Lecture 8 - Pediatric Hip Pain Flashcards
Limb buds appear during the ____ in the caudal position.
Fourth Week
_________t week extend anteriorly and internally rotate
Seventh to eight week
Primary centers of ossification (long bones) appear at _______ with onset of ossification by the end of the embryonic period.
twelve weeks
Concavity in upper ____
Convexity in lower ____
2/3
1/3
: relationship between the femoral head/neck to the femoral condyles
Angle of declination
adult this reduces to 10 degrees internally torqued
The final position of the femoral condyles is _______ to the frontal plane.
PArallel
Causes of Hip Pain in Children
Infectious-Septic* Inflammatory- Transient synovitis* Mechanical/Orthopedic SCFE*, LCPD* Neoplastic/Infiltrative Sickle cell pain crisis
> incidence in males
LCPD, SCFE
3-12 years (mean 7)
Insidious onset with painless limp
LCPD
Leg length discrepancy
Decreased abduction and internal rotation
Early radiograph joint effusion (synovitis) or normal, later flattening and fragmentation of the femoral head
Articular osteochondrosis
LCPD
> incidence in males
SCFE
10-16 years
Overweight
Hypothyroidism
Acute onset, may recall an inciting event
SCFE
Hip and knee pain, holds extremity externally rotated, resists internal rotation.
Posterior slippage of epiphysis of the femoral neck, femoral head displaced medially to femoral neck
Required urgent attention
SCFE
Avascular necrosis of primary/secondary growth centers followed by resorption, revascularization and reconstitution
Osteochondrosis
Osteochondrosis Classification
Primary: involvement of articular, epiphyseal cartilage and subadjacent endochondral ossification (Freiberg’s infraction).
Secondary: involvement of articular and epiphyseal cartilage as a consequence of avascular necrosis of subadjacent bone (LCPD, Kohler’s, osteochondritis desiccans)-compression.
Articular
