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Paediatric Orthopaedics Flashcards

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1
Q

What is Osteogenisis Imperfecta?

A

brittle bone disease

there is a defect in the maturation and organization of type 1 collagen

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2
Q

multiple fragility childhood fracture, short stature, blue sclerae and loss of hearing

what congenital disorder is this?

A

Osteogenisis Imperfecta

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3
Q

What is Skeletal dysplasias?

A

DWARF!

short stature due to genetic error resulting in abnormal development of bone.

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4
Q

what is the most common type of skeletal dysplasia?

A

achondroplasia

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5
Q

what is achondroplasia like?

A

disproportionately short limbs with prominent forehead and widened nose.

joints are lax and mental development is normal

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6
Q

what do connective tissue disorders usually result in?

A

hypermobility

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7
Q

what is marfan’s syndrome?

A

an autosomal dominant or sporadic mutation of the fibrillin gene resulting in TALL STATURE WITH DISPROPORTIONATELY LONG LIMBS AND LIGAMENTOUS LAXITY

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8
Q

name some features associated with marfan’s syndrome?

A 
glaucoma
lens dislocation
high arch palate in mouth
spontaneous pneumothorax
flattening of chest-pectus excavatum)
heart problems-mitral regurge, aortic aneurysm  and regurg
long arms
scoliosis
long legs
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9
Q

what is Ehlers-Danlos syndrome?

A

abnormal elastin and collagen formation

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10
Q

Name some clinical features of Ehlers-Danlos syndrome?

A

profound joint hypermobility
vascular fragility with ease of bruising
joint instability
scoliosis

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11
Q

what are the MSK manifestations with Downs syndrome?

A

short stature and joint laxity and possible recurrent dislocation

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12
Q

What causes Duchenne Muscular Dystrophy?

A

a defect in the dystrophin gene which is involved in calcium transport

results in muscle weakness

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13
Q

how do you diagnose Duchenne Muscular Dystrophy?

A

raised serum creatinine phosphokinase and abnormalities on muscle biospy.

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14
Q

What is beckers Muscular Dystrophy?

A

similar to DMD but milder and they can live to 30’s/40’s instead of 20’s.

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15
Q

What is cerebral Palsy?

A

a neuromuscular disorder due to an insult to the immature brain before, during or after birth.

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16
Q

what is the most common expression (type) of cerebral Palsy?

A

spastic CP

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17
Q

what spina bifida?

A

2 halves of the posterior vertebral arch fail to fuse (probs in the first 6 weeks of gestation)

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18
Q

what is the mildest form of spina bifida?

A

spina bifida occulta

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19
Q

what is the most severe form of spina bifida?

A

spina bifida cystica

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20
Q

what is Polio?

A

a viral infection which affects motor anterior horn cells in the spinal cord or brain stem resulting in lower motor neurone deficit.

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21
Q

how does the polio virus enter the body?

A

via the Gi tract

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22
Q

When do you get obstetric brachial nerve palsy?

A

mainly in large babies and twins.

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23
Q

what is the most common type of obstetric brachial nerve palsy?

A

Erb’s Palsy

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24
Q

Waiter’s tip posture

A

Erb’s Palsy

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25
what happens in Erb's Plasy?
injury to the upper nerve roots (C5 and 6) resulting in loss of motor innervation of deltoid, supraspinatus, infraspinatus, biceps and brachialis can lead to internal rotation of the humerus.
26
what is Klumpke's Palsy?
a rarer type of obstetric brachial nerve palsy injury to C8 and T1 can result in paralysis of intrinsic hand muscles and horner's syndrome
27
when should a baby sit alone/crawl?
6-9 months
28
when should a baby stand?
8-12 months
29
when should a baby walk?
14-17 months
30
when should a baby jump?
2 years
31
when should a baby manage stairs by themselves?
3 years
32
when should a baby have head control?
2 months
33
when should a baby speak a few words?
9-12 months
34
when should a baby eat with fingers/ use spoon?
14 months
35
when should a baby stack 4 blocks?
18 months
36
when should a baby understand 200 words/ learn 10 words a day?
18-20 months
37
when should a baby be potty trained?
2-3 years
38
what is genu varum
bow legs
39
what is genu valgus
knock knees
40
what can cause genus valgum?
rickets | tumours
41
clumbsy and wear through shoes at an alarming rate
in toeing- feet pointing towards midline
42
what is femoral neck anteversion?
the femoral neck is slightly averted (pointing forward) this can give appearance of in toeing and knock knees.
43
what is internal tibia torsion?
tibia rotated inward about its vertical axis. but this a normal variation and should be ignored!!
44
what 2 types of flat feet do you get?
mobile and fixed
45
which type of flat foot is there tarsal coalition?
fixed flat foot
46
what are curly toes?
minor overlapping of the toes and curling of the toes.. 5th toe is most affected
47
what is developmental dysplasia of the hip?
dislocation or subluxation of femoral head during the perinatal period which affects the development of hip
48
which hip is more commonly affected in DDH?
left | and girls are more commonly affected that boys
49
risk factors for DDH?
``` family history of DDH breech presentation first born babies downs syndrome other congential disorders ```
50
click or clunk with Ortolani and/or Barlow test?
DDH
51
what is Ortolani test?
reducing a dislocated hip with abduction and anterior displacement
52
what is Barlow test/
dis-locatable hip with flexion and posterior displacement.
53
what can you use to help diagnose DDH?
ultrasound
54
what is transient synovitis of the hip?
inflammation of the synovium of a joint (hip)
55
when do you commonly get transient synovitis of the hip?
after an upper resp tract infection
56
when are mosy children affected by transient synovitis of the hip?
2-10 years
57
name some signs/symptoms of transient synovitis of the hip?
limp or reluctance to weight bare range of motion restricted low grade fever
58
Name some investigations for transient synovitis of the hip?
x-ray to exlcude Perthes CRP- normal aspiartion MRI
59
what is the treatment for transient synovitis of the hip?
NSAIDS and rest
60
what is Perthes disease?
osteochondritis of the femoral head which usually occurs between ages of 4-9 and more common in boys
61
name some signs/symptoms of perthes disease?
``` pain/limp usually unilateral loss of internal rotation (usually first sign) loss of abduction positive trendleberg test ```
62
management of perthes?
regular x ray observation and avoid physical activity
63
who is mainly affected by slipped upper femoral epiphysis?
FAT pre-pubertal teenage boys
64
what can predispose you to SUFE?
hypothyroidism and renal disease
65
signs/symptoms of SUFE?
pain and limp pain may be felt in groin CAN HAVE KNEE PAIN ONLY!!! loss of internal rotationmof hip
66
treatment of SUFE?
urgent surgery
67
when is dislocation of the patella most common?
teenage years | girls more common
68
what is osteochondritis dissecans?
fragment of hyaline cartilage with some bone fragments breaks off the surface of the joint the knee is most commonly affected.
69
patient presentation of osteochondritis dissecans?
poorly localised pain effusion locking knee (occasionally)
70
what is Talipes Equinovarus?
club foot abnormal alignment of joints between talus, calcaneus and navicular. boys more affected than girls
71
deformities from club foot/
plantarflexion supination of forefoot varis alignment of the forefoot
72
treatment for club foot/
early splintage!!
73
what is scoliosis?
lateral curvature in the spine
74
what is spondylothesis?
slippage of one vertebrae over another usually at l4/5 level or l5/s1 level present with lower back pain!!

MSK (15 decks)

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