Paediatic Hip

Question 1

Unequal skin folds and leg length in a breech newborn indicates what condition? How do you confirm?

Answer 1

Developmental dysplasia

Positive Barlow’s and Ortolani’s test

Question 2

What is the treatment for developmental dysplasia of the hip?

Answer 2

<4-5 months: Pavlik
>4-5 months: Osteotomy and realignment
Replace if arthritic

Question 3

5 year old boy presents with knee pain, they cant internally rotate or abduct their leg. hip x-ray shows widening of joint space, what do they have?

Answer 3

Perthe’s disease

Question 4

How do you treat Perthe’s?

Answer 4

Stabilise hip

if >6 years: Surgical management

Question 5

How does SUFE present differently to Perthe’s?

Answer 5

SUFE // Perthe’s
over 10s // under 10s
Acute // progressive
postero-inferior slip // widened space, joint flattening

Question 6

Acute hip pain following viral infection suggests what condition?

Answer 6

Transient synovitis of hip

Question 7

What constitutes JIA?

Answer 7

<16 yrs + symptoms >3 months

Question 8

What antibody is associated with JIA?

Answer 8

ANA

Question 9

What suggests septic arthritis in children

Answer 9

Fever
Non-weight bearing
Raised ESR and WCC