Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Phase 3a conditions list flashcards > Paediatrics - MSK + rheum > Flashcards

Paediatrics - MSK + rheum Flashcards

(125 cards)

Start Studying
1
Q

What are some causes of hip (or other joint) pain in 0-4 year olds (3)?

A
  • Septic arthritis
  • Developmental dysplasia of the hip
  • Transient sinovitis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are some causes of hip (or other joint) pain in 5-10 year olds (3)?

A
  • Septic arthritis
  • Transient sinovitis
  • Perthes disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are some causes of hip (or other joint) pain in 10-16 year olds (4)?

A
  • Septic arthritis
  • Slipped upper femoral epiphysis
  • Juvenile idiopathic arthritis
  • Transient
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How can hip pain present (3)?

A
  • Pain
  • Refusal to walk/ weight bear
  • Swollen/ tender joint
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some red flag features for hip pain (6)?

A
  • Child under 3
  • Fever (38.5)
  • Night waking/ pain
  • Swollen/ red joint
  • Persistent pain
  • Other injuries (NAI)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some general investigations for joint pain (5)?

A
  • Bloods
  • Xray
  • USS
  • Joint aspiration
  • MRI
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the most common cause of hip pain in children 3-10?

A

Transient synovitis

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

What is transient synovitis also known as?

A

Irritable hip

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

What causes transient synovitis?

A

Inflammation of the synovial membrane typically following a viral URTI

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

What are the signs/ symptoms of transient synovitis (3)?

A
  • Limp/ inability to weight bear
  • Groin/ hip pain
  • Mild low grade fever
    children should otherwise be well
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How should children with transient synovitis be managed?

A

Refer if symptoms not improving after 72 hours

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

What is an important differential for transient synovitis and how can it be differentiated?

A

Septic arthritis - usually present with a high fever

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

What age is septic arthritis most common in children?

A

Under 4 years old

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

What is a risk factor for septic arthritis?

A

Joint replacement

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

What is the most common bacteria and what other bacteria cause septic arthritis (5)?

A
  • Staph aureus = mc
  • Neiserria gonorrhoea
  • GAS (strep pyogenes)
  • H. influenza
  • E. coli
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the signs/ symptoms of septic arthritis (5)?

A
  • Red, hot, swollen joint
  • Fever
  • Reduced range of motion
  • Stiffness
  • Non weight bearing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How is septic arthritis investigated (2)?

A
  • Joint aspiration (high WBC, MC+S)
  • Bloods
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What criteria can be used to differentiate between transient synovitis and septic arthritis?

A

Kocher criteria

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

What are the kocher criteria (3)?

A
  • Non weight bearing
  • Temp > 38.5
  • High WCC/ ESR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

How is septic arthritis managed (2)?

A
  • IV Abx (3-6 weeks)
  • Surgical debridement (if severe)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is developmental dysplasia of the hip?

A

Structural abnormality caused by abnormal development of the foetal bones during pregnancy

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

What are the risk factors for DDH (6)?

A
  • Family history
  • Breech position
  • Fibroids
  • Multiple pregnancy
  • Oligohydramnios
  • First born
    anything that reduces space in-utero
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the signs/ symptoms of DDH (4)?

A
  • Leg length discrepancy
  • Skin folds on one side
  • Restricted hip abduction
  • Clunking noise when leg examined
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are two special tests that can be used to check for DDH?

