Childhood Hip Disorders Flashcards
What are some common risk factors of developmental dysplasia of the hip?
Breech position
FHx
Musculoskeletal abnormalities
How does developmental dysplasia of the hip commonly present?
Extra skin fold in thigh in first 2 months
What need to be checked in an examination of developmental dysplasia of the hip?
Asymmetry
Click/clunk
Abduction
What tests need to be done to assess for instability?
Barlow
Ortolani
What is the most useful imaging technique for developmental dysplasia of the hip?
Ultrasound
What harness can be used if developmental dysplasia of the hip is diagnosed early?
Pavlik harness
How is developmental dysplasia of the hip corrected if recognised late?
Open reduction
What should be done first in a preschool child with a limp?
Exclude infection
What criteria can be used to exclude infection?
Kocher criteria Temp >38 Unable to bear weight CRP >20 WCC >12
What is the commonest cause of a limp in a preschool child?
Transient synovitis
What is the classic presentation of a patient with Perthes?
A small hyperactive boy
What occurs in Perthes?
Avascular necrosis - blood supply is cut off to the epiphysis
What are the four stages of Perthes?
Necrosis
Fragmentation
Re-ossification
Remoddeling
What are the treatment principles of Perthes?
Influencing the shape of the recovering head
Maintaining hip abduction
What does SUFE stand for?
Slipped upper femoral epiphysis
How does a patient with SUFE classically present?
Shortened leg that is laterally rotated
What are usual features of a patient with SUFE?
10-16
Obese child
Boy
Black
What is Trethowan’s sign?
When the line from the neck of the femur does not transect the femoral head
How is SUFE treated?
Physis is stabilised
What can occur in acute unstable SUFE?
Avascular necrosis - may lead to total hip replacement
