Childhood Problems - Limp

Question 1

What conditions can cause limp from birth?

Answer 1

CHD

infection of the hip

Question 2

What condition commonly causes a limp between the ages of 4-10?

Answer 2

Perthe’s Disease

Question 3

What condition commonly causes a limp between the ages of 10-15?

Answer 3

SUFE

Question 4

What is Perthe’s?

Answer 4

idiopathic osteochondritis of the femoral head

Question 5

How does Perthe’s present?

Answer 5

painful limp with a slow recovery
deterioration in radiographs over time.
USS reveals hip effusion

Question 6

How is Perthe’s Managed?

Answer 6

Maintain the femoral head in the acetabulum until the disease runs its course.

Periods of gentle traction to relieve pain

Question 7

What is a SUFE?

Answer 7

children who have recently undergone a growth spurt/ overweight causes slippage of the epiphysis of the femoral head so the head is abnormally tilted

Question 8

How does SUFE present?

Answer 8

limp commonly with pain radiating to the knee (obturator nerve)

any young adolescents must be regarded as having this condition until it is otherwise proven

Question 9

How is SUFE managed?

Answer 9

Surgically

The epiphysis must be pinned in place although risk of avascular necrosis is high.

Pins are removed once the hip has fused.