Locomotor: Young MSK Flashcards
Paediatric Bone Disease, Paediatric Trauma, Non-Accidental Injury
What is transient synovitis?
It is a benign condition where the synovial membrane around the hip is inflamed, often in children 2-5yo
What is DDH?
Developmental dysplasia of the hip, the hip joint of the baby is either dislocated or prone to dislocation
DDH risk factors
- Hereditary
- Born in breach
- First born
- Female:Male 5:1
DDH examinations
- Barlows/Ortolani - passive dislocation of hip by practitioner with relocation, only useful for babies
- When slightly older you are looking for leg length discrepancy, assymetry of leg creases is a good sign
- When older can also look for reduce abduction in one side
DDH Treament
Stirrups/Strap
What is Perthes disease?
It is where blood supply to the femoral head is cut off resulting in osteonecrosis of the femoral head
Perthes disease treatment
Because the loss of blood supply is only tempory the femoral head can actually heal
Treatment is therefore focussed around ensuring this heals well
This is mainly done by keeping the femoral head within the acetabulum and treating symptoms. Sometimes with surgury.
Perthes causes and risk factors
- Causes not really know but it is non genetic
- Male:Female 4:1
- 4-8 years
- Lower social class increases risk, maybe due to smoking
What does SUFE stand for?
Slipped Upper Femoral Epiphysis
What is actually happening in SUFE?
The femoral head (epiphysis when growing) slipped downward at the growth plate
SUFE causes and risk factors
- Males:Females 3:1
- Happens during rapid growth at puberty
- Happens slightly earlier in females and not after menarche (first menstrual period)
- Obesity or Lanky are both risk factors
- Small 7% risk if a family member is involved
SUFE signs, symptoms and presentation
- Limp
- Pain at groin/thigh/knee
- Externally rotated and adducted limb
- Roughly bilateral 50% of the time
SUFE surgical treatment
Screw throught he growth plate in order to stop it slipping further
Red flag: back pain but can be non specific
Discitis