Paeds: MSK trauma, infective & inflammatory

Playlist contributed by: Dr Annabelle Skelley

Paediatric Fracture/Trauma

  1. Greenstick fracture
    • Incomplete fracture -> bending of bone
    • Usually mid diaphysial
  2. Bowing fractures
    • Incomplete fracture
    • Usually found with transverse or greenstick fracture of paired bone (eg. radial greenstick & ulna bowing fracture)
  3. Salter-Harris fractures
    • Straight through - good prognosis
    • Above - good prognosis, mot common 
    • Lower - poorer prognosis 
    • Through - poor prognosis
    • Rammed - worst prognosis
  4. Torus fracture = circumferential buckle fracture
  5. Monteggia fracture/dislocation
    • Proximal ulna fracture and radial head dislocation
    • GRIMUS
      • Galeazzi = Radius Inferior (distal)
      • Monteggia = Ulnar Superior (proximal)
  6. Apophyseal avulsion
    • Pelvis/hip: ASIS, AIIS, ischial tuberosity
    • 5th metatarsal
  7. Toddler fracture
    • Undisplaced spiral tibia fracture

NAI

  • Metaphyseal fractures (corner fractures) -> pathagnomic
  • Rib fractures (posterior)
  • Skull fractures
  • Scapular & sternal fractures
  • Spiral femur fractures in non-weightbearing children

Bone Infarcts

  • Osteonecrosis of metaphysics or diaphysis
  • XR: sheet like central lucency surrounded by shell-like sclerosis with serpiginous border
  • MRI: central signal isointense to marrow -> marrow not replaced, T1 serpiginous low signal, T2 high

Brodie Abscess = intraosseous abscess

  • Lytic lesion in oval configuration with thick sclerotic rim fading into surrounding bone 

Transient Synovitis

  • Clinical diagnosis
  • Cause of hip pain and limp in young children

Juvenile Idiopathic Arthritis

  • 13/100,000
  • Oligoarticular or polyarticular
  • May have systemic onset (Still disease) with spiking fevers and rash
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Playlist information

rID: 21083
Visibility: public

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