CLIPP 17 - transient synovitis

Question 1

DDX limp/extremity pain (10)

Answer 1

• leukemia
• osteomyelitis
• reactive arthritis
• septic arthritis
• transient synovitis
• trauma
• JIA
• slipped capital femoral epiphysis
• Legg-calve-Perthes Disease

Question 2

Developmental Dysplasia of the hip (definition, risk factors, screening, complications)

Answer 2

• femoral head not properly aligned with acetabulum
• Risk factors: female sex, breech delivery, family history
• Screening: Ortolani/Barlow maneuvers
• Complications: abnormal growth of hip joint

Question 3

ibuprofen dosing

Answer 3

Dosage: 10mg/kg every 6-8 hours, max dose = 40mg/kg/day
Concentration: 100mg/5mL (20mg/1mL)

Question 4

Lyme disease (cause, symptoms, complications)

Answer 4

• Borrelia burgdorferi
• characteristic rash (erythema migrans), fever, malaise, fatigue, headache
• Complications: arthritis

Question 5

Accidental vs non-accidental bruising

Answer 5

• Accidental: bony prominences (shins/forearms)

- Non-accidental: well-cushioned areas (buttocks, back, genitalia)

Question 6

Independent predictors of septic arthritis of the hip (5)

Answer 6

• fever, non-weight bearing, ESR >40mm/hr, WBC >12, CRP >20mg/L
• predicted probability increases with each predictor present

Question 7

Septic arthritis (diagnostic testing/results, causative organisms, treatment)

Answer 7

• diagnosis:ultrasound, joint aspiration
• synovial fluid with turbid appearance, polymorphocytic leukocytosis, gram+ bacteria
• staph, strep, Hib, N. gonorrhea, K. kingae
• IV abx, surgical I&D

Question 8

Transient synovitis (definition, cause, treatment, duration, complications)

Answer 8

• inflammation and swelling of tissues around the hip joint
• post-infectious (?)
• Tx: rest + ibuprofen
• duration: 3-10 days
• slight risk of recurrence, no long-term complications