hip conditions Flashcards

1
Q

what are the causes of painless limp in toddlers ?

A

usually due to developmental dysplasia of the hip

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2
Q

how is developmental dysplasia of the hips screened for in newborns ?

A

using barlow and ortolani tests

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3
Q

what is barlows test ?

A

dislocating a dislocatable hip

by adduction, flexion and posterior displacement

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4
Q

what is the ortolani test ?

A

reduce a dislocatable hip

abduction of flexed femur

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5
Q

what is the presentation of DDH in newborns less than 3 months ?

A

asymmetric thigh crease

can not change diapers easily

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6
Q

what is the presentation of DDH between 3 months and 1 year ?

A

limb length discrepancy

limited abduction

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7
Q

what is the presentation of DDH in a walking child ?

A

limb length discrepancy
lumbar lordosis
pelvic obliquity
trendelenburg gait

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8
Q

what is the management for DDH ?

A

non-operative - Pavlik harness
closed reduction
operative - open reduction along with femoral osteotomy

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9
Q

what is perthes disease ?

A

idiopathic avascular necrosis of the proximal femoral epiphysis

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10
Q

what is the most imp prognostic factor in perthes disease ?

A

sphericity of the femoral head

head to acetabulum congruence

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11
Q

what is the presentation of perthe’s disease ?

A

gradual onset limp
hip pain
pain referred to the knee
ddx: transient synovitis

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12
Q

what is SUFE ?

A

slippage of the metaphysis relative to the epiphysis

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13
Q

what type of patients are more likely to suffer from SUFE ?

A

teenagers
boys
obese

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14
Q

what are the associated conditions with SUFE ?

A

hypothyroidism
GH deficiency
Down

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15
Q

what is the movement limitations associated with SUFE ?

A

loss of internal rotation

externally rotated limb

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16
Q

what position in imaging is best to appreciate SUFE ?

A

frog lateral view

17
Q

what is the radiological sign associated with SUFE ?

A

melting ice cream cone sign

18
Q

what is the management of SUFE ?

A

percutaneous in-situ fixation

19
Q

what is the most common cause of hip pain in children ?

A

irritable hip / transient synovitis of the hip

20
Q

what are the DDX of irritable hip ?

A

septic arthritis

SUFE

21
Q

what is the most important factor to rule out septic arthritis ?

A

CRP

22
Q

what is the imaging modality of choice for the diagnosis of DDH ?

A

ultrasound