Locomotor

Question 1

Most common cause of septic arthritis?

Answer 1

haematological spread from elsewhere in body. Staph A common

Question 2

Diagnostic investigation for septic arthritis?

Answer 2

Aspiration of joint space

Question 3

An x-ray shows widened joint space and soft tissue swelling. Likely Dx?

Answer 3

septic arthritis

Question 4

What investigation would show osteomyelitis?

Answer 4

MRI

Question 5

Tx of septic arthritis

Answer 5

Prolonged IV Abx - Fluclox 4-6w

Question 6

How is DDH detected?

Answer 6

Barlow & Ortolani tests

Question 7

RFs of DDH?

Answer 7

Female (x6), breech, C-section, >5kg at birth, FH,

Question 8

Signs of DDH?

Answer 8

Unequal skin folds, limited abduction, shortening of affected leg

Question 9

Investigation of suspected DDH?

Answer 9

USS

Question 10

Mx of DDH?

Answer 10

Most resolve spontaneously by 3-6w. If not use Pavlik’s Harness if <4-5m. Older children –> surgery

Question 11

What joint problem might occur following an infection?

Answer 11

Reactive arthritis. Causes include: salmonella, campylobacter, shigella, viruses, STIs, strep

Question 12

What might knee pain indicate in a child?

Answer 12

Pain referred from the hip, e.g. Perthe’s disease

Question 13

How is Perthe’s diagnosed?

Answer 13

Xray –> early changes include widening of joint space, later show decreased size femoral head

Question 14

Mx of Perthe’s?

Answer 14

Aim to keep femoral head in acetabulum - casting, braces.
<6y: observation
Older: surgery

Question 15

In what direction do femoral epiphysis slip? At what age might you see this?

Answer 15

Postero-inferiorly.

Age 10-15y, during growth spurt

Question 16

How does slipper femoral epiphysis present?

Answer 16

Can be acute following trauma, or gradual & subtle. Limp, hip/knee pain.

Question 17

What movements are limited with slipped femoral epiphysis?

Answer 17

Abduction & internal rotation.