Children's Orthopaedics

Question 1

What are the common hip abnormalities in 0-5y/os?

Answer 1

Normal variant
Trauma
Transient synovitis
Osteomyelitis
Septic arthritis
DDH
JIA

Question 2

What are the common hip abnormalities in 5-10y/os?

Answer 2

Trauma
Transient synovitis
Osteomyelitis
Septic arthritis
Legg-Calve
-Perthes disease

Question 3

What are the common hip abnormalities in 10-15y/os?

Answer 3

Trauma
Osteomyelitis
Septic arthritis
SUFE
Chondromalacia
Neoplasm

Question 4

What is DDH?

Answer 4

Developmental Displasia of the Hip

Question 5

Incidence of DDH is highest in which groups?

Answer 5

Eastern Europe
Native American
Western europe
Girls > Boys

Question 6

What conditions can increase the incidence of DDH?

Answer 6

First Born
Oligohydramnios
Breech Presentation
Family History
Other lower limb deformities

Question 7

What are the clinical features of DDH?

Answer 7

Ortolani’s Sign
Barlow’s Sign
Piston Motion Sign
Ultrasound

Question 8

How is DDH managed?

Answer 8

Splinting

Question 9

How does Legg-Calve-Perthes Disease present?

Answer 9

15% bilateral
Primary school age male
Short 
Limp
Knee pain on exercise 
Stiff hip joint

Question 10

What are the stages of Legg-Calve-Perthes Disease?

Answer 10

Avascular Necrosis
Fragmentation (revascularisation)
Reossification
Residual deformity

Question 11

Unilateral Legg-Calve-Perthes Disease shares a differential with what?

Answer 11

Septic hip
JIA
SCFE
Lymphoma

Question 12

Bilateral Legg-Calve-Perthes Disease shares a differential with what?

Answer 12

Hypothyroid
Sickle
Epiphyseal
dysplasia

Question 13

How is Legg-Calve-Perthes Disease treated?

Answer 13

Maintain hip motion
Analgesia
Restrict painful activities
Osteotomy in >7

Question 14

What is the indicator of good prognosis in Legg-Calve-Perthes Disease?

Answer 14

Onset <9 y/o

Question 15

What is SCFE?

Answer 15

Slipper capital femoral epiphysis

Question 16

SCFE is most common in which group?

Answer 16

Teenage boys ++

Question 17

What proportion of SCFE becomes bilateral?

Answer 17

20%

Question 18

How does SCFE present?

Answer 18

Pain in hip or knee
Externally rotated posture & gait
Reduced internal rotation
Plain x-rays

Question 19

What is the cause of SCFE?

Answer 19

Displacement of bone through the hypertrophic zone

Metaphysis moves anterior/proximally

Question 20

How is SCFE managed?

Answer 20

Surgical fixation

Question 21

SCFE increases the risk of what?

Answer 21

Avascular necrosis
Chondrolysis
Deformity
Early osteoarthritis

Question 22

When is Avascular necrosis of increased risk in SCFE?

Answer 22

Unstable slips (where the patient cannot weight bear)