Childhood hip disorders

Question 1

On examination of suspected Developmental Dysplasia of the Hip (DDH), look for _______, feel for ______ and move to check________

Answer 1

look for asymmetry

feel for clicking

check abduction

Question 2

What are the two instability tests performed in Developmental Dysplasia of the Hip? How are they performed?

Answer 2

Barlow test

• abduct hip and apply pressure on the knees
• test if hip can be dislocated

Ortolani test

• flex, adduct and apply pressure on greather trochanter
• attempt to reduce the hip

Question 3

______ harness is used as treatment of Developmental Dysplasia of the Hip in neonates.

Answer 3

Pavlik harness

Question 4

What are the Kochner criteria, indicative of hip joint infection?

Answer 4

1. unable to bear weight
2. temp >38oC
3. CRP >20
4. WBC>12

Question 5

______ ______ is the most common cause of limping in pre-school children.

Answer 5

Transient synovitis

Question 6

What is Perthes?

Answer 6

Idiopathic avascular necrosis

-blood supply o the head of the femur is transiently cut off

Question 7

Who most commonly gets Perthes?

Answer 7

4-8 year old boys, highly active

Question 8

What are the 4 pathological stages of Perthes?

Answer 8

1. Necrosis
2. Fragmentation
3. Reossification
4. Remodelling

Question 9

What’s SUFE?

Answer 9

slipped upper femoral epiphysis

Question 10

SUFE most commonly presents in __-__ year old.

Answer 10

10-16

Question 11

Trethowan’s sign can be used to confirm SUFE on X-ray. How is it done?

Answer 11

1. Draw a line up the neck of the femur
2. It should ‘slice off’ a portion of the femoral head
3. in SUFE, the line passes above the head of the femur

Question 12

What are the risk factors for developing SUFE? (5)

Answer 12

• boys
• obese
• hyperthyroidism
• endocrine disorders
• 11-15 yo