Paediatric ortho

Question 1

0-5 year hip problems

Answer 1

normal variant
trauma - JIA - transient synovitis - osteomyelitis, septic arthritis
DDH

Question 2

5-10 years hip problems

Answer 2

trauma - transient synovitis - OM - septic arthritis

PERTHES - legg calve

Question 3

10-15 years hip problems

Answer 3

trauma - OM - sep A - chondromalacia - neoplasm

SUFE

Question 4

DDH incidence

Answer 4

more in Europe as children carried differently in other countries

Question 5

DDH - stands for

Answer 5

developmental dysplasia of the hip

Question 6

DDH - boys or girls? left or right hip?

Answer 6

girls

left

Question 7

DDH - increased incidence

Answer 7

oligohydramnios
LL deformities
1st born, breech, FH

Question 8

3 signs of DDH

Answer 8

ortolanis
barlows
piston motion

Question 9

% of DDH picked up by examination

Answer 9

40

Question 10

USS - what lines are looked at in DDH?

Answer 10

shenton, perkin and hilgenreiner

Question 11

DDH management

Answer 11

bilateral long leg or 1 + 1 1/2 hip spica cast

Question 12

legg calve perthes disease - who is affected?

Answer 12

male 5:1 female

primary school age

Question 13

perthes presentation

Answer 13

15% bilateral, short, limp, pain on exercise, stiff hip joint

Question 14

Phases of LCP

Answer 14

avascular necrosis
fragmentation - revascularisation and pain
reossification - bony healing
residual deformity

Question 15

differential of unilateral LCP

Answer 15

septic hip
JIA
SCFE
lymphoma

Question 16

differential of bilateral LCP

Answer 16

hypothyroid
sickle
epiphyseal dysplasia

Question 17

Treating LCP

Answer 17

maintain hip motion 
analgesia 
restrict painful activities 
supervised neglect 
containment

Question 18

SCFE - who affected?

Answer 18

boys, teenage, 1-10/100 000

Question 19

how to fix stable vs unstable SCFE

Answer 19

stable = fix in situ 
unstable = serendipitous reduction

Question 20

detecting SCFE

Answer 20

pain in hip or knee
ER posture and gait
decreased internal rotation
plain x-rays (lateral)

Question 21

classifying SCFE

Answer 21

femoral neck width
mild = <1/3
moderate = 1/3-1/2
severe = >1/2

Question 22

What zone does displacement occur in SCFE?

Answer 22

hypertrophy zone

Question 23

Metaphysis moves what way in SCFE?

Answer 23

anterior and proximal

Question 24

treating SCFE

Answer 24

surgery and screws to fix in place

Question 25

outcome of SCFE

Answer 25

avascular necrosis
early OA
deformity
chondrolysis

Question 26

Do stable or unstable slips in SCFE have high risk of AVN?

Answer 26

unstable