Paediatric orthopaedics Flashcards
(34 cards)
What are the 7 classes of condition that may cause a child to limp?
Developmental Infectious Occult trauma Neoplastic Inflammatory Osteochondroses Non-MSK
What is the difficulty of getting an MRI scan in young children?
Often requires general anaesthetic
What does crawling in a child who has learnt to walk imply?
Foot, ankle or shin pathology
What should you examine if one joint of a child is swollen?
Every other joint
When are mandatory newborn-infant physical examinations done?
First 48 hours
6-8weeks
Which parts of the body are examined in the newborn-infant physical examination?
Hips
Eyes
Heart
Testes
Which tests are used to examine the hip in the newborn-infant physical examination?
Barlow test
Ortolani test
Galeazzi test
What is the Barlow test?
Adduct the hip while placing a posterior force on the knee
What is the Ortolani test?
Abduct the hip while placing an anterior force on the knee
What is Galeazzi’s test?
When the infant is lying down, flex both hips and knees so the ankles are touching the buttocks and look for asymmetry in knee height
What is the management of DDH detected early?
Put child in a harness so the hip develops into a non-dislocated hip
What is the problem with DDH going undetected until later in childhood?
Hip develops into irreducible non-dislocated hip requiring major surgery
What is a toddler’s fracture?
Twist in the tibia causing a periosteal reaction
What is the management of a toddler’s fracture?
Put in cast and follow-up X ray in 2-4 weeks
What indicates a slipped upper femoral epiphysis on examination?
External rotation when the hip and knee are flexed
Which X ray view is useful in investigating a slipped upper femoral epiphysis?
Frog leg X ray
What is a Threthowan sign?
Line down the lateral edge of the femoral neck fails to interdect the epiphysis
What is the management of a slipped upper femoral epiphysis?
Put patient on crutches, then surgery
What causes Perthes’ disease?
Transient interruption to the blood supply of the femoral head
How does Perthes’ disease present?
Dull ache
Restricted abduction
Pain at the limits of abduction
Which antibodies are found in 50% of juvenile idiopathic arthritis?
Anti-nuclear antibodies
Which joint is most often affected by juvenile idiopathic arthritis?
Knee
What does the Salter-Harris classification classify?
Physeal (growth plate) fractures
What is a Salter-Harris type I fracture?
Fracture through the growth plate but not through bone
