Peadiatric Ortho:The Big Three Flashcards
what are the risk factors for developmental dysplasia of the hip?
> family history
oligohydramnios
first born
breech presentation
what are the clinical features of developmental dysplasia of the hip?
> ortolani’s sign
barlow’s sign
piston motion sign
what imaging would you carry out to assess for developmental dysplasia of the hip?
> US
shentons line will be broken
how do you manage developmental dysplasia of the hip?
bilateral long leg cast
what are the phases of leg-calve-perthes disease?
> avascular necrosis
fragmentation (revascularisation)
reossification (bony healing)
residual deformity
what are the clinical features of legg-calve-perthes disease?
> limp > short stature > knee pain on exercise > stiff hip joint > systemically well
what is the differential diagnosis of unilateral legg-calve-perthes disease?
> septic hip
SCFE
JIA
lymphoma
what is the differential diagnosis of bilateral legg-calve-perthes disease?
> sickle
hypothyroidism
epiphyseal dysplasia
what is the treatment for legg-calve-perthes disease?
> maintain hip motion > analgesia > restrict painful activities > "supervised neglect" > consider osteomy in selected groups of children older than 7
what is SCFE?
slipped capital femoral epiphyseal
what is the pathology of slipped capital femoral epiphyseal?
there is displacement throughout the hypertrophic zone- the metaphysis moves anterior and proximal
how is SCFE treated?
operatively
for how long does SCFE occur to be classed as chronic?
3 weeks
how does management differ between a stable SCFE and an unstable SCFE?
> stable is fixed in situ
> unstable is fix with serendipidus reduction
what are the outcomes of SCFE?
> chondrolysis
deformity
early osteoarthritis
avascular necrosis (unstable slips-unable to weight bear)
