Musculoskeletal Problems

Question 1

What are the risk factors for DDH?

Answer 1

Female
First born
Breech at term
Family history
Oligohydramnios

Question 2

What imaging modalities are used in DDH?

Answer 2

Ultrasound scan of the hips

Consider X-ray if older than 4.5 months

Question 3

What are the management options for DDH?

Answer 3

Pavlik harness before 6 months of age - hips are flexed and abducted
Surgery

Question 4

What are the key features of transient synovitis?

Answer 4

Viral URTI or gastroenteritis
Acute pain and limping, low grade fever
X-ray: joint space widening

Question 5

What are the key features of SUFE?

Answer 5

More common in obese children, boys
10-15 years old
Pain, radiating to thigh, knee and groin

Question 6

What are the key features of Perthes disease?

Answer 6

5 x more common in boys
Age 4-8 typically affected
Progressive hip pain, limping

Question 7

What are the Kocher criteria for septic arthritis?

Answer 7

Non-weight bearing
Temp >38.5
WBC >12
ESR > 40

Question 8

Which newborn babies should be routinely referred for USS hips?

Answer 8

Breech at any point after 36 weeks
Multiple pregnancy
Family history of DDH

Question 9

What are the X-ray features of Perthes disease?

Answer 9

Joint space widening
Flattening of femoral head