Paediatric & Adolescent Knee Problems Flashcards Preview

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Flashcards in Paediatric & Adolescent Knee Problems Deck (20)
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1
Q

what is patellar tendonitis

A

jumpers knee - inflammation of patellar tendon

2
Q

what is treatment of patellar tendonitis

A

self limiting requires rest and possibly physiotherapy

3
Q

what is apophysitis

A

inflammation of a growing tubercle where a tendon attaches which can occur at either end of patellar tendon due to repetitive strain

4
Q

what are the two different kinds of apophysitis

A

osgood-schlatter disease = inflammation of tibial tubercle apophysis, most common sinding-larsen-johanssen = inflammation of inferior pole of patella

5
Q

what is treatment of apophysitis

A

self limiting requires rest +/- physiotherapy

6
Q

what may patient be left with after apophysitis

A

bony prominence which does not require surgery

7
Q

what is patellofemoral dysfunction

A

just adolescent knee pain which is common in adolescence, especially girls

8
Q

what is cause of patellofemoral dysfunction

A

unclear may be due to muscle imbalance, ligamentous laxity and subtle skeletal predisposition there may be softening of hyaline cartilage of patella (chondromalacia patellae)

9
Q

how is patellofemoral dysfunction treated

A

self limiting physio to rebalance muscles most patients outgrow condition very rarely resistant cases may require surgery to shift the forces on patella (tibial tubercle transfer) but results unpredictable

10
Q

what is patellar instability

A

dislocation and subluxation of patella, common

11
Q

what may cause patellar instability

A

trauma = tear in medial patellofemoral ligament ligamentous laxity and variations in body anatomy (shallow femoral trochlea, valgus, hip anteversion)

12
Q

what may the dislocations in patellar instability cause

A

osteochondral fracture with a fragment of hyaline cartilage with or without subchondral bone breaking off

13
Q

what % of first time dislocations go on to have second episode

A

20% have second episode 10% have multiple dislocations

14
Q

what is treatment of patellar instability

A

many stabilise as grow older and physio may help recurrent dislocation may require surgery to correct any bony predisposition or to reconstruct the medial patellofemoral ligament

15
Q

what is osteochondritis dissecans (OCD)

A

osteochondritis where a fragment of hyaline with variable amounts of bone fragments breaks off the surface of the joint

16
Q

does OCD only occur in adolescent

A

no, also adulthood

17
Q

how can OCD predispose to osteoarthritis

A

can result in loose bodies within knee joint and a pothole on surface and this predisposes to osteoarthritis

18
Q

what is symptoms of OCD

A

poorly localised pain effusion occasionally locking

19
Q

how is OCD diagnosed

A

defect can be difficult to see on standard xrays and my require special views or MRI to diagnose

20
Q

how is OCD treated

A

lesions at risk of breaking off (with fluid signal behind them on MRI) may be fixed and loose fragments may require removal