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MSK > Paediatric hips > Flashcards

Paediatric hips Flashcards

1
Q

What is important in the history in diagnosing a hip disorder?

A 
If breech
Family history
Girl
First born
Left hip
Other MSK abnormalities
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2
Q

What is important in the examination in diagnosing a hip disorder?

A

Assymmetry - leg length, position and thigh crease
Feeling for a click
how well it abducts

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3
Q

What instability tests can be done during examination?

A

Barlow’s test

Ortolani test

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4
Q

What is Barlow’s test?

A

Attempt to dislocate/sublux a hip by flexion

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5
Q

What is Ortolani’s test?

A

Attempt to relocate a dislocated hip by abduction

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6
Q

What imaging can be useful?

A

If over 3 months then x-ray

If under then USS

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7
Q

What does DDH stand for?

A

Developmental dysplasia of the hip

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8
Q

What is DDH?

A

Dislocation or subluxation of the femoral head during the perinatal period

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9
Q

Why can an x-ray not be used before 3 months?

A

Ossification has not yet completed so little bone is available for imaging

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10
Q

What might be seen on imaging?

A

Dislocated hip or

shallow acetabulum

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11
Q

What equipment can be used to realign the hip?

A

Pavlik harness

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12
Q

“Extra skin fold”

A

DDH

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13
Q

When is a routine USS done?

A

If breech or have a family history

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14
Q

Why is it better to diagnose DDH early?

A

Can lead to dislocation in future

higher risk of arthritis

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15
Q

If diagnosed after two years what is the management?

A

Femoral and acetabular surgery

Will never have a normal hip

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16
Q

What is important to exclude in history in an older child with a hip issue?

A

Exclude infection.

Could be septic arthritis

17
Q

What does transient synovitis present as?

A 
Insidious onset of inflammation of synovium
9/10 years old
low grade fever
pain on movement
Normal bloods
18
Q

What can Perthes present as?

A

Pain in knee or groin
Limp
May be painless

19
Q

Who does perthes present in?

A

boys
4-8
Small, active children

20
Q

What is Perthes?

A

Idiopathic avascular necrosis

21
Q

What is treatment for perthes?

A

Rest- no activity
Regular x-ray
some surgery

22
Q

Who gets SUFE?

A 
10-16 years
Males
obesity
More common in black patients
Sometimes bilateral

MSK (30 decks)

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