Hip pain in a child

Question 1

most common cause of sudden onset of hip pain in young children

Answer 1

Transient synovitis of the hip

Question 2

how does Transient synovitis of the hip present?

Answer 2

Acute onset of limp with or without pain, reduced hip movements

Question 3

potential painful areas in transient synovitis of hip?

Answer 3

pain in inner thigh, knee area instead of around hip

Question 4

cause of transient synovitis of hip?

Answer 4

unknown however may occur following an URTI or gastroenteritis

Question 5

prognosis for transient synovitis of the hip?

Answer 5

with rest & ibuprofen/paracetamol, should resolve in 3-4 days

Question 6

follow up following transient synovitis of the hip?

Answer 6

x ray in 6 months time to confirm everything is ok

Question 7

transient synovitis: more common in what gender and what age group?

Answer 7

boys & 4-8 year olds

Question 8

acute onset of pain & non weight bearing & extreme pain on movement & local signs of redness & heat

Answer 8

septic arthritis & osteomyelitis

Question 9

Perthes disease age and gender demographic

Answer 9

boys & 4-8 year olds

Question 10

presentation of perthes disease?

Answer 10

gradual onset of limp, can be painless

Question 11

what causes perths disease?

Answer 11

avascular necrosis of femoral head due to interruption of blood flow to the femoral epiphysis

Question 12

early x ray changes in perthes disese?

Answer 12

• widening of joint space

- later –> decreased femoral head size/flattening

Question 13

what condition can cause early onset of OA

Answer 13

perthes disease

Question 14

age and gender demographics of SUFE

Answer 14

boys & 10 years old

Question 15

risk factors for SUFE

Answer 15

• overweight

- hypothyroidism

Question 16

presentation of SUFE

Answer 16

sudden onset of pain & non weight bearing

OR

gradual onset of vague pain that may be referred to the knee & limp

Question 17

what causes SUFE?

Answer 17

proximal femoral growth plate becoming unstable and the epiphysis & diaphysis can slip

Question 18

hip pathology more common in girls?

Answer 18

developmental dysplasia of the hip is 6 times more common in females

Question 19

when is developmental dysplasia usually detected

Answer 19

at birth

Question 20

what happens in developmental dysplasia of the hip?

Answer 20

ball and socket of the hip joint does not properly form in babies and young children

Question 21

risk factors for developmental dysplasia of the hip

Answer 21

• 1st born child
• breech presentation
• birth weight greater than 5 kg
• positive family history

Question 22

signs of developmental dysplasia of the hip

Answer 22

• assymetrical skin folds
• leg length discrepencies
• buttock flattening
• walking with the affected leg in external rotation

Question 23

when to suspect juvenile idiopathic arthritis?

Answer 23

child with a warm hot swollen joint lasting over 8 weeks with pain worse on waking up in the morning, no fever or systemic symptoms

Question 24

what is stills disease

Answer 24

rare cause of inflammatory arthritis associated with salmon-pink, maculopapular rash

Question 25

what causes testicular torsion

age incidence peaks

Answer 25

twist of the spermatic cord resulting in testicular ischaemia & necrosis

13-15 years old

Question 26

what is the end of a long bone called?

Answer 26

epiphysis

Question 27

what is the name of the shaft of the bone

Answer 27

diaphysis