How is DDH usually detected?

A

Newborn screening examination (Barlow + Ortolani)

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3
Q

In a case of suspected DDH, how is the diagnosis confirmed?

A

USS

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4
Q

Describe the management of developmental dysplasia of the hip

A
  • Conservative = Pavlik harness

- If this fails/presentation is late, surgery may be required

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5
Q

Describe the pathophysiology of osteomyelitis

A

Inflammation of the metaphysis of long bones, caused by infection

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6
Q

Which sites are most commonly affected in osteomyelitis?

A
  • Distal femur

- Proximal tibia

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7
Q

What is the most common causative organism for osteomyelitis?

A

Staphylococcus aureus

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8
Q

Describe the clinical features of osteomyelitis

A

Fever, plus cardinal signs of inflammation:

  • Pain
  • Redness
  • Warmth
  • Swelling
  • Loss of function
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9
Q

Describe the investigation of suspected osteomyelitis

A
  • Blood cultures

- MRI

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10
Q

Describe the management of osteomyelitis

A
  • IV antibiotics

- Surgery if unresponsive to antibiotics

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11
Q

Are there any risk factors for developing osteomyelitis?

A
  • Immunodeficiency

- Sickle cell disease

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12
Q

Describe the pathophysiology of septic arthritis

A

Inflammation of a joint, caused by infection

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13
Q

What is the most common causative organism for septic arthritis?

A

Staphylococcus aureus

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14
Q

Are there any risk factors for developing septic arthritis?

A
  • Immunodeficiency

- Sickle cell disease

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15
Q

What are the clinical features of septic arthritis?

A

Fever, plus cardinal signs of inflammation:

  • Pain
  • Redness
  • Warmth
  • Swelling
  • Loss of function
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16
Q

Describe the investigation of suspected septic arthritis

A
  • Blood cultures

- Joint aspirate

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17
Q

Describe the management of septic arthritis

A
  • IV antibiotics

- Surgery if unresponsive to antibiotics

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18
Q

Describe the epidemiology of transient synovitis

A

Most common cause of acute hip pain in children

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19
Q

Describe the pathophysiology of transient synovitis

Study These Flashcards
A
  • Transient inflammation of the hip joint

- Often triggered by a preceding viral infection, e.g. URTI

20
Q

Describe the clinical features of transient synovitis

Study These Flashcards
A
  • Hip pain
  • Reduced ROM at hip
  • Limp
21
Q

Describe the investigation of transient synovitis

Study These Flashcards
A

It can be difficult to differentiate between transient synovitis and early septic arthritis. If there is any suspicion it may be septic arthritis, perform:

  • Blood cultures
  • Joint aspiration
22
Q

Describe the management and natural course of transient synovitis

Study These Flashcards
A

Self-limiting:

  • Rest
  • Analgesia
23
Q

Perthes disease is more common in…

Study These Flashcards
A

More common in boys

24
Q

Describe the pathophysiology of Perthes disease

Study These Flashcards
A
  • Avascular necrosis of the femoral head

- Followed by revascularisation and reossification (gradual healing)

25
What are the clinical features of Perthes disease?
- Hip pain - Reduced ROM at hip - Limp
26
Describe the investigation of Perthes disease
XR
27
Describe the management of Perthes disease
Usually condition is self-resolving, therefore treatment is mainly supportive: - Rest - Analgesia - Physiotherapy In severe cases, surgery may be required
28
Describe the prognosis of Perthes disease
- Good prognosis for recovery | - Higher risk of developing degenerative arthritis in later life
29
Describe the pathophysiology of Osgood-Schlatter disease
Inflammation of the patellar tendon at its insertion site (tibial tuberosity)
30
Describe the clinical features of Osgood-Schlatter disease
- Knee pain after physical activity | - Palpable lump over tibial tuberosity
31
Describe the management of Osgood-Schlatter disease
- Reduce physical activity | - Physiotherapy
32
What is osteogenesis imperfecta? Describe its pathophysiology
- Group of genetic disorders of collagen metabolism | - This results in bones which are more fragile and become deformed/fracture easily
33
Which is the most common type of osteogenesis imperfecta
Type I
34
Describe the clinical features of type I osteogenesis imperfecta (MSK and other)
MSK: - Frequent fractures - Bone deformity Other: - Blue appearance to the sclerae - Some children develop hearing loss
35
Describe the management of type I osteogenesis imperfecta
Bisphosphonates to reduce frequency of fractures
36
Describe the pathophysiology of slipped femoral epiphysis
- Displacement of the femoral epiphysis postero-inferiorly | - Onset may be acute, e.g. following minor trauma, or insidious
37
Slipped femoral epiphysis is more common in...
More common in obese boys
38
Describe the clinical features of slipped femoral epiphysis
- Hip pain - Reduced ROM at the hip - Limp
39
Describe the investigation of slipped femoral epiphysis
XR
40
Describe the management of slipped femoral epiphysis
Surgery
41
Describe the epidemiology of juvenile idiopathic arthritis
Most common type of chronic arthritis in children
42
What are the clinical features of juvenile idiopathic arthritis? (MSK and other)
MSK: - Pain - Swelling - Stiffness Other: - Fever - Salmon-coloured rash - Lymphadenopathy
43
Describe the classification of juvenile idiopathic arthritis
- Polyarthritis (more than four joints affected) - Oligoarthritis (up to and including four joints affected) - Systemic (with fever, rash, lymphadenopathy)
44
Describe the management of juvenile idiopathic arthritis (conservative and medical)
Conservative: - Physiotherapy Medical: - Analgesia, e.g. NSAIDs - Intra articular corticosteroid injections - Methotrexate - Biologics
45
Hip pain in a child < 3 years old - how is this managed?
Urgent further investigation
46
Which criteria are used to assess the probability of septic arthritis in children? Describe the interpretation
Kocher's criteria: - Non weight bearing = 1 point - Fever > 38.5 = 1 point - WCC > 12 x 10^9/L = 1 point - ESR > 40 = 1 point 1 point = highly unlikely 2 points = 50/50 3-4 points = highly likely

Paediatrics (17 decks)

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