Paediatric Hip Conditions

Question 1

DDH presents…

Answer 1

birth - 2 years

Question 2

perthes presents…

Answer 2

4-8 years

Question 3

SUFE presents…

Answer 3

10 - 16 years

Question 4

name the 3 bones that contribute to the acetabulum

Answer 4

ilium
ischium
pubis

Question 5

DDHencompasses a _______ of disease that includes:

_________ - a shallow or underdeveloped acetabulum;

___________;

___________

Answer 5

dysplasia - a shallow or underdeveloped acetabulum

subluxation

Dislocation

Question 6

DDH most commonly affects what sex?

Answer 6

female

Question 7

DDH is rarely seen in patients of what descent?

Answer 7

african

Question 8

name the risk factors of DDH

Answer 8

firstborns
females
breech
FH

Question 9

name the patient presentation of DDH

Answer 9

abnormality on screening
limping child - trendelenberg gait
pain

Question 10

what are the 2 clinical tests performed in DDH?

Answer 10

ortolani

Barlows

Question 11

name the treatment of the early presentation of DDH

Answer 11

pelvic harness

23 hours a day for 12 weeks

Question 12

what position is the hip in a pavlik harness?

Answer 12

abducted

flexed

Question 13

name the treatment of the late presentation of DDH

Answer 13

surgery

Closed reduction +/- tenotomies + spica

Open reduction + osteotomies + spica

Question 14

reactive synovitis is ____________ of the ________, often secondary to a _____ illness

Answer 14

reactive synovitis is inflammation of the synovium, often secondary to a viral illness

Question 15

what is the patient presentation in reactive synovitis?

Answer 15

viral illness
limp and pain
referred pain to knee
pain at end range of movement
systemically well

Question 16

what is the diagnosis of reactive synovitis?

Answer 16

Kochers criteria

Ultrasound +/- aspiration

Question 17

what does koshers criteria distinguish between?

Answer 17

RS and sept arthritis

Question 18

koshers criteria is graded between what?

Answer 18

0-4

fever of 38.5
refusal to weight bear
high CRP
WBC > 12000

Question 19

what is the treatment in reactive synovitis?

Answer 19

Self-limiting condition
Analgesia / NSAIDs
Repeat review / admission if any concern

Question 20

septic arthritis of the hip joint is a medical emergency

true or false?

Answer 20

true

Question 21

what is the patient presentation of septic arthritis of the hip?

Answer 21

short duration
can't bear weight
hip/groin pain
severe pain
pyrexial

Question 22

how can you get septic arthritis?

Answer 22

trauma
surgery
osteomyelitis spread

Question 23

name the number 1 bug that causes septic arthritis

Answer 23

staph. aureus

Question 24

how do you diagnose septic arthritis of the hip?

Answer 24

blood test
blood cultures
kochers criteria
radiographs
US +/- aspiration

Question 25

what is the treatment in septic arthritis?

Answer 25

open surgical washout | antibiotics 6/52

Question 26

what is (Legg-Calve-) Perthes disease?

Answer 26

avascular necrosis of the hip

Question 27

what is the cause of (Legg-Calve-) Perthes disease?

Answer 27

idiopathic - unknown

Question 28

in what sex is (Legg-Calve-) Perthes disease more common?

Answer 28

males

Question 29

what age is (Legg-Calve-) Perthes disease more common?

Answer 29

4-8 years old

Question 30

bilateral (Legg-Calve-) Perthes disease is seen at the same time true or false?

Answer 30

false - NEVER at the same time!

Question 31

what are the risk factors of (Legg-Calve-) Perthes disease?

Answer 31

``` FH low birth weight second hand smoke asian inuit central european ```

Question 32

what happens in (Legg-Calve-) Perthes disease?

Answer 32

osteonecrosis occurs secondary to disruption of blood supply to femoral head

Question 33

name the 4 stages in (Legg-Calve-) Perthes disease

Answer 33

initial fragmentation reossification remodelling

Question 34

the younger at presentation, the better the prognosis in (Legg-Calve-) Perthes disease true or false?

Answer 34

true

Question 35

whats the diagnosis in (Legg-Calve-) Perthes disease?

Answer 35

radiographs and MRI

Question 36

what is the aim in treatment of (Legg-Calve-) Perthes disease?

Answer 36

to keep the femoral head round whilst the process self-terminates

Question 37

what is the treatment in (Legg-Calve-) Perthes disease?

Answer 37

restrict weight-bearing physiotherapy surgery only in young with severe disease or older with secondary osteoarthritis

Question 38

what does SUFE stand for?

Answer 38

slipped upper femoral epiphysis

Question 39

SUFE is a condition affecting the ________ femoral ______ that leads to slippage of the __________ relative to the _________.

Answer 39

SUFE is a condition affecting the PROXIMAL femoral PHYSIS that leads to slippage of the METAPHYSIS relative to the EPIPHYSIS

Question 40

what age range of patients does SUFE affect?

Answer 40

10-16 years

Question 41

what are the risk factors in SUFE?

Answer 41

male obesity endocrine disorders

Question 42

diagnosis of SUFE is via radiograph and MRI true or false?

Answer 42

true

Question 43

what is the treatment in SUFE?

Answer 43

SURGERY Percutaneous pinning of the hip +/- pinning of the other side +/- open reduction if a very severe slip

Question 44

what bone makes up the superior part of the obturator foramen and which bone makes up the inferior part?

Answer 44

superior - pubis | inferior - ischium

Question 45

whats the difference between rubbish and an Irish girl?

Answer 45

rubbish gets you picked up