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MIDS 227 (module 4) > Ch 11 Hips > Flashcards

Ch 11 Hips Flashcards

1
Q

What are the 2 pathologies we cover regarding ped hips?

A

-Hip effusion (transient synovitis + septic arthritis)
-Developmental dysplasia

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2
Q

The hip joint is composted of the ___ + the ___?

A

Pelvic girdle + femur

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3
Q

The hip bone (aka pelvic girdle) is composed of what 3 structures?

A

Ilium, ischium + pubis

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4
Q

___ is the socket of the hipbone into which the femur head fits?

A

Acetabulum

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5
Q

___ is a lip of cartilage that sits at the rim of the acetabulum?

A

Acetabular labrum

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6
Q

The femoral head is cartilaginous at birth + begins to ossify from the center outward at ___ months of age?

A

2-8

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7
Q

Differentiate abduct + adduct?

A

Abduct: move AWAY from midline

Adduct: move TOWARD midline

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8
Q

What 2 things create the acetabulum?

A

Triradiate cartilage (growth plate) + bone

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9
Q

What is hip effusion?

A

Increased fluid within joint

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10
Q

Can u/s differentiate b/w transient synovitis + septic arthritis?

A

No! Must aspirate the fluid to tell, as u/s can only assess for presence of fluid with hip effusion

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11
Q

What are the 2 main S/S of hip effusion?

A

Pain + limping or refusal to bear weight

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12
Q

___ is a common cause of hip pain b/w 3-8 years old?

A

Transient synovitis

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13
Q

Which type of hip effusion is self limiting/treated with anti-inflammatory meds + rest?

A

Transient synovitis

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14
Q

Both types of hip effuison have similar symptoms, which form m/c has milder symptoms + no long term effects?

A

Transient synovitis

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15
Q

Which type of hip effusion m/c presents with a fever?

A

Septic arthritis

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16
Q

Which type of hip effusion may have a recent history of a upper respiratory infection but are afebrile at presentation?

A

Transient synovitis

(afebrile = no fever)

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17
Q

___ is a serious bacterial infection + is considered a medical emergency that requires rapid treatment?

A

Septic arthritis

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18
Q

Which type of hip effusion may have elevated RBCs, C-reactive protein + WBCs?

A

Septic arthritis

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19
Q

Which form of hip effusion may present with complications if not treated?

A

Septic arthritis

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20
Q

Which form of hip effusion requires IV antibiotics + surgery if severe?

A

Septic arthritis

21
Q

How do we align our probe when checking for hip effusion?

A

Place probe on the anterior part of leg + parallel to long axis of femoral neck

22
Q

What measurements would indicate hip effusion on u/s?

A

Capsular thickness >5mm
OR
2mm difference b/w both hips (assuming unilateral)

23
Q

What is developmental dysplasia of the hip (DDH)?

A

Range of hip dysplasia includinng instability, subluxation + frank dislocation

24
Q

What is DDH also known as?

A

Congenital hip dysplasia (even tho most dislocations occur after birth)

25
Q

List 2 causes of DDH?

A

-Mechanical (position in utero or after birth)

-Physiologic (maternal hormones in utero or physical makeup after birth)

26
Q

Differentiate subluxation + dislocation?

A

Subluxation: partial dislocation
Dislocation: not in socket at all

27
Q

What 2 maneuvers are used to assess hip stability?

A

Barlow + ortolani

28
Q

The ___ maneuver attempts to push the femoral head posteriorly out of socket?

A

Barlow (a clunk is felt as the femoral head exits the acetabulum posteriorly)

29
Q

The ___ maneuver attempts to reduce a recently dislocated hip?

A

Ortolani (a clunk is felt as the dislocated femoral head reduces into the acetabulum)

30
Q

List 3 visual signs of DDH?

A

-Asymmetry of thighs or gluteal folds
-Discrepancy of leg lengths
-Positive allis or galeazzi sign

31
Q

What is a positive allis or galeazzi sign?

A

Short femur when hips + knees are flexed (1 knee appears lower than other)

32
Q

U/s of the hip is best performed up to ___ months of age?

A

6 (due to bony ossification, radiography is more reliable after)

33
Q

During a hip u/s, do we only image the hip presenting with problems?

A

No, must image both to assess for asymmetry

34
Q

___ angle is the m/c measurement obtained?

A

Alpha

35
Q

The femoral head can be identified sitting in the ___?

A

Acetabulum

36
Q

The iliac line should appear as a straight line superiorly or posteriorly?

A

Superiorly

37
Q

The alpha + beta angles can be obtained by using the ___ scan plane?

A

Coronal

38
Q

Where is the baseline, roof line + inclination line?

A

Baseline: along ilium through femoral head

Roof: along acetabular roof intersecting baseline

Inclination: across top of femoral head through labrum + intersects baseline + roof line

39
Q

What is considered a normal alpha angle?

A

> 60 degrees

40
Q

What info can we obtain when scanning coronally?

A

-Can assess the femoral head + see if it is in contact with acetabulum (50% normally sit in it)

-A dislocated hip will sit completely out of acetabulum

41
Q

What is considered an abnormal alpha angle?

A

<60 degrees

42
Q

90% of babies are born with which type of hip?

A

Type 2

43
Q

Which scan plane is 90 degrees from coronal + is posterior lateral?

A

TRV plane

44
Q

What shape is seen in TRV due to the ischium + femoral shaft wrapping around the femoral head?

A

U or V shape

45
Q

What is the only plane we obtain measurements from?

A

Coronal

46
Q

If a dislocation is seen in TRV, what should we do when scanning?

A

Apply stress (abduction) to observe reduction

47
Q

___ is the gold standard for treating DDH?

A

Pavlik harness

48
Q

Sonography of the hips should be done in what planes + what positions?

A

Scan both hips in coronal + TRV with neutral + flexed positions (supine or decub)

49
Q

What 4 things create the hip joint?

A

Pelvic girdle, acetabulum, triradiate cartilage + femoral head

MIDS 227 (module 4) (11 decks)

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