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Diagnosis of pathology of bone and joint system at children

Pathology of bone and joint system


Symptom complex

42 Arthrogryposis

Contractures of large joints of upper and lower extremities
Provisions of extremities with rotation of hands inside, and knaruzha legs
Deformation of feet as an ekvino-varus clubfoot
The provision of brushes in a condition of palmar bending, abduction or adduction
Restriction of movements in knee and elbow joints

43 Arthritis is brucellous

1 The instruction in the anamnesis on the use by the child in food of crude milk in one-three weeks prior to emergence of clinical symptomatology
Flying arthralgias
Mono - and oligoartrita
Leukopenia, neutropenia with the increased maintenance of band forms, a relative and absolute lymphocytosis in peripheral blood
Positive takes of reactions of Wright, Heddelson, Byurne

44 Arthritis is psoriasis

Skin manifestations of psoriasis process
Asymmetric damage of joints (is more often than distal interphalangeal joints of brushes with defeat of soft tissues, development of an akroosteolizis)
Hemilesion in the field of a sacroiliac joint
Radiological — osteoporosis, osteoarticular destructions, an osteolysis of trailer phalanxes of the affected joints
Detection of HLA-B27 of a bitigen in blood

45 Arthritis is reactive

Arises against an intercurrent disease
Intoksikatsionny syndrome
Mono - or an oligoarthritis
Fast return dynamics of pathological process against antiinflammatory therapy
Lack of morning constraint and deformation of joints after elimination of acute process


6 Peripheral blood — a leukocytosis with a neutrocytosis during the acute period

46 Arthritis is tubercular

The most frequent damage of coxofemoral or knee joints
Protective analgetic contracture of the affected joint
Atrophy of muscles of an extremity on the party of defeat
Positive symptom of Alexandrov
Radiological — osteoporosis, thinning of a cortical layer of bones of the affected joint, existence of the centers of destruction of bones
Leukocytosis, lymphocytosis, the increased SOE
Positive Mantoux test

47 Arthritis is juvenile rhematoid, Visler's subsepsis - Fankoni

Intermitgiruyushy hyperthermia steady against antibiotic and antipyretic therapy
Allergic rashes on skin
Moderate limfopoliadeniya
Mono - oligo-or polyarthritis
Neutrophylic leukocytosis with shift to the left, the raised SOE

48 Arthritis is juvenile rhematoid, a joint form

Mono - oligo or polyarthritis
Permanent deformation of the affected joints
Amiotrofin in the affected joints
Morning constraint in the affected joints
Bilateral uveitis
Neutrocytosis, the raised SOE
Rhematoid factor in blood

49 Arthritis is juvenile rhematoid, joint vistsiralnaya a form

Intoksikatsionny syndrome
Mono - oligo-or polyarthritis
Neutrocytosis, increase in SOE
Definition in blood of a rhematoid factor is possible

50 Arthritis is juvenile rhematoid, Stilla-Shoffar's form

Joint syndrome
Involvement in process atlanto-oktsipitalny joint
Symmetric polymorphic rash
Peripheral blood — a leukocytosis with a neutrocytosis, the increased SOE

51 Inborn fragility of bones

Repeated changes
Blue scleras
Imperfect ossification of a skull
Lag in growth
Normal intellectual development of children

52 Congenital dislocation of a knee joint

Restriction of movements in the affected joint
Stupeneobrazny form of a knee joint
Excess overextension of a shin. the corner of a knee joint is open kpered
Sgibateli of a shin moved kpered, get function of razgibatel and prevent bending of a knee
Considerable shortening of an extremity at hemilesion
Radiological — the shift of an axis of a tibial bone of a kpereda up, and hip condyles — kzad and down

53 Congenital dislocation of a patella

Patella shift in the lateral party
Difficulties of extension of the affected extremity in a knee joint
Tension of lateral part four-head of a muscle
Radiological — the patella of the smaller sizes, is sideways in the sagittal direction

54 Congenital dislocation of a hip joint

Restriction of assignment of a hip in a hip joint on the party of defeat
Symptom of Marx-Marksa-Ortolani of "click"
Asymmetry of folds and existence of additional folds on a hip in front and asymmetry of buttock folds behind
Shortening of the affected extremity
Outside rotation of the affected extremity
Radiological — the head of a femur is above an acetabular hollow. Disturbances of conditional lines of Shenton and Kalve-Shturma are expressed

55 The multiple deforming joint chondrodysplasia

Increase in sizes of joints, their deformation
Rigidity of the deformed joints
Hyperostosis of bones of a calvaria
Dysplasia of teeth
Changes from skin (a hyperkeratosis, an angiomatosis, lipomatoz)
Radiological — flattening of an epiphysis, emergence in a cavity of a joint of the calciphied cartilaginous growths connected with joint hryashchy, massive bone growths with accurate hilly contours in the field of a calvaria

56 Multiple epiphyseal dysplasia (illness of Famerbank)

Low growth
Existence of contractures and deformations, mainly joints of the lower extremities
Wide brushes with reinforced fingers
Radiological — reduction in sizes of heads of femurs, flattening of acetabular hollows, epiphysis of tubular bones, bodies of vertebrae

57 Calcaneus apophysis osteochondropathy

Pains, especially after loading, in the field of a calcaneal hillock
Megalgia at a palpation or extension of foot in the field of a calcaneal hillock
Swelling over a calcaneal hillock without inflammation signs
Gait of patients with a support on front department of foot

