Paediatric Limp Flashcards
Common cause of Limp in Child
Toxic Synovitis
Limp age 0-5 Reasons
‘Normal variant’ Trauma Transient synovitis Osteomyelitis Septic arthritis DDH JIA
Limp age 5-10 Years Reasons
Trauma Transient synovitis Osteomyelitis Septic arthritis Perthes disease
Limp age 10-15 reasons
Trauma Osteomyelitis Septic arthritis SUFE Chondromalacia Neoplasm
Septic Arthritis in Child presentation
Limp pseudoparalysis swollen red joint refuse to move joint pain temp
Septic arthritis in child route of entry
Haematogenous
Dissemination from Osteomyelitis
Spread from soft tissue
Tests in Septic Arthritis
FBC WCC Raised ESR >50 CRP Blood Cultures Ultrasound X-Ray Synovial Fluid Raised WCC
Septic Arthritis name of criteria for clinical prediction
Kocher Criteria
Four Criteria for Septic Arthritis Clinical Prediction
Pyrexia >38
No Weight Bear
WBC >12,000
ESR >40
Bacteria causing Septic Arthritis in Child
Staph Aureus
Treatment of Staph Aureus
Aspiration
Arthroscopy
Arthrotomy
Antibiotics for 2 Weeks IV then 4 Weeks oral
Osteomyelitis in children mean age
6
Osteomyelitis risk factors
Blunt Trauma
Recent infection
Pathogenesis of Acute Haematogenous Osteomyelitis
Vascular Anatomy
Inhibited Phagocytosis (Low Po2)
Trauma
Presentation of Osteomyelitis in Children
Pain Localised Signs/Symptoms Fever Reduced ROM Reduced Weight Bear
Tests for Osteomyelitis in Children
Raised WCC, ESR and CRP
Bacteria causing Osteomyelitis in Children
Staph Aureus
Other tests for Osteomyelitis in child
MRI
Bone Scan
CT
Bone Biopsy
Indications for surgery in osteomyelitis
Aspiration for culture Drainage of subperiosteal abscess Drainage of joint sepsis Debridement of dead tissue Failure to improve Biopsy in equivocal cases
When is it transient synovitis in children
Limping, often touch weight bearing Slightly unwell History of viral infection eg URTI/ ear Apyrexial Allowing joint to be examined Low CRP, normal WCC May have joint infusion Not that unwell
