MSK

Question 1

How does developmental dysplasia of the hip present?

Answer 1

Often picked up on newborn examination
Barlow’s test and Ortolani’s test are positive
Unequal skin folds/leg length

Question 2

What is transient synovitis (irritable hip)?

Answer 2

Typical age group = 2-10 years
Acute hip pain associated with viral infection
Commonest cause of hip pain in children

Question 3

What is Perthe’s disease?

Answer 3

degenerative condition affecting the hip joints of children, typically between 4-8 years

due to avascular necrosis of the femoral head

more common in boys

Features
hip pain: develops progressively over a few weeks
limp
stiffness and reduced range of hip movement
x-ray: early changes include widening of joint space, later changes include decreased femoral head size/flattening

Question 4

What is SUFE?

Answer 4

‘Slipped upper femoral epiphysis’
Typical age group = 10-15 years
obese children and boys

Displacement of the femoral head epiphysis postero-inferiorly
May present acutely following trauma or more commonly with chronic symptoms

knee or distal thigh pain is common
loss of internal rotation of the leg in flexion

Question 5

What is Juvenile idiopathic arthritis (JIA)?

Answer 5

arthritis in someone who is less than 16 years old that lasts for > 3 months

joint pain and swelling: usually medium sized joints e.g. knees, ankles, elbows
limp
ANA may be positive in JIA - associated with anterior uveitis

Question 6

How does septic arthritis of the hip present?

Answer 6

Acute hip pain associated with systemic upset e.g. pyrexia

Inability/severe limitation of affected joint