58 Osteochondropathy of tuberosity of a bolsheberdovy bone (Osgood-Shlattera's illness)

Morbidity at a support on a knee joint at the time of bending and carrying out of an extremity forward
Swelling in the field of tuberosity of a tibial bone
Thickening and protrusion of a cartilage in the field of tuberosity of a tibial bone
Discrepancy between considerable protrusion of tuberosity at clinical trial and almost normal sizes of an apophysis on the roentgenogram

59 Osteochondropathy of a head of plusnevy bones (Köhler's illness of ll)

1 Pains at the basis of the II—III fingers of foot amplifying time of walking and at a palpation of heads of the II—III metatarsal bones
Hypostasis without inflammation signs over heads of the above-stated bones
Gait of patients with a support on a heel
Radiological — consolidation and decrease in height of a head of a plusnevy bone, expansion of a joint crack

60 Foot navicular osteochondropathy (Köhler's illness of I)

Pains in the field of a foot dorsum
Swelling without inflammation signs at the level of a navicular
Gait of patients with a support on the outer edge of foot
Radiological — osteoporosis, reduction of a kernel of ossification of a navicular

61 Backbone osteochondropathy (youthful kyphosis, Sheyermanna-Mau's illness)

Emergence of the deformed bearing with the increased kyphosis of chest department of a backbone in the period of the first period of the strengthened growth
Increase in a pathological kyphosis and shift of its top at the Th8 level — L1 during the second period of the strengthened growth
Emergence of pains in a backbone after forming of a kyphosis at the above-stated level
Radiological — the shift of top of a physiological kyphosis caudally, narrowing of intervertebral spaces, a wedge-shaped shape of bodies of vertebrae

62 Bamatter's syndrome

intra spongy hernias of a disk (cartilaginous small knots of Shmorl)
Dwarfish growth
Flabby skin
The increased joints
Generalized dysplasia of bones

63 Blagvad's syndrome - Hakstkhauzena

Fragility of bones
Decrease in a muscle tone
Dislocations and incomplete dislocations of joints
Gray-bluish spots on skin with the involved surface
Cyanosis of scleras

64 Dreyfus's syndrome

Usually appears at children during the first attempts of walking
Pain and weakness of muscles of a back
Decrease in a muscle tone
Increase in a stomach
Disproportional constitution

65 Syndrome Wife

The shortened and horizontally located edges
Low arrangement of clavicles
Difficulty of breath in connection with restriction of movements of a thorax
Disturbance of ossification of long tubular bones

66 A syndrome of Kalve-Legga - Pertesa

It is observed mainly at boys
The affected extremity pain
Positive symptom of Alexandrov over area of defeat
Atrophy of gluteuses on the struck party

67 Kafi-Silvermen's syndrome

Radiological — expansion of a joint crack, a femur head thickening
It is shown to 6-month age
Subfebrile condition
Moderately painful swelling of soft tissues around a diaphysis of tubular bones
Pseudopareses of extremities

68 Konradi-Hyunerman's syndrome

Hondrodistrofichesky constitution
Growth inhibition of long tubular bones
Rather big skull
Restriction of movements in large joints
Radiological — fungoid expansion of metaphyses

69 Syndrome of Reuters

Inflammatory damage of urinary tract (urethritis, cystitis, etc.)
Asymmetric damage of large joints 1 — 4 week later after emergence of the above-stated inflammatory processes
Existence of a bursitis, achillobursites, fascites, fibroostit
Pustular, urtikarny, vesicular, psoriazopodobny elements on skin

70 Sjegren's syndrome

Dryness of integuments
Dry keratoconjunctivitis
Dry stomatitis
Hypo - and anacid gastritis
Lack of a seroobrazovaniye in the ear courses
Accession of arthritis to the above-stated symptomatology
7 Existence of a rhematoid factor in blood

71 Felti's syndrome

Articulate syndrome
Peripheral blood — a leukopenia, a neutropenia
a) braking of maturing of granulocytes at a stage of promyelocytes and myelocytes
b) reduction of quantity of mature neutrophils
c) plasmacytosis

72 Hondroblastoma (Kodman's tumor)

Most often humeral and tibial bones are surprised
Localization of tumoral growth in a proximal epiphysis
Homotopic pain
Exudate in the affected joint
Radiological — the enlightenment center in an epiphysis with existence of cartilaginous impregnations

73 Ekzostoznaya chondrodysplasia

Dense bone ledges, painful when pressing on a neurovascular bunch, in the field of the distal end femoral, the proximal end tibial and humeral bones
Restriction of movements, the affected joint pains
Change of a tension of muscles at emergence of big bone ledges over a muscular layer

74 Epiphyseal dysostosis (Moroto-Lamy's illness)


Scoliotic deformation of a backbone and thorax
Looseness in joints up to dislocations and incomplete dislocations
Flexion contractures

Bilateral clubfoot
Atrophy of muscles of a trunk and extremities
Radiological — flattening, expansion of an epiphysis with the expressed their incongruence, expansion of metaphyses

75 Youthful epiphysiolysis

Pain in inguinal area or in a knee joint, arising when walking
The fixed outside rotation of a hip with restriction internal and corresponding increase in amplitude of outside rotation
Signs of a dizgormonoz (obesity, striya on skin, a hypogenitalism, the increased arterial pressure)
Radiological: b) general osteoporosis;
b) thinning of a cortical layer of tubular bones;
c) alternation of sites of osteoporosis with osteosclerosis sites in a paraepiphyseal zone of a neck of a hip

According to Ostropolets S. S., V. N. Beet, Diagnostic syndromes of diseases of children's age.

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