hip conditions Flashcards
what are the causes of painless limp in toddlers ?
usually due to developmental dysplasia of the hip
how is developmental dysplasia of the hips screened for in newborns ?
using barlow and ortolani tests
what is barlows test ?
dislocating a dislocatable hip
by adduction, flexion and posterior displacement
what is the ortolani test ?
reduce a dislocatable hip
abduction of flexed femur
what is the presentation of DDH in newborns less than 3 months ?
asymmetric thigh crease
can not change diapers easily
what is the presentation of DDH between 3 months and 1 year ?
limb length discrepancy
limited abduction
what is the presentation of DDH in a walking child ?
limb length discrepancy
lumbar lordosis
pelvic obliquity
trendelenburg gait
what is the management for DDH ?
non-operative - Pavlik harness
closed reduction
operative - open reduction along with femoral osteotomy
what is perthes disease ?
idiopathic avascular necrosis of the proximal femoral epiphysis
what is the most imp prognostic factor in perthes disease ?
sphericity of the femoral head
head to acetabulum congruence
what is the presentation of perthe’s disease ?
gradual onset limp
hip pain
pain referred to the knee
ddx: transient synovitis
what is SUFE ?
slippage of the metaphysis relative to the epiphysis
what type of patients are more likely to suffer from SUFE ?
teenagers
boys
obese
what are the associated conditions with SUFE ?
hypothyroidism
GH deficiency
Down
what is the movement limitations associated with SUFE ?
loss of internal rotation
externally rotated limb
what position in imaging is best to appreciate SUFE ?
frog lateral view
what is the radiological sign associated with SUFE ?
melting ice cream cone sign
what is the management of SUFE ?
percutaneous in-situ fixation
what is the most common cause of hip pain in children ?
irritable hip / transient synovitis of the hip
what are the DDX of irritable hip ?
septic arthritis
SUFE
what is the most important factor to rule out septic arthritis ?
CRP
what is the imaging modality of choice for the diagnosis of DDH ?
ultrasound
