MSK

Question 1

What is developmental dysplasia of the hip

Answer 1

A spectrum of hip instability ranging from a dislocated hip to hips with various degrees of acetabular dysplasia

Question 2

What are the risk factors of developmental dysplasia of the hip

Answer 2

Breech delivery
FHx
First born
Female
Oligohydramnios
Neuromuscular disorders
Syndromes
Congenital muscular torticollis
Congenital foot abnormalities

Question 3

What are the clinical signs for developmental dysplasia of the hip

Answer 3

Delayed walking
A painless limp
A waddling gait
Assymetrical skin creases

Question 4

How is developmental dysplasia of the hip diagnosed

Answer 4

Screening at birth and at the 6 week baby check:

Barlow test: apply backward pressure to each femoral head to detect displacement

Ortolani test: apply forward pressure to each femoral head in turn and attempt to move a posteriorly dislocated femoral head back into the acetabulum

USS is diagnostic. Hip X ray not useful after 4-5 months

Question 5

How is developmental dysplasia of the hip managed

Answer 5

Pavlik harness

Reduction (open/closed)

Question 6

What is transient synovitis (irritable hip)

Answer 6

A self limiting condition occuring between the ages of 2-10 years following a viral infection

Question 7

What are the clinical features of transient synovitis

Answer 7

Sudden onset of pain
Limp
Refusal to bear weight on the affected side
No pain at rest