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FINALS > paediatric orthopaedic conditions > Flashcards

paediatric orthopaedic conditions Flashcards

1
Q

who is patellofemoral dysfunction most commonly seen in?

A

adolescent girls

athletic (increased activity or recent injury)

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2
Q

how does patellofemoral dysfunction present?

A

anterior knee pain walking up stairs

anterior knee pain after prolonged periods of sitting

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3
Q

what is osgood schlatters disease?

A

inflammation of tibial tuberosity - sit of attachment of patellar ligament

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4
Q

who does osgood shclatters disease most commonly present in?

A

boys aged 10-15

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5
Q

what sign indicates osgood shclatters disease?

A

pain worse with straight leg raise - contraction of quadriceps

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6
Q

what is osteochrondritis dissecans?

A

fragment of hyaline cartilage breaks of the surface of the joint

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7
Q

where is osteochondritis dissecans most commonly seen?

A

knee - medial femoral condyle

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8
Q

what symptoms are seen with osteochondritis dissecans?

A

poorly localised pain
effusion
occasionally locking

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9
Q

what features of effusion indicates osteochondritis dissecans?

A

takes hours/days to form

if it does form quickly, will be filled with blood

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10
Q

what imaging is used for osteochondritis dissecans?

A

MRI (difficult to view on x-ray)

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11
Q

what meniscal abnormality can be seen in children?

A

lateral meniscus circular rather than c-shaped

causes pain and popping sensation

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12
Q

what is the fancy name for club foot?

A

talipes equinovarus

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13
Q

what joints are abnormally aligned in club foot?

A

tallus
calcaneus
navicular

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14
Q

what does club foot cause?

A

planter flexion of ankle
supination of forefoot
varus alignment of forefoot

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15
Q

what does club foot increase your chances of?

A

DDH

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16
Q

what technique is used to treat club foot?

A

Ponseti technique - regimen of serial casts started after birth

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17
Q

what is required for club foot after casting?

A

achilles tendonotomy

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18
Q

what is required after full correction for club foot?

A

brace
worn 23 hours a day for 3 months
during sleep until 3-4 years old

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19
Q

what is back pain in children a red flag for?

A

infection - discitis

tumours - osteoid osteoma

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20
Q

what is scoliosis?

A

lateral curvature of the spine

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21
Q

what is the most common cause of scoliosis in females?

A

idiopathic
present as adolescence due to cosmetic appearance
younger children have underlying cause

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22
Q

what are some risks with large curvatures in scoliosis?

A

restrictive lung defect

risk of spinal cord injury

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23
Q

what is spondylolisthesis?

A

slippage of one vertebrae over another

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24
Q

what level does spondyloisthesis commonly occur at?

A

L4/L5 or L5/S1

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25
Q

how does spondyloisthesis present?

A

in adolescence - increase weight and activity
lower back pain
flat back due to muscle spasm
waddling gait

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26
Q

what is syndactyly?
where does it most commonly occur?
what is polydactyly?

A

fusion of fingers - most commonly 3rd and 4th

extra finger

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27
Q

what is fibular hemimelia?

how does it present?

A

partial or complete absence of the fibula

  • shortened limb
  • bowing of tibia
  • ankle deformity
28
Q

how is fibular hemimelia treated?

A

if severe, ankle amputation at 10 months to 2 years and use of below knee prosthetic

29
Q

what does radius deformity cause?

A

absence of thumb

radius club hand

30
Q

what most commonly causes obstetric brachial plexus palsy’s?

A 
large babies (macrosomia diabetes)
twin deliveries 
shoulder dystocia
31
Q

what its he most common obstetric brachial plexus palsy’s?

A

erb’s palsy

32
Q

where is the injury in erb’s palsy?

A

upper nerve roots C5 and C6

33
Q

what posture is there with erb’s palsy?

A

waiter tip posture

34
Q

what muscles are affected with erb’s palsy?

A

loss of motor innervation of

  • deltoid
  • supraspinatus
  • infraspinatus
  • biceps
  • brachialis
35
Q

what is the prognosis with erb’s palsy?

