limping child

Question 1

ages 1-3 common DDx for limping or pain

Answer 1

Septic arthritis from Staph Aureus or hematogenous spread of staph, ecoli, candida; happens after a URI)

Spiral fracture (epiphyseal fractures pathognomonic for child abuse)

Developmental Dysplasia of the hip (common in first born females on the left side born by breech)

Oteomyelitis

Question 2

Pavlic harness can be used to tx

Answer 2

developmental dysplasia of the hip

Question 3

Clunk during Ortolani/Barlow provocative test when you try to remove the femur head from the acetabulum

Answer 3

pathognomonic for developmental dysplasia of the hip

Question 4

Kosher criteria for Septic arthritis

Answer 4

WBC>12000
ESR>40
Inability to ambulate
CRP>2.5

Question 5

REpeated microtrauma that is likely recurrent happens n boys 2-17

Answer 5

Legg-Calve-Perthes disease (avascular necrosis)

Question 6

Antalgic gait

Answer 6

pain in the hip/knee/ankle. Shortened stance on the affected side

Question 7

Trendelenburg gait

Answer 7

downward pelvic tilt that can be seen in kids with developmental dysplasia, Legg-calves-perthes or slipped capital femoral epiphysis

also could be indicative in adults of superior gluteal nerve damage

Question 8

Steppage or equinus gait

Answer 8

inability to dorsiflex

seen in those with neuromuscular disease like cerebral palsy

Question 9

Neoplastic differential with limping child

Answer 9

Leukemia
Neuroblastoma

Benign Primary bone tumors (bone cyst, osteoid, osteoma)

Malignant bone tumors (Ewing, osteogenic sarcomas)

Question 10

Pinpoint pain over the tibial tuberosity indicative of

Answer 10

Osgood-schlatters