Paediatric Hip Problems

Question 1

Name 3 types of paediatric hip problems

Answer 1

DDH
Legg-Calve-Perthes Disease
SUFE

Question 2

What does DDH stand for?

Answer 2

Developmental Dysphasia Hip

Question 3

Who does DDH affect?

What is dysphasia?

Answer 3

affects children between 0-2 years

it’s abnormal growth when developing organs/cells

Question 4

how can dysphasia be caused? - 2 ways

Answer 4

by the acetabulum being too shallow/deformed and so is unable to house the femoral head correctly
femoral dysphasia is where the femoral head grows at too shallow or too wide an angle in conjunction with the acetabulum

Question 5

how can DDH be caused? - 2 points

Answer 5

hereditary

hormonal link - relaxin

Question 6

how is DDH diagnosed?

Answer 6

click test & imaged using US rather than radiographs

Question 7

how is DDH treated?

Answer 7

harnesses, casts, traction to immobilise but allow growth in the correct position
surgery may be needed if this is unsuccessful

Question 8

how does Legg-Calve-Perthes Disease occur?

what is this medically called?

Answer 8

by a disruption of blood flow to the femoral head causing the bone to necrose, during the healing process new blood vessels infiltrate the dead bone and remove the necrosis which ultimately weakens the femoral head - this bone loss causes collapse and causes deformity of the femoral head and sometimes changes the shape of the hip socket = AVASCULAR NECROSIS OF THE FEMORAL HEAD/OSTEO-CHONDROSIS OF THE FEMORAL HEAD

Question 9

who does LCPD affect?

what is the main LT problem with LCPD?

Answer 9

affects 5-10 year olds

permanent deformity of the femoral head which increases the risk of developing OA in adulthood

Question 10

what does SUFE stand for?

Answer 10

Slipped Upper Femoral Epiphysis

Question 11

what is SUFE?

Answer 11

a # through the growth plate resulting in slippage of the epiphysis
the femoral epiphysis remains in the acetabulum while the metaphysis moves anteriorly with external rotation

Question 12

who is SUFE most common in?
how does SUFE present?
what can SUFE be linked with?

Answer 12

10-15 year olds
with groin pain with associated knee & thigh pain and limited movement
linked to hormone related factors & mechanical issues such as obesity

Question 13

how is SUFE diagnosed?

what is the treatment for SUFE?

Answer 13

through radiographs and assessment of range of movements

pt on strict bed rest to minimise further vascular complication then treated surgically - ORIF