Paediatric ortho Flashcards
0-5 year hip problems
normal variant
trauma - JIA - transient synovitis - osteomyelitis, septic arthritis
DDH
5-10 years hip problems
trauma - transient synovitis - OM - septic arthritis
PERTHES - legg calve
10-15 years hip problems
trauma - OM - sep A - chondromalacia - neoplasm
SUFE
DDH incidence
more in Europe as children carried differently in other countries
DDH - stands for
developmental dysplasia of the hip
DDH - boys or girls? left or right hip?
girls
left
DDH - increased incidence
oligohydramnios
LL deformities
1st born, breech, FH
3 signs of DDH
ortolanis
barlows
piston motion
% of DDH picked up by examination
40
USS - what lines are looked at in DDH?
shenton, perkin and hilgenreiner
DDH management
bilateral long leg or 1 + 1 1/2 hip spica cast
legg calve perthes disease - who is affected?
male 5:1 female
primary school age
perthes presentation
15% bilateral, short, limp, pain on exercise, stiff hip joint
Phases of LCP
avascular necrosis
fragmentation - revascularisation and pain
reossification - bony healing
residual deformity
differential of unilateral LCP
septic hip
JIA
SCFE
lymphoma
differential of bilateral LCP
hypothyroid
sickle
epiphyseal dysplasia
Treating LCP
maintain hip motion analgesia restrict painful activities supervised neglect containment
SCFE - who affected?
boys, teenage, 1-10/100 000
how to fix stable vs unstable SCFE
stable = fix in situ unstable = serendipitous reduction
detecting SCFE
pain in hip or knee
ER posture and gait
decreased internal rotation
plain x-rays (lateral)
classifying SCFE
femoral neck width
mild = <1/3
moderate = 1/3-1/2
severe = >1/2
What zone does displacement occur in SCFE?
hypertrophy zone
Metaphysis moves what way in SCFE?
anterior and proximal
treating SCFE
surgery and screws to fix in place
outcome of SCFE
avascular necrosis
early OA
deformity
chondrolysis
Do stable or unstable slips in SCFE have high risk of AVN?
unstable
