Other orthopaedic problems Flashcards
What is the most common cause of acute hip pain in children?
Transient synovitis
When is transient synovitis often seen?
Following/accompanied by viral infection
What is the presentation of transient synovitis? (5)
- Sudden onset pain in hip or a limp
- No pain at rest
- Decreased range of movement, particularly internal rotation
- Pain may be referred to knee
- Afebrile/mild fever and does not appear ill
What investigations should be done to differentiate transient synovitis from septic arthritis?
Blood cultures
Joint aspiration
How is Juvenile idiopathic arthritis (JIA) defined?
Persistent joint swelling (>6wks) presenting before 16 years of age in absence of infection or other defined cause.
What are the clinical features of JIA? (5)
- Gelling (Stiffness after periods of rest e.g. car journey)
- Morning joint stiffness and pain
- Intermittent limp
- Deterioration in behaviour or mood
- Avoidance of previously enjoyed activities.
What pattern of swelling is seen in JIA?
Initially minimal evidence of joint swelling
Subsequently there may be swelling due to fluid within, inflammation and, if chronic, proliferation (thickened) synovium and swelling of periarticular soft tissues.
What long term complications can result from unmanaged JIA? (4)
- Bone expansion from overgrowth, which in knee may cause leg lengthening or valgus deformity. In hands - discrepency in digit length. In wrist - advancement of bone age.
- Chronic anterior uveitis (common, asymptomatic)
- Growth failure
- Flexion contractures of joints (when joint held in most comfortable position, causes decreased intra-articular pressure)
To what orthopaedic problem does sickle cell anaemia predispose pts?
Staphylococcal and salmonella osteomyelitis
How does type I osteogenesis imperfecta manifest?
Pathological #
Blue sclera
