Paediatric Orthopaedics Flashcards Preview

MP: MSK > Paediatric Orthopaedics > Flashcards

Flashcards in Paediatric Orthopaedics Deck (70):
1

Osteogenesis imperfecta?

brittle bone disease - autosomal dominant

2

how does Osteogenesis imperfecta present?

multiple fractures in childhood
short stature
blue sclera
loss of hearing

3

what causes Osteogenesis imperfecta?

defect in the maturation and organisation of type 1 collagen

4

what does XR show in Osteogenesis imperfecta?

bones tend to be thin cortices and oesteopenia

5

how is Osteogenesis imperfecta treated?

fractures tend to heal with abundant but poor quality callus - spintahe and traction

6

what is a possible complication of Osteogenesis imperfecta?

oesteopenia - results from prematurity and result in lower energy fractures

7

what is skeletal dysplasia?

medical term for short stature

8

how does skeletal dysplasia present?

short limbs
prominent forehead
widened nose
joints are lax - mental development is normal

9

what causes skeletal dysplasia?

abnormal development of bone and connective tissue

10

what is the most common type of skeletal dysplasia?

achondroplasia

11

how is skeletal dysplasia treated?

orthopaedic treatment - deformity correct and limb lengthening

12

how does marfin's present?

tall stature + long limbs with ligamentous laxity
high arched palette
pectus excavatum (flattening ot chest)
eye problems - lens dissolution

13

what causes marfin's?

mutation in fibrillin gene - autosomal dominant

14

what is ehler's danlos syndrome?

heterogeneous condition which abnormal elastin and collagen formation

15

how does ehler's danlos syndrome present?

profound joint hyper mobility, vascular fragility with easy bruising
joint instability and scoliosis

16

how is ehler's danlos syndrome treated?

bony surgery - dislocated joints but bleeding can be a problem so you can get stretched cards and wound healing

17

what is duchenne Muscluar dystrophy?

X linked hereditary disorder resulting in progressive muscle weakness and wasting

18

how does duchenne Muscluar dystrophy present?

muscle weakness - usually noted when boys begin to walk

19

what is gower's sign?

difficulty in walking + use of hands

20

what causes duchenne Muscluar dystrophy?

defect in dystrophin involving in Ca2+ transport results in muscle weakness

21

how is duchenne Muscluar dystrophy diagnosed?

raised serum creatinine phosphokinase
abnormalities in muscle biopsy

22

what is backer's muscular dystrophy?

similar to DMD but milder and boys able to walk in teens and suffers may survive into 30s

23

what is cerebral palsy?

neuromuscular disorder with onset before 2-3 years of age to insult of brain during birth

24

what is the most common type of CP?

spastic

25

what is spastic CP?

injury to corticospinal tract which results in muscle weakness and spasticity and worsens when child grows

26

what is ataxic CP?

affects cerebellum and so results in lack of co-ordinationa and balance

27

what is athetoid CP?

affects extra-pyramidal system + basal ganglia so uncontrolled withering motion, difficulty in speech

28

what is spina bifida?

congenital disorder where 2 halves of posterior vertebral arch fail to fuse

29

what are the 2 types of spina bifida?

spina bifida occulta
spina bifida cystica

30

what is spina bifida occult?

deep tethered of spinal cord and roots

clawed toes and high arched foot

31

what is the tell tale sign of spina bifida occult?

tuft of hair in skin overlying defect

32

what is spina bifida cystica?

contents of vertebral canal herniate through defect with either herniation and meninges alone or with spinal cord

33

what is spina bifida cystica associated with?

hydrocephalus

34

how is spina bifida treated?

defect closed within 48 hours
hydrocephalus - treated with VP shunt

35

what is polio/

viral infection with affects motor anterior horn cells in spinal cord result in motor neurone deficit

36

how does polio present?

muscle paralysis which recovers but can be left
joint deformities and growth defects can occur

37

how is polio managed?

vaccine
residual paralysis - splint-age, shortening of limb - show raise

38

what is erb's palsy?

injury to C5/6

39

what is affected in erb's palsy?

loss of motor innervation of deltoid, suprspinatous, biceps, infraspinatos and brachialis muscle

40

how does erb's palsy present?

internal rotation of humerus + waiter's tip posture

41

what is Klumpke's palsy?

injury to C8-T1

42

how is Klumpke's palsy caused?

forceful adduction which results in intrinsic hand muscles - fingers are flexed

43

what is development dysplasia of the hip?

dislocation/subluxation of femoral head during perinatal period which affects subsequent development of the hip

44

how does DDH present?

shorting
asymmetric groin/thigh crease

45

how is DDH diagnosed?

ortolani - reducing dislocated hip wiwth abduction and anterior displacement

barlow's - dislocate able hip with flexion and posterior displacement

46

how is DDH treated?

Pavlick's harness - maintains reduction

47

what is the transient synovitis of the hip?

self limiting inflammation of the synovium of a joint, mostly hip after an upper respiratory tract infection

48

how does transient synovitis of the hip present?

limp
range of motion restricted

49

how is transient synovitis of the hip treated?

short course of NSAIDs

50

what is Perthe's disease?

idiopathic oesteochonditis of femoral head which usually present between 4-9 years

51

what group of people is Perthe's disease most common in?

very active boys with short stature

52

how does Perthe's disease present?

pain and limp
unilateral
loss of internal rotation
loss of abduction
positive trendellenburg's test

53

what causes Perthe's disease?

femoral head transiently loses blood supply resolution in necrosis with abnormal growth

54

how is Perthe's disease treated?

watchful waiting
surgery if the femoral head becomes aspherical and flattened

55

what is SUFE?

femoral head slips inferior in relation to the femoral neck

56

what causes SUFE?

obese boys
growth plate is not strong enough to hold body weight

57

how does SUFE present?

pain in groin
pain can present in the knee
loss of internal rotation

58

why can SUFE present in the knee?

due obturator nerve supply

59

what predisposes you to SUFE?

hypothyroidism
renal disease

60

how is SUFE treated?

urgent surgery to pin femoral head down
hip replacement

61

what is oestochonritis dissecans?

osteochondritis where fragment of hyaline cartilage with variable amount of boney fragments break off surface of the joint

62

how does oestochonritis dissecans present?

medial femoral condyle is most commonly affected
poor localised pain
occasional locking

63

how is oestochonritis dissecans treated?

lesions which are risk of breaking off are fixed and loose fragments are removed

64

what are the possible complications in oestochonritis dissecans?

loose bodies within knee joint - pot hole on surface - oestoarthritis

65

what is scoliosis?

lateral curvature of the spin - rotational deformity

66

how is scoliosis diagnosed?

XR
MRI - painful

67

how is scoliosis treated?

surgery - complex - vertebral fusion and long rods connecting the poster elements of the spine

68

what is Spondylolisthesis?

slippage of one vertebral disc over another

69

how does Spondylolisthesis present?

low back pain
paradoxical flat back due to muscle spasm
waddling gait

70

how is Spondylolisthesis treated?

physiotherapy
stabilisation and possible reduction