paediatric hip conditions

Question 1

painless limp in a toddler ?

Answer 1

development dysplasia of the hip

Question 2

what are the risk factors associated with DDH ?

Answer 2

female
first born
family history
breech presentation

Question 3

what is the pathology associated with DDH ?

Answer 3

defective shallow acetabulum
coxa valga

Question 4

how is screening for DDH done ?

Answer 4

barlow and ortolani test

Question 5

what is the barlow test ?

Answer 5

dislocating a dislocatable hip
exit click

Question 6

what is the ortolani test ?

Answer 6

reduce a dislocatable hip
click of entry

Question 7

what is the primary modality oof imaging for DDH ?

Answer 7

ultrasound from birth up to 4 months of age

Question 8

what is the primary imaging modality for DDH after 4 months ?

Answer 8

X-ray

Question 9

what is the management for DDH ?

Answer 9

non operative - pavlik harness ( for less than 6 months of age)
closed reduction + hip spica for older babies

operative - Open reduction + hip spica (> 18 months )
Open reduction + femoral osteotomy 
or pelvic osteotomy or both

Question 10

what is perthes disease ?

Answer 10

avascular necrosis of the femoral head in children

Question 11

what is the most important prognostic factor of perthes’ disease ?

Answer 11

sphericity of the femoral head
head to acetabulum congruence

Question 12

what are the 3 stages associated with perthes disease ?

Answer 12

fragmentation
reossification
remodelling

Question 13

what is the clinical picture of perthes disease ?

Answer 13

hip groin knee pain

Question 14

what is notedd on examination of a patient with perthes’ disease ?

Answer 14

loss of internal rotation and abduction
antalgic gait early
trendelenburg gait late
limb length discrepancy

Question 15

what view must be viewed in order to properly see perthes disease ?

Answer 15

AP and frog lateral view

Question 16

what is SUFE ?

Answer 16

Slipped upper femoral epiphysis , happens due to proximal femoral growth plate weakness

Question 17

what type of patients are more likely to have SUFE ?

Answer 17

obese males

Question 18

what are the diseases associated with SUFE ?

Answer 18

hypothyroidism
growth hormone deficiency

Question 19

what are the indications for endocrine work up in SUFE ?

Answer 19

child is under 10 years old
or his weight is more than the 50th percentile

Question 20

what is the clinical presentation of SUFE ?

Answer 20

externally rotated limb
loss of internal rotation

Question 21

what is the sign seen on AP view on xray of SUFE ?

Answer 21

melting ice cream cone sign

Question 22

what is the treatment for SUFE ?

Answer 22

must be operative
Percutaneous in-situ fixation
Contralateral prophylactic fixation

Question 23

what is irritable hip ?

Answer 23

trransient synovitis

Question 24

what is the most common cause of hip pain in the paediatric age group ?

Answer 24

irritable hip

Question 25

what must irritable hip differentiated from ?

Answer 25

septic arthritis
SUFE

Question 26

what are the causes of irritable hip ?

Answer 26

usually post viral infection
after an allergic reaction
a diagnosis of exclusion

Question 27

what is the prognosis for irritable hip ?

Answer 27

self limiting condition

Question 28

a painful joint with limitation in movement is ?

Answer 28

septic arthritis until proven otherwise

Question 29

what is the most important factor to rule out septic arthritis ?

Answer 29

CRP