DDH, SUFE, Perthe's Flashcards
age specific hip problems: 0-5
normal varient trauma transient synovitis osteomyelitis septic arthritis DDH JIA
age specific hip problems: 5-10
trauma transient synovitis osteomyelitis septic arthritis Legg-Calve Perthe's disease
age specific hip problems: 10-15
trauma osteomyelitis septic arthritis SUFE chondromalacia neoplasma
DDH: incidence
2.4/1000
DDH: M:F
1:6
DDH: increased incidence in
first born oligohydramnios breech family Hx other LL deformities
DDH: clinical features
ortolani’s sign
barlow’s sign
piston motion sign
Legg-Calve-Perthe’s disease: M:F
5:1
Legg-Calve-Perthe’s disease: age
primary school
Legg-Calve-Perthe’s disease: what % are bilateral
15
Legg-Calve-Perthe’s disease: features
short limp knee pai on exercise stiff hip joint systemically well
Legg-Calve-Perthe’s disease: phases
avascular necrosis
fragmentation - revascularisation (pain)
reossificaiton
residual deformity
Legg-Calve-Perthe’s disease: differential unilateral
septic hip
JIA
SUFE
lymphoma
Legg-Calve-Perthe’s disease: bilateral
hypothyroid
sickle cell disease
epiphyseal dysplasia
Legg-Calve-Perthe’s disease: treatment
o Maintain hip motion o Analgesia o Restrict painful activities o “supervised neglect” in most cases o “containment” consider osteotomy in selected groups of older children (>7) o Prognosis good is onset <9
SUFE: incidence
1-10/100,000
SUFE: boys or girls?
boys
SUFE: age
9-14
SUFE: what % become bilateral?
20
SUFE: classification
acute vs chronic - 3 weeks
stable - ? fix in situ
unstable = SH1# = fix (serendipitous reduction)
SUFE: detection
pain in hip or knee
externally rotated posture and gait
reduced internal rotation, esp in flexion
plain x-rays
what xray view best detects SUFE?
lateral
SUFE: pathology
dysplacement through hypertrophic zone
metaphysis moves anterior and proximal
SUFE: outcome
AVN
chondrolysis
deformity
early OA
SUFE: risk of AVN
o Stable slips (able to bear weight) have a low risk of AVN
o Unstable slips (unable to weight bear) have a high risk of AVN
