Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MDD > Paediatric Orthopaedics > Flashcards

Paediatric Orthopaedics Flashcards

(81 cards)

Start Studying
1
Q

what is developmental dysplasia of the hip

A

spectrum of disorders ranging from subluxation to dysplasia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

why is early identification of developmental dysplasia important

A

because it responds to conservative treatment early on but requires surgery if you leave it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

how is developmental dysplasia of the hip screened for

A

ortolanis and barlows procedure in the newborn examination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

if missed at screening, how does developmental dysplasia of the hip usually present

A

limping, or asymmetrical skin folds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the next line investigation for ?developmental dysplasia of the hip

A

paeds referral + ultrasound of the hip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what is the treatment for developmental dysplasia of the hip

A

pavlick harness for several months

monitoring via several xrays/USS

surgery if insufficient response or if detected late

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

why must a pavlick harness be set up by an expert?

A

incorrect splinting may lead to avascular necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the risk factors for developmental dysplasia of the hip?

A

Breech presentation

Oligohydramnios

Female sex

Family history

Firstborn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what is pes planus

A

flat feet (loss of medial longitudinal arch)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what condition is marked flat feet common in

A

hypermobility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

when is a rigid flat food pathological

A

in older children/adolescents as young most young children grow out of it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are common causes of a pathological flat foot

A

Teno-achilles ocntracture

Juvenile inflammatory arthropathy

Tarsal coalition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is positional talipes

A

mild inversion deformity of the foot due to intrauterine pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

how do you treat positional talipes

A

passive manipulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is talipes equinovarus

A

aka club foot

entire foot is inverted and supinated
forefood adducted and heel rotated inwards in plantar flexion

foot is shorter and calf muscle thinner than usual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are causes of talipes equinovarus

A

secondary to oligohydramnios
features of malformation syndrome
features of neuromuscular disorders such as spina bifiida

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

how do you treat talipes equinovarus

A

Caster plasting and bracing

May be required for many months

Surgery required if unsuccessful

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what is scoliosis

A

abnormal lateral curvature in the spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what are the causes of scoliosis

A

most commonly idiopathic

congenital (VACTERL, spina bifida, hemivertebrae)

secondary (neuromuscular imbalance, disorders of bone, leg length discrepancy)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

how should you investigate scoliosis

A

look at spine whilst standing up straight

if disappears when they bend over its postural

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what is the management for scoliosis

A

mild = resolves spontaneously/progresses minimally

severe = specialist referral for bracing

surgery only indicated if there is respiratory/cardiovascular/neurological interference

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is torticollis

A

flexion/extension/twisting of the muscles in the neck allowing the neck to move beyond what is normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is the most common cause of torticollis in infants

A

SCM tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what are common causes of torticollis in kids

