Paediatric Hip Problems

Question 1

what are five childhood hip problems?

Answer 1

1. development dysplasia
2. slipped upper femoral epiphysis (SUFE)
3. transient synovitis
4. septic arthritis
5. Perthes disease

Question 2

what is developmental dysplasia of the hip?

Answer 2

the joint does not form correctly leading to dislocation

Question 3

who is developmental dysplasia of the hip more common in?

Answer 3

females
breech
oligohydramnios

Question 4

diagnosis of developmental dysplasia of the hip

Answer 4

baby checks

examination shows asymmetry, loss of knee height, less abduction and flexion

Question 5

specific tests for developmental dysplasia of the hip

Answer 5

Barlow’s

Ortolani

Question 6

what is Barlow’s test?

Answer 6

adduction and downward pressure

Question 7

what is Ortolani’s test?

Answer 7

abduction and lift

Question 8

management of developmental dysplasia of the hip

Answer 8

Pavlik harness if under 3

gallows traction if over 3

Question 9

what age does SUFE present in?

Answer 9

8-18

Question 10

risk factors for SUFE

Answer 10

weight

Question 11

presentation of SUFE

Answer 11

pain
limp
antalgic gait

Question 12

diagnosis of SUFE

Answer 12

clinical

XR used to assess degree of slip

Question 13

management of SUFE

Answer 13

surgery to pin femoral head
OR
hip replacement

Question 14

what is transient synovitis?

Answer 14

inflammation of the synovium

Question 15

cause of transient synovitis?

Answer 15

secondary to viral illness

Question 16

what is septic arthritis?

Answer 16

intra-articular infection with destruction and osteonecrosis of the joint

Question 17

presentation of septic arthritis

Answer 17

quick onset
pyrexia
unable to bear weight
hip lying flexed and externally rotated

Question 18

what is Perthes disease?

Answer 18

avascular necrosis of the hip

Question 19

who presents with Perthes disease?

Answer 19

4-8 year olds

usually male

Question 20

presentation of Perthes disease

Answer 20

pain
limb
Trendellenburg’s sign
loss of internal rotation

Question 21

management of perthes disease

Answer 21

avoid physical activity

Question 22

presentation fo displaced fractured neck of femur

Answer 22

shortened leg and externally rotated

Question 23

presentation of dislocated femoral head

Answer 23

shortened leg and internally rotated