Orthopaedics

Question 1

What are the differentials for limb pseudoparalysis in a child (reluctance to move a limb)?

Answer 1

INFECTION-septic arthritis or osteomyelitis
trauma
neurological aetiology uncommon

Question 2

clinical features of septic arthritis in children?

Answer 2

acute pain in single large joint, commonly knee or hip
pseudoparalysis-this may be the main feature if child unable to complain of pain
swinging pyrexia
tachycardia
erythematous overlying skin, may be swollen
local warmth and marked tenderness, all movements restricted

Question 3

presentation of septic arthritis in neonates?

Answer 3

baby irritable
refuses to feed
tachycardia
sometimes fever
local warmth, tenderness and resistance to joint movement
examine UC for infection source
look for inflamed IV infusion site

Question 4

children most commonly affected by perthes disease?

Answer 4

boys 5 times more common than girls

between 4 and 8 years of age

Question 5

proportion of perthes disease cases which are bilateral?

Answer 5

10%

Question 6

complications of perthes disease?

Answer 6

secondary OA

premature fusion of epiphyseal growth plates