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J MSK > Paediatric hip conditions > Flashcards

Paediatric hip conditions Flashcards

1
Q

first line investigation for all kids hip problems

A

xray

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2
Q

when does the problem first arise in DDH (developmental dysplasia of the hip )

A

perinatal period

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3
Q

what happens in the perinatal period in DDH (developmental dysplasia of the hip)

what does this result in

A

dislocation of femoral head = hip doesnt develop properly

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4
Q

risk factors for DDH (developmental dysplasia of the hip) (3)

A

breech birth
girls>boys
downs syndrome

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5
Q

presentation of DDH (developmental dysplasia of the hip) at birth (2)

A

asymmetrical extra skin fold in thigh

asymmetrical shortened limb

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6
Q

delayed presentation of DDH (developmental dysplasia of the hip) >2 year old (3)

A

painless limp
asymmetrically short leg
trendelenburg gait

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7
Q

what are the examination tests done on every baby after birth to screen for DDH (developmental dysplasia of the hip)

A

look for asymmetry
feel for click
ortolani test (opposite of barlow test)
barlow test

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8
Q

what is the barlow test for

how is it done

A

DDH (developmental dysplasia of the hip)

try and dislocate the hip posteriorly

Barlow test = looking for a dislocataBle hip

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9
Q

which investigation is used for DDH (Developmental dysplasia of the hip) in <3month olds

what will it show

A

ultrasound

dislocated hip
shallow acetabulum

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10
Q

which investigation if used for DDH (developmental dysplasia of the hip) in 3-6 month olds

what will it show

A

xray

ossified femoral head epiphysis

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11
Q

treatment of DDH (developmental dysplasia of the hip)

A 
relocate hip (if >1 year old = surgery)
then stabilise (eg pavlik harness)
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12
Q

prognosis of an early diagnosis of DDH (Developmental dysplasia of the hip)

A

good, 95% normal

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13
Q

prognosis of late diagnosis of DDH (developmental dysplasia of the hip)

what can it predispose

A

hip will never be normal

acetabular dysplasia

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14
Q

what is acetabular dysplasia

A

inadequate development of acetabulum

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15
Q

who gets acetabular dysplasia

A

young women

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16
Q

most common cause of hip pain in kids

A

transient synovitis of the hip (aka irritable hip)

17
Q

what predisposes someone to getting transient synovitis of the hip (irritable hip)

A

infection (eg had the cold 2 weeks ago and now has a sore hip)

18
Q

how does transient synovitis of the hip (irritable hip) present (4)

A

sudden onset
limp, non weight bearing
pain

previous recent infection

19
Q

why do you need to do loads of investigations for transient synovitis of the hip (irritable hip)

A

to exclude other causes of hip pain

20
Q

what investigations do you need to do for transient synovitis of the hip (irritable hip)

A

xray - to exclude perthes
bloods - to exclude septic arthritis
MRI - to exclude osteomyelitis

21
Q

which investigation should be positive in transient synovitis of the hip (irritable hip)

A

inflammatory markers

22
Q

treatment of transient synovitis of the hip (irritable hip)

A

bed rest
pain relief

self limiting condition - will be fine after a few weeks

23
Q

what condition is;

idiopathic osteochondiritis (AVN) of femoral head = fracture likely = blood supply to the head of the femur is poor = poor fracture healing

A

perthes

24
Q

bilateral perthes

A

skeletal dysplasia

25
Q

typical patient with perthes (4)

A

boys
aged 4-8
hyperactive (ADHD)
short stature

26
Q

presentation of perthes

A

hip pain
limp
Trendelenburg gait

27
Q

diagnostic investigation for perthes

A

xray

28
Q

treatment of perthes (2)

A

nothing

NSAIDs for pain
avoid physical activity
surgery if severe

29
Q

common complication of perthes

A

early onset osteoarthritis

30
Q

what happens in SUFE (slipped upper femoral epiphysis )

A

femoral head epiphysis slips inferiorly from the femoral neck

31
Q

why does SUFE (slipped upper femoral epiphysis) occur

A

physis isnt strong enough to support body weight

32
Q

risk factors for SUFE (slipped upper femoral epiphysis) (3)

A

boys
overweight
age 10-16

33
Q

which nerve may be affected in SUFE (slipped upper femoral epiphysis)

A

obturator

34
Q

presentation of SUFE (slipped upper femoral epiphysis)

A

groin/knee pain(from obturator nerve)
limp
non weight bearing (sometimes)

35
Q

investigations for SUFE (slipped upper femoral epiphysis)

A

xrays - AP and lateral

36
Q

treatment of SUFE (slipped upper femoral epiphysis)

A

urgent surgery - stabilisation of physis with pin

probs do both hips

37
Q

complication of an unstable (non weight bearing) SUFE (slipped upper femoral epiphysis)

A

avascular necrosis (AVN)

J MSK (30 decks)

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