A

muscular spasm
secondary ENT infection
cervical spine arthritis
spinal tumour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what is the management for acute torticollis
Painkiller Possibly diazepam for muscle relaxation but caution Exercise of head and neck important to prevent neck stiffening Heat packs and good posture Persistence = botox Surgery reserved for very severe cases – involves severing nerves around the face to help with relaxation
26
what are common sites of non accidental fractures in children
posterior ribs long bones complex skull fractures usually multiple
27
what should be ruled out whne reviewing possible non accidental injury fractures
osteogenesis imperfectica copper deficiency both can cause decreased fracture thresholds
28
what is osteomyelitis
infection of the metaphysis (head portion) of the long bones
29
what are the most common sites for osteomyelitis
distal femur/proximal tibia
30
what are common causative organisms for osteomyelitis
S.aureus streptococcus Hib Tb
31
what pathogens are at an increased risk of causing osteomyelitis if the patient has sickle cell disease
salmonella/staph
32
what are clinical features of osteomyelitis
Painful immobile limb Acute febrile illness Local swelling/tenderness with erythema Pain on movement Sterile effusion in joint space May be more insideous In infants where limb immobilisation/swelling is the first sign
33
when do radiographic changes begin to occur in osteomyelitis
7-10 days
34
what is the best imagine method to visualise osteomyelitis
MRI
35
what does chronic osteomyeltitis look like on an XR
periosteal reaction along the shaft | multiple hypodense areas with metaphyseal regions
36
how do you manage osteomyelitis
IV ABx for several weeks surgical drainage if required (no rapid response to Abc) immobilisation of the bone
37
what are the complications of osteomyelitis
Bone necrosis Chronic infection Limb deformity Amyloidosis
38
how does subacute osteomyelitis present
insideous onset with mild symptoms over a period of months ``` Signs include: Swelling Erythema Warmth Pain on movement of the adjacent joint Some joint effusion present Surrounding muscle wasting ```
39
what is the average time of diagnosis from inital presentation of symptoms of subacute osteomyelitis
1-6 months
40
what are symptoms of chronic osteomyelitis
Bone pain Persistent fatigue Pus draining from a sinus Local swelling Skin changes Excessive sweating Chills
41
what are the risks of untreated osteomyelitis
Left untreated this can spread to other bones, causing widespread infection, sepsis or death With chronic disease there is destruction of bone which is permanent and may result in the need for amputation due to poor vascularisation of remaining bone
42
in children, what age group most commonly gets septic arthritis
<2 years
43
what organisms most commonly cause septic arthritis
staph aureus | Hib
44
what is the clinical presentation of septic arthritis
Erythematous, warm, acutely tender joint Reduced range of movement Unwell, febrile child Infants cry and hold the limb There may be joint effusion In toddlers if the pathology is in the legs there may be a limb or referred knee pain (if hip)
45
how should you investigate ?septic arthritis in a child
Increases WCC/CRP Positive blood cultures USS of deep joints identifies effusions XR excludes bony trauma and other lesions – but usually normal apart from joint space widening and soft tissue swelling Bone scan may be helpful MRI excludes adjacent osteomyelitis DEFINITIVE MEASURE Aspiration of joint space and culture under ultrasound guidance
46
what is the treatment for septic arthritis
Prolonged course of antibiotics – especially IV Washing out of joint spaces/surgical drainage may be required if resolution does not occur rapidly Immbolisation of joint in a functional position – but must be mobilised to prevent deformity
47
what is perthes disease
Avascular necrosis of the capital femoral epiphysis of the femoral head due to the interruption of the blood supply followed be revascularisation and reossification over the next 18-36 months
48
what is the common gender and age range for perthes disease
boys, 5-10 years old
49
how does perthes disease present
insideous onset of limping, knee pain hip pain
50
what is a common differential of perthes disease
transient synovitis
51
what % of cases is perthes disease bilateral
10-20%
52
how should perthes disease be investigated
AP, Lateral and frog legs XR
53
whar radiological signs indicate perthes disease
increased density of the femoral head, subsequently becoming fragmented and more irregular
54
what is the management for perthes disease
if found early and <50% of femoral head affected = bed rest and traction more severe disease/late presentation: femoral + pelvic osteotomy with maintained hip abduction
55
whats the prognosis of perthes disease
Mostly good, Particularly those below the age of 6 with less than half of the epiphyses involved In older children, or in those with more extensive involvement of the epiphyses, deformity of the femoral head and metaphyseal damage is more likely, with potential for subsequent degenerative arthritis in adult life
56
what is a slipped upper femoral epiphysis
Postero-inferio displacement of the femoral head requiring prompt treatment in order to prevent avascular necrosis
57
what patient population is slipped upper femoral epiphysis most common in
overweight 10-15 year old boys
58
what % of slipped upper femoral epiphysis cases are bilateral
20%
59
what metabolic abnormalities is slipped upper femoral epiphysis assoicated with
hypogonadism | hypothyroidism
60
how does slipped upper femoral epiphysis present
limp/hip pain maybe referred knee pain restricted abduction and external rotation of the hip
61
how do you confirm slipped upper femoral epiphysis
XR frog legs lateral should be included
62
how do you manage slipped upper femoral epiphysis
Surgical Pin fixation in situ This should be based on if the condition is acute (<3 weeks) or chronic and if they can weight bear or not Post-surgery rehab Crutches for 6-8 weeks Physio Analgesia NSAIDS
63
what is transient synovitis
acute hip pain associated with a viral infection
64
what is the most common cause of hip pain in children
transient synovitis
65
what is the age range for transient synovitis
kids 2-12
66
whats the presentation of transient synovitis
Sudden onset pain in hip No pain at rest Decreased range of movement Specifically internal rotation Afebrile or mild fever Does not appear ill
67
what is an important differential for transient synovitis
septic arthritis
68
how do you manage transient synovitis
Bed rest Traction Usually improves within a few days
69
what kind of inheritence is achondroplasia
autosomal dominant - 50% are new mutations
70
what are clinical features of achondroplasia
Short stature Marked shortening of limbs Large head Frontal bossing Depression of nasal bridge Short + broad hangs Marked lumbar lordosis Hydrocephalus – sometimes
71
what is thanatophoric dysplasia
cause of still birth - infants have large head, extremely short limbs and a small chest
72
how is cleidocranial disorder inherited
autosomal dominant
73
what are the features of cleidocranial disorder
Absence of clavicle, delay in closure of anterior fontanelle and/or ossification of the skull short stature normal intelligence patients can bring shoulders to meet in front of their body
74
what is athorogryposis
Heterogenous group of congenital disorders in which there is stiffness and contracture of joints
75
what is athorogryposis associated with
oligohydramnios, widespread congeintal anomalies or chromosomal disorders
76
what type of deformities are common with athorogryposis
Marked flexion of the knees/elbows/wrists + dislocation of the hips and other joints, talipes equinovarus and scoliosis are common skin is thin intelligence usually unaffected
77
whats the management for athorogryposis
physio correction of deformities where possible - splints/casts/surgery
78
what is osteopetrosis
increased density of bone leading to over-deposition of calcium and brittleness
79
how is osteopetrosis inherited
autosomal recessive
80
how does osteopetrosis present
FTT Recurrent infection Hypocalcaemia Anaemia Thrombocytopenia
81
what cures osteopetrosis
bone marrow transplant

MDD (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions