Pediatric Hip Flashcards
What is the triradiate cartilage?
‘Y’-shaped epiphyseal plate between the ilium, ischium and pubis to form the acetabulum of the os coxae, in children, the triradiate cartilage closes at an approximate bone age of 12 years for girls and 14 years for boys.[1]
What is the triradiate cartilage?
‘Y’-shaped epiphyseal plate between the ilium, ischium and