A
  • Barlow (hip dislocate posteriorly)
  • Ortolani (hip relocate anteriorly)
    go out to a bar - so barlow is dislocate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
When is DDH often picked up/ diagnosed?
When examining the baby in the NIPE and again at 6-8 weeks
26
How is DDH diagnosed (2)?
* USS * Xray if > 4.5 months
27
How is DDH managed?
**Pavlik harness** is worn permanently for 6-8 weeks *if child diagnosed before 6 months old, if not surgery may be required*
28
How is DDH managed if the child is diagnosed after 6 months?
Surgery
29
What is Perthes disease?
Disruption of blood flow to the femoral head causing **avascular necrosis**
30
What are some risk factors for Perths disease (3)?
* Male * Family history * Downs
31
How quickly do symptoms of Perthes disease come on?
Slow onset
32
What are the signs/ symptoms of Perthes disease (4)?
* Slow onset **pain** in the hip * Limp * Restricted range of movement (abduction + internal rotation) * Trendelenburg +ve (muscle waisting - from lack of use)
33
What age is Perthes disease most common?
Mostly 5-8 years (can be 4-12 years)
34
How is Perthes disease investigated (3)?
* Xray * Bloods * MRI
35
What are the signs of Perthes on x-ray (2)?
* Wide joint space * Caffey sign (decreased BMD, thin fracture)
36
How can Perthes disease be monitored?
Using the catterall classification (from xray appearance)
37
How is Perthes disease managed (2)?
* < 6 = observe * >6 = surgery - osteotomy (reshape joint)
38
How long can Perthes disease last?
5 years
39
What is a common-ish complication of Perths disease?
OA of the hip
40
What is a slipped upper femoral epiphysis?
When the head of the femur is displaced along the growth plate
41
What type of fracture occurs in SUFE?
Salter Harris 1 fracture
42
What are some risk factors for SUFE (3)?
* Obese * Male * Trauma
43
What age is usually affected by slipped upper femoral epiphysis?
10 -15 year olds (during growth spurt)
44
What are the signs/ symptoms of SUFE (3)?
* Hip/ groin/ thigh/ knee pain * Restricted range of movement * Painful limp
45
What position do children with slipped upper femoral epiphysis like to rest their leg in?
Externally rotated (drehmann sign)
46
What usually precedes children with SUFE in the history?
Minor trauma
47
How is SUFE investigated (3)?
* Xray (frog leg position - AP + lateral) * Blood (rule out other stuff) * Other imaging (CT, MRI)
48
How is SUFE managed?
Surgical internal fixation
49
What is a complication of SUFE?
Avascular necrosis of the femoral head as blood supply cut off by fracture
50
What condition not mentioned yet may cause hip and other larger joint pain?
Rheumatic fever associated arthritis
51
What is a cause of anterior knee pain in childhood?
Osgood schlatter disease
52
What is osgood schlatter disease?
Inflammation at the tibial tuberosity where the patella ligament inserts
53
What age and gender does osgood schlatter occur?
10-15 year old boys
54
What are the signs/ symptoms of osgood schlatter (2)?
* Anterior knee pain * Tender boney growth/ lump
55
How is osgood schlatter managed?
Analgesics + rest
56
What is a complication of osgood schlatter?
Full avulsion fracture (tibial tuberosity completely separates from rest of tibia)
57
What is an abnormal ankle position present from birth known as?
Talipes *"clubfoot"*
58
What are some risk factors for talipes (3)?
* Family history * Oligohydramnios * Amniocentesis
59
How is talipes managed?
Foot is manipulated into an improved position and a cast is applied on it to hold it there. This process is repeated
60
What is the treatment for talipes known as?
Ponseti method
61
What is a more minor version of talipes?
Positional talipes *the resting position of the foot is plantarflexion/ dorsiflexion, however there is no boney abnormality preventing the movement to a normal position*
62
What is osteomyelitis?
Infection in the bone and bone marrow
63
What are three routes osteomyelitis can be introduced?
* Directly (e.g. through open fracture) * Haematogenous spread (through blood from other infection e.g. skin) * Spread from nearby tissue (e.g. septic arthritis)
64
What is the most common bacteria causing osteomyelitis?
Staph aureus
65
What is the most common cause of osteomyelitis in those with sickle cell?
Salmonella
66
What are some risk factors for osteomyelitis (5)?
* Male * Under 10 * Open fracture * Immunocompromised * Sickle cell
67
How does osteomyelitis present (4)?
* Refusing to weigh bear * Sever bone pain * Swelling + tenderness * Fever
68
What are the two types of presentation in terms of time frames of those with osteomyelitis?
* Acute * Chronic (more slow growing bacteria in bone)
69
What are some investigations of those with osteomyelitis (3)?
* X-ray = first line * MRI * Bloods + cultures
70
How is osteomyelitis managed (2)?
* Prolonged antibiotics * Surgical debridement
71
What is rickets?
Osteomalacia (poor bone mineralisation) in children
72
What minerals are important for the mineralisation of bone (2)?
* Calcium * Phosphate
73
What are some causes of low calcium (5)?
* Diet * Vitamin D deficiency * CKD * Hyperparathyroidism (causing absorption of calcium from the bone, so high Ca2+ in blood) * Liver disease
74
What are some causes of low phosphate?
Various genetic conditions (often X-linked)
75
What are the signs/ symptoms of rickets (6)?
* Poor growth * Bone deformities * Lethargy * Bone pain * Dental problems * Pathological fractures
76
What bone deformities occur in rickets (5)?
