FN: The Limping Child Flashcards
1
Q
Aetiology
A
- DDH
- Transient synovitis
- Septic synovitis
- Perthes
- Slipped Capital Femoral Epiphyses
6 JIA/Still’s disease
2
Q
DDH
A
Congenital hip joint deformity in which the femoral head is or can be completely/partially displaced
3
Q
DDH epi
A
Incidence: 1/1000
Sex: F>M
4
Q
DDH predisposing factors
A
- FH
- Breach presentation
- Oligohydramnios
5
Q
DDH presentation
A
- Screening
- Asymmetric skin folds
- Limp/abnormal gait
6
Q
DDH Ix
A
US is v. specific
7
Q
DDH Mx
A
Maintain abduction
- double nappeis
- Pavlik harness
- Plaster hip spica
- Open reduction: derotation varus osteotomy
8
Q
Transient Synovitis: Irritable Hip Presentation
A
Commonest cause of hip pain in children
- 2-12 yrs
- Sudden onset hip pain/limp
- Often following or with viral infection
- Not systemically unwell
9
Q
Transient Synovitis: Irritable Hip Ix
A
- PMN and ESR/CRP are normal
- -ve blood cultures
- May need joint aspiration and culture
10
Q
Transient Synovitis: Irritable Hip Mx
A
- Rest and analgesia
- Settles over 2-3d
11
Q
Perthes Disease description
A
Osteochondritis of the femoral head
12
Q
Perthes Disease epi
A
4-10 yrs
M>F = 5:1
13
Q
Perthes Disease Presentation
A
- Insidious onset
- Hip pain initially, then painless
- 10-20% bilateral
14
Q
Perthes Disease Ix
A
- X-rays normally initially
- raised density of femoral head
- Bone scan is useful
15
Q
Perthes Disease Femoral head changes
A
Becomes fragmented and irregular
Flattening and sclerosis
