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Musculoskeletal > Paediatric Hip Conditions > Flashcards

Paediatric Hip Conditions Flashcards

Miss S Gill

1
Q

DDH presents…

A

birth - 2 years

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2
Q

perthes presents…

A

4-8 years

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3
Q

SUFE presents…

A

10 - 16 years

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4
Q

name the 3 bones that contribute to the acetabulum

A

ilium
ischium
pubis

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5
Q

DDHencompasses a _______ of disease that includes:

_________ - a shallow or underdeveloped acetabulum;

___________;

___________

A

dysplasia - a shallow or underdeveloped acetabulum

subluxation

Dislocation

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6
Q

DDH most commonly affects what sex?

A

female

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7
Q

DDH is rarely seen in patients of what descent?

A

african

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8
Q

name the risk factors of DDH

A

firstborns
females
breech
FH

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9
Q

name the patient presentation of DDH

A

abnormality on screening
limping child - trendelenberg gait
pain

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10
Q

what are the 2 clinical tests performed in DDH?

A

ortolani

Barlows

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11
Q

name the treatment of the early presentation of DDH

A

pelvic harness

23 hours a day for 12 weeks

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12
Q

what position is the hip in a pavlik harness?

A

abducted

flexed

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13
Q

name the treatment of the late presentation of DDH

A

surgery

Closed reduction +/- tenotomies + spica

Open reduction + osteotomies + spica

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14
Q

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

A

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

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15
Q

what is the patient presentation in reactive synovitis?

A 
viral illness
limp and pain
referred pain to knee
pain at end range of movement
systemically well
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16
Q

what is the diagnosis of reactive synovitis?

A

Kochers criteria

Ultrasound +/- aspiration

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17
Q

what does koshers criteria distinguish between?

A

RS and sept arthritis

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18
Q

koshers criteria is graded between what?

A

0-4

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

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19
Q

what is the treatment in reactive synovitis?

A

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

20
Q

septic arthritis of the hip joint is a medical emergency

true or false?

A

true

21
Q

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

A 
short duration
can't bear weight
hip/groin pain
severe pain
pyrexial
22
Q

how can you get septic arthritis?

A

trauma
surgery
osteomyelitis spread

23
Q

name the number 1 bug that causes septic arthritis

A

staph. aureus

24
Q

how do you diagnose septic arthritis of the hip?

A 
blood test
blood cultures
kochers criteria
radiographs
US +/- aspiration
25
Q

what is the treatment in septic arthritis?

A

open surgical washout

antibiotics 6/52

26
Q

what is (Legg-Calve-) Perthes disease?

A

avascular necrosis of the hip

27
Q

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

A

idiopathic - unknown

28
Q

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

A

males

29
Q

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

A

4-8 years old

30
Q

bilateral (Legg-Calve-) Perthes disease is seen at the same time

true or false?

A

false - NEVER at the same time!

31
Q

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

A 
FH
low birth weight
second hand smoke
asian
inuit
central european
32
Q

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

A

osteonecrosis occurs secondary to disruption of blood supply to femoral head

33
Q

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

A

initial
fragmentation
reossification
remodelling

34
Q

the younger at presentation, the better the prognosis in (Legg-Calve-) Perthes disease

true or false?

A

true

35
Q

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

A

radiographs and MRI

36
Q

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

A

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

37
Q

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

A

restrict weight-bearing
physiotherapy

surgery only in young with severe disease or older with secondary osteoarthritis

38
Q

what does SUFE stand for?

A

slipped upper femoral epiphysis

39
Q

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

A

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

40
Q

what age range of patients does SUFE affect?

A

10-16 years

41
Q

what are the risk factors in SUFE?

A

male
obesity
endocrine disorders

42
Q

diagnosis of SUFE is via radiograph and MRI

true or false?

A

true

43
Q

what is the treatment in SUFE?

A

SURGERY

Percutaneous pinning of the hip

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

44
Q

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

A

superior - pubis

inferior - ischium

45
Q

whats the difference between rubbish and an Irish girl?

A

rubbish gets you picked up

Musculoskeletal (37 decks)

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