Children’s Orthopaedics - The Limping Child Flashcards

1
Q

Limp?

A

Abnormal gait usually due to pain, weakness or deformity

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2
Q

If a limping child is in pain, which type of gait do they tend to have?

A

Antalgic gait

->maybe think similar to analgesics which are pain meds??

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3
Q

If a limping child is in weakness, which type of gait do they tend to have?

A

Trendelenburg gait

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4
Q

If a limping child has a shorter limb, which type of gait do they tend to have?

A

Toe walk

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5
Q

If a limping child has a stiff joint, which type of gait do they tend to have?

A

Adducted gait and loss of rotation

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6
Q

Most likely causes of a limping child are broken into groups depending on age.
List some of the more likely causes of a limping child aged 0-5yrs.

A

Trauma
Transient synovitis
Osteomyelitis
Septic arthritis
Developmental dysplasia of the hip
Juvenile idiopathic arthritis

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7
Q

Most likely causes of a limping child are broken into groups depending on age.
List some of the more likely causes of a limping child aged 5-10yrs.

A

Trauma
Transient synovitis
Osteomyelitis
Septic arthritis
Perthes disease

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8
Q

Most likely causes of a limping child are broken into groups depending on age.
List some of the more likely causes of a limping child aged 10-15yrs.

A

Trauma
Osteomyelitis
Septic arthritis
SUFE (slipped upper femoral epiphysis)
Chondromalacia
Neoplasm

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9
Q

When in the day are rheumatic conditions the worst?

A

Worst in the morning and get better as the day goes on

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10
Q

A child that is unable to weight bare is unusual. What will often need to be done as a follow up?

A

An appropriate investigation

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11
Q

What is elevated in the blood in muscle dystrophy?

A

Creatinine kinase

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12
Q

Management of septic arthritis?

A

Immediate drainage and antibiotics

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13
Q

Transient synovitis?

A

Post-viral infection of the joints

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14
Q

Which criteria can be used to predict how likely a patient is to have sepetic arthritis.
There are four criteria, the more the patient has, the more likely they have to have septic arthritis.
For example, a score of 1 = <3% chance they have it
Score of 2 = 40%
Score of 3 = 93% chance
Score of 4 = 99.6%

Don’t get bogged down by the numbers, this is just to show how much these criteria help with diagnosis.

Okay, so what are the four criteria?

A

Pyrexia (>38 degrees)
Unable to weight bear
WBC >12,000/ml
ESR >40mm/hr

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15
Q

What is a high ESR indicative of?

A

Inflammaion

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16
Q

RECAP- septic arthritis presentation?

A

Limping
Pseudoparalysis
Swollen, red joint
Refusal to move joint
Pain
Temperature

17
Q

Commonest sites for septic arthritis?

A

Knee
Hip
Sacroiliac joint in older children and young adults

18
Q

RECAP- route of entry for septic arthritis?

A

Infection from removed tooth
Spread from adjacent infected tissue
Dissemination from osteomyelitis

19
Q

RECAP- which microorganism is the most common cause of septic arthritis?

A

Straph. Aurues

20
Q

What are some of the red flag symptoms in children?

A

Sweats
Fever, particularly at night
Abnormal blood tests

->all indicative of serious underlying disease e.g. malignancy

21
Q
A