Physical and Developmental Disorders of Skeletal System Quiz

Physical or Developmental Disorders of the Skeletal System

• Causes of skeletal disorders in newborns: genetic, environmental, maternal drug ingestion, virus invasion, amniotic band formation, and unknown factors.

Finger and Toe Conditions

• Polydactyly: presence of one or more additional fingers or toes.
• Achondroplasia (Chondrodystrophia): a dominant trait that causes a disorder in cartilage production in utero, resulting in a prominent forehead, flattened nose, and near-normal trunk size, but with thoracic kyphosis and lumbar lordosis of the spine.
• Syndactyly: two fingers or toes are fused, usually caused by a simple webbing.

Chest Deformations

• Pectus excavatum (funnel chest): an indentation of the lower portion of the sternum, occurring in 1 out of 500 live births, more common in boys.
• Pectus carinatum: a sternum displaced anteriorly, increasing the anteroposterior diameter of the chest, can be surgically corrected.

Talipes Disorders

• Ankle-foot disorders, also known as clubfoot, characterized by bone deformity and foot malposition with soft tissue contracture, occurring in 1 in every 1000 children, more common in boys.
• Types of talipes disorders: pectus carinatum, torticollis (wry neck), and talipes equinovarus.

Talipes Equinovarus

• Characterized by plantar flexion (equinus or "horse foot position"), forefoot lower than the heel, and varus deviation (the foot turns in).
• Assessment: detection involves straightening all newborn feet to the midline, referral to a pediatric physician and orthopedist for further evaluation.

Craniosynostosis

• Premature closure of skull sutures, more common in boys, caused by dominant inheritance, rickets, calcium irregularities, or phosphate metabolism.
• Sagittal suture line closure: head tends to grow anteriorly and posteriorly.
• Coronal suture line closure: eye orbits are misshapen, leading to increased intracranial pressure and eye disorders.

Developmental Dysplasia of the Hip (DDH)

• Referred to as congenital hip dysplasia, a spectrum of abnormalities affecting the hip joint.
• Causes: unknown, may be related to polygenic inheritance, uterine position, or breech birth.
• Risk factors: family history, oligohydramnios, large birth gestational age, metatarsus adductus, and torticollis.
• Assessment: Ortolani and Barlow maneuvers to screen all infants (birth-3 months old).

Physical or Developmental Disorders of the Gastrointestinal System

Ankyloglossia (Tongue-tie)

• Congenital anomaly characterized by a tight or shortened lingual frenulum, causing restricted tongue mobility and impaired tongue function.
• Causes difficulty with breastfeeding due to difficulty with tongue mobility and ability to latch.

Thyroglossal Cysts

• An autosomal dominant trait, characterized by an irregular neck mass or lump that develops from cells and tissues left over after formation of the thyroid gland.
• Located in or around the neck midline, extending to the base of the tongue.

Orofacial Clefts: Cleft Lip and Cleft Palate

• No specific information provided.

Therapeutic Management

• Mild DDH: close monitoring, as 60% - 80% of clinically identified abnormalities and 90% of ultrasonographic abnormalities spontaneously resolve without treatment in early infancy.
• Severe DDH: may require treatment to prevent osteoarthritis of the hip in adulthood.