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Med Finals - Paediatrics > Orthopaedics > Flashcards

Orthopaedics Flashcards

(57 cards)

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1
Q

Classification of fractures

A

Salter-Harris classification - detrmine likely hod to affect growht
SALTR
1- Straight
2 - Above
3 - beLow
4 - Through
5 - cRush

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2
Q

Management of fractures

A

Closed or open reduction
External casts
K wirse
Intramedullary wires
[Intramedullary nails
Screws
Plates

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3
Q

Pain management in children

A

Paracetamol
Ibuprofen
Morphine
Not codeine
Not tramadol

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4
Q

Causes of hip pain in 0-4 years

A

Septic arthritis
Developmental dysplasia
Transient sinovitis

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5
Q

Causes of hip pain in 5-10 years

A

Septic arthritis
Transient sinovitis
Perthes disease

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6
Q

Causes of hip pain in 10-16 years

A

Septic arthritits
Slipped upper femoral epiphysis
Juvenile idiopathic arthritis

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7
Q

Red flags of hip pain

A

Child under 3
Fever
Waking at night with pain
Weight loss
Anorexia
Night sweats
Fatigue
Persistent pain
Stiffness in morning
Swollen or red joint

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8
Q

Investigations of hip pain

A

Bloods
Xray
US
Joint aspiration
MRI

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9
Q

Define septic arthritis

A

Infection inside a joint -

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10
Q

Presentation of septic arthritis

A

Hot
Red
Swollen
Painful joint
Refusing to weight bear
Stiffness
Reduced rang of motion
Systemic symptoms - fever, lethargy, sepsis

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11
Q

Commm causitive organism in septic arthritis

A

Staphylococcus aureus

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12
Q

Commm causitive organism in septic arthritis

A

Staphylococcus aureus

Neisseria gonorrhoea
Group A strep
Haemophilus influenza
E. Coli

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13
Q

Investigations in septic arthritis

A

Joint aspiration

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14
Q

Management of septic arthritis

A

IV antibiotics
Surgical drainage and wash out
Supportive management

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15
Q

Define transient synovitis

A

Temporary irritation and inflammation in the synovial membrane of the joint.
Most common cause of hip pain in 3-10 years
Often preceded by URTI

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16
Q

Presentation of transient synovitis

A

URTI
Limp
Refusal to weight bear
Groin or hip pain
Mild low grade temperature
Otherwise well!

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17
Q

Management of transient synovitis

A

Symptomatic management
Exclusion and close monitoring for septic arthritis

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18
Q

Define perthes disease

A

Disruption of blood flow to the femoral head causing a vascular necrosis.

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19
Q

Presentation of Perthes disease

A

Pain in the groin or hip
Limp
Restricted hip movement
Referred pain to knee

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20
Q

Investigations in Perthes disease

A

Blood tests
Technetium bone scar
MRI

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21
Q

Management of Perthes disease

A

Conservative
Bed rest
Traction
Crutches
Analgesia
Physio
Monitoring and surgery

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22
Q

Define slipped upper femoral epiphysis

A

Slipped capital femoral epiphysis - where the head of the femur is displaced along the growth plate.

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23
Q

Presentation of SUFE

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A

Adolescent
Obese
Male
During growth spurt
Caused by minor trauma
Hip groin thigh or knee pain
Restricted range of movement
Painful limp

24
Q

What movement is normal restricted in SUFE

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A

Restriction of internal rotation - like to keep externally rotated

25
Investigation of SUFE
Bloods Technetium bone scan CT MRI
26
Management of SUFE
Surgery
27
Define osteomyelitits
An infection in the bone and bone marrow - typically in the metaphysis of long bones.
28
Risk factors for osteomyelitis
Open bone fractures Orthopaedic surgery Immunocompromised Sickle cell anaemia HIV TB
29
Presentation of osteomyelitis
Refusing to use limb or weight bear Pain Swelling Tenderness Acutely unwell child High fever
30
Investigations in osteomyelitis
Xrays MRI Bloods Culture Marrow aspiration
31
Define osteosarcoma
Bone cancer usually presenting in 10-20 years in the femur, tibia or humerus
32
Presentation of osteosarcoma
Persistent bone pain Worse at night - disturbing sleeo Swelling Palpable mass Restricted joint movement
33
Investigation of osteosarcoma
Xray! Bloods - ALP CT MRI PET Bone Biopsy
34
Management of osteosarcoma
Surgical resection Limb amputation Adjuvant chemo MDT support
35
Define Talipes
Club foot - fixed abnormal ankle position that presents at birth Corrected with surgery
36
Define developmental dysplasia of the hip
Condition where there is a structural abnormality in the hips caused by abnormal development of fetal bones during pregnancy Leads to instability and dislocation
37
Risk factors for developmental dysplasia of the hip
First degree family history Breech presentation Multiple pregancy
38
Clinical signs of developmental dysplasia of the hip
Different leg lengths Restricted hip abduction on one side Signification bilateral restriction in abduction Ortolani and barlow test
39
Define Ortolani test
Baby on back - abduct hips Applying pressure to identify if likely to dislocate anteriorly
40
Define Barlow test
Gentle downward pressure on hip adduction to identify if dislocates posteriorly
41
Investigations in developmental dysplasia of the hip
US! Xray if older
42
Management of developmental dysplasia of the hip
Pavlik harness - hold femoral head in correct position Surgery
43
Define riskets
A condition affecting children where there is a defection mineralisation of bones leading to soft and deformed structures.
44
Causes of Riskets
Vit D or calcium deficiency
45
Presentation of rickets
Bowing legs Knock knees Rachitic rosary - ribs expand at the costochondral junction - lumps along chest Craniotabes - soft skull - delayed closure of sutures and frontal bossing Delayed teeth Risk factors for vit D deficiency Lethargy Bone pain Swollen wrists Bone deformity Dental problems Muscle weakness Pathological fractures
46
Investigations in rickets
Vit D Xray Serum calcium phosphate ALP Parathyroid hormone Bloods Autoantibodies
47
Management of rickets
Prevention! Breastfeed! Formula with fortified vit D Vit d replacement Calcium supplementation Correct deformities
48
Define achondroplasia
Most common cause of disproportionate short stature, mostly caused by autosomal dominant patter of homozygous gene mutations
49
Presentation of achondroplasia
Limbs affects more than spine. Short digits Bow legs Disproportionate skull Foramen magnum stenosis
50
COnditions associated with achondroplasia
Recurrent otitis media - cranial abnormalities Kyphosis Spinal stenosis Obstructive sleep apnoea Obesity Foramen magnum stenosis - cord copression, hydrocephalus
51
Management of achondroplasia
MDT supportive management Leg lengthening
52
Define Osgood-Schlatters disease
Caused by inflammation at the tibial tuberosity where the patella ligament inserts - anterior knee pain in adolescents
53
Presentation of Osgood-Schlatter
Visible or palpable hard and tender lump Pain at anterior aspect of knee Pain exacerbated by physical movement
54
Management of Osgood-Schlatters
Reduce physical activity ICE NSAIDs Physio
55
Define osteogenesis imperfecta
Genetic condition that results in brittle bones that are prone to fractures - affects formation of collagen
56
Presentation of osteogenesis imperfecta
Blue sclera! Unusual and recurrent fractures Hypermobility Triangular face Short stature Deafness Dental problems Bone deformities - bowed legs Joint and bone pain
57
Management of osteogenesis imperfecta
Genetic counselling Bisphosphonates Vit D supplementation MDT support

Med Finals - Paediatrics (17 decks)

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