* Tibial bowing * Knock knees * Harrisons sulcus (indentation in chest) * Craniotabes (soft skull + frontal bossing) * Delayed teeth
77
How is rickets investigated (2)?
* X-rays * Bloods
78
What blood screen should be done on those with rickets (7)?
* Serum 25-hydroxyvitamin D, calcium, phosphate * Malabsorption screen (coeliacs) * FBC, ferritin * LFT, TFT, kidney function * PTH * Autoimmune antibodies * ESR, CRP
79
How is rickets managed?
Adcal-D3
80
What group of babies are at higher risk of vitamin D deficiency?
Breastfed babies (as milk not fortified with vitamin D
81
What is a differential for a bone deformity seen in rickets?
Blunts disease = isolated bowed tibia
82
What is a disorder that causes bones to become brittle?
Osteogenesis imperfecta
83
What is osteogenesis imperfecta?
Genetic condition affecting the formation of collagen
84
What is the usual inheritance pattern of osteogenesis imperfecta?
Autosomal dominant *although lots of different types of inheritance pattern*
85
What are the most common gene mutations that result in osteogenesis imperfecta?
COL1A1 or COL1A2 genes
86
What are the signs/ symptoms of osteogenesis imperfecta (6)?
* Recurrent/ inappropriate fractures * **Blue sclera** * Hypermobility * Bone deformities * Dental problems * Short stature
87
How is osteogenesis imperfecta diagnosed?
Clinical diagnosis (sillence criteria)
88
How is osteogenesis imperfecta managed (3)?
* **Bisphosphinates/ vitamin D** * PT/ OT * Surgical interventions *managed by MDT*
89
What is juvenile idiopathic arthritis?
Chronic autoimmune inflammatory arthritis without another identifiable cause
90
What age is affected by JIA?
Under 16s
91
How long does arthritis typically have to last before being classified as JIA?
6 weeks or more
92
What are the 5 main types of JIA?
* Oligoarticular = MC * Systemic (stills disease) * Polyarticular * Enthesitis related * Juvenile psoriatic
93
How many joints are affected in oligoarticular JIA?
4 or less
94
How many joints are affected in polyarticular JIA?
5 or more
95
What are the joint features of inflammatory arthritis (3)?
* Joint pain * Swelling * Stiffness
96
What are the features of systemic JIA (6)?
* **Salmon-pink rash** * High swinging fevers * Lymphadenopathy * Weight loss * Arthritis * Pleuritis, pericarditis
97
What are the blood findings in those with systemic JIA (3)?
* Negative RF, ANA * Raised CRP/ESR, ferritin * Raised platelets
98
What is a complication of systemic JIA?
Macrophage activation syndrome
99
What is macrophage activation syndrome?
Severe activation of the immune system with a massive inflammatory response
100
What are the features of macrophage activation syndrome?
* DIC (non blanching rash) * Anaemia * Thrombocytopenia (bleeding)
101
What is a key finding in macrophage activation syndrome?
Low ESR
102
How is macrophage activation syndrome treated (2)?
* IV fluids * Steroids
103
What are some key differentials for a high fever lasting for more than 5 days (4)?
* Systemic JIA * Kawasaki disease * Leukaemia * Rheumatic fever
104
What are the features of polyarticular JIA (5)?
* Affects small and large joints * Symmetrical * Mild fever * Anaemia * Reduced growth *childhood equivalent to RA*
105
What is a key blood finding in those with polyarticular JIA?
Can be positive or negative RF
106
What are the features of oligoarticular JIA (3)?
* **Anterior uveitis** * Larger joints more commonly affected * Often monoarticular
107
What are the key blood findings in oligoarticular JIA?
* ANA often +ve * RF usually -ve
108
Who is most commonly affected by oligoarticular JIA?
Girls under 6
109
What is the adult equivalent of enthesitis related arthritis?
Seronegative spondyloarthropathy
110
What are the key features of enthesitis related arthritis (4)?
* Enthesitis (inflammation of the tendon) * HLA-B27 positive * Anterior uveitis * IBD
111
What are the key features of juvenile psoriatic arthritis (5)?
* Psoriasis * Nail pitting * Onycholysis * Dactylitis * Enthesitis
112
How is JIA managed (4)?
* NSAIDs * Steroids * DMARDs * Biologics
113
What are 3 DMARDs used for the treatment of JIA?
* **Methotrexate** * Sulfasalazine * Leflunomide
114
What are 3 biologics used for the treatment of JIA?
* Etanercept * Infliximab * Adalimumab
115
What are some complications of JIA (3)?
* Anterior uveitis * Pericarditis/ pleuritis * Osteoporosis
116
What is the most common cause of dwarfism?
Achondroplasia
117
What is achondroplasia?
Genetic disorder affecting fibroblast growth factor receptor 3 (FGFR3) gene on chromosome 4 *this causes abnormal function of the epiphyseal growth plate*
118
What are the features of achondroplasia (5)?
* Short stature * Short digits * Bow legs * Frontal bossing * Foramen magnum stenosis
119
What are some complications of achondroplasia (4)?
* Recurrent otitis media * Kyphoscoliosis * Spinal stenosis * OSA
120
How is achondroplasia inherited?
Autosomal dominant
121
What are the main causes of scoliosis in children (6)?
* Idiopathic (probably genetic cause) * Congenital e.g. spina bifida * Neuromuscular e.g. cerebral palsy * Tumours * Trauma * Infections
122
What is torticollis?
Abnormal head position causing the head to be tilted to one side (the cause is often unknown)
123
What can cause knee pain in 6-10 year olds often triggered by twisting or squatting whilst playing sports?
Discoid meniscus
124
What is a discoid meniscus?
An abnormality in the way the meniscus (cartilage) has formed
125

Phase 3a conditions list flashcards (31 decks)

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