A 
return of bicep function by 6 months 
good outcomes (90%)
36
Q

what is klumpe’s palsy?

A

lower brachial plexus injury - C8 to T1
paralysis of intrinsic hand muscles
fingers flexed

37
Q

what may cause klumpe’s palsy?

A

Horner’s syndrome

38
Q

what is the prognosis for klumpe’s palsy?

A

bad - less than 50% recover

39
Q

what is osteogenesis imperfecta?

A

brittle bone disease

defect in the maturation of type 1 collagen

40
Q

what is the most common type of osteogenesis imperfecta?

A

autosomal dominant

41
Q

what are the symptoms of osteogenesis imperfecta?

A 
multiple fractures in childhood
short stature 
multiple deformities 
blue sclera 
loss of hearing
42
Q

what is seen with osteogenesis imperfecta if autosomal recessive?

A

very rare
fatal in perinatal period
spinal deformity

43
Q

what is the outcome of osteogenesis imperfecta?

A

bones are thin and osteopenic - fractures heal with poor quality callus
most adults have scoliosis

44
Q

what is achondroplasia?

A

disproportionately short limbs
prominent forehead
widened nose

45
Q

what is the genetic mutation in marfans?

A

autosomal dominant

sporadic mutation of fibrillin gene

46
Q

what are the symptoms of marfans?

A 
high arched palate 
scoliosis 
pectus excaratum 
spontaneous penumonthorax 
lens dislocation 
aortic aneurysm 
arachnodactyly (long fingers and toes)
47
Q

what is Ehlers danlos syndrome?

A 
autosomal dominant - abnormal collagen and elastin 
hyper mobility
vascular fragility - bruise easily
joint instability 
scoliosis
48
Q

what is Down syndrome?

A

trimosy 21

49
Q

what orthopaedic symptoms are seen in down syndrome?

A

short stature
joint laxity
recurrent dislocations - patella
atlanto-axial instability of spine - OA

50
Q

who do muscular dystrophies affect and why?

A

boys - x linked recessive conditions

51
Q

what is Duchenne muscular dystrophy?

A

defects in dystrophin gene involved in calcium transport

52
Q

what symptoms are seen with Duchenne muscular dystrophy?

A

difficulty standing/walking up stairs

Gower’s sign

53
Q

what is the prognosis for Duchenne muscular dystrophy?

A

age 10 - no longer walking
age 20 - res and cardiac failure
death in 20s

54
Q

how is Duchenne muscular dystrophy diagnosed?

A

raised CK

abnormalities on muscle biopsy

55
Q

how is becker’s muscular dystrophy different from duchenne’s muscular dystrophy?

A

milder form
boys able to walk into their teens
survive until 30/40

56
Q

what is the most common type of cerebral palsy? what are the subtypes?

A

spastic
hemiplegic - leg and arm on same side
diplegic - both lower limbs
quadraplegic - all 4 limbs

57
Q

what are the symptoms of spastic CP?

A

increased tone due to damage to UMN

58
Q

what is ataxia CP?

A

reduced co-ordination and balance due to cerebellar damage

59
Q

what is dyskinetic CP?

A

damage to basal ganglia and substania nigra
uncontrolled writhing motion
sudden changes in tone
difficulties controlling speech

60
Q

what causes spina bifida?

A

2 halves on posterior vertebral arch fail to fuse during first 6 weeks of gestation

61
Q

what is spina bifida occulta?

A

mildest form
no associated problems
may have tethering of spinal cord - pes cavus, clawing of toe
birthmark, skin tag, fatty deposit, dimple, tuft of hair

62
Q

what is spina bifida cystica?

A

can’t walk

contents of vertebral canal herniate through

63
Q

what is meningocele spina bifida?

A

only meninges herniate through

64
Q

what is myelomeningocle spina bifida?

A

herniation of meninges with spinal cord/cauda equine

neurological defects - most serious

65
Q

what is polio?

A

viral infection of anterior horn cells resulting in lower motor neurone deficit

66
Q

what can happen due to polio?

A

variable degree of paralysis affecting muscles of lower limb in 2-3 days
can cause residual paralysis
joint deformities and shortening of limb

FINALS (25 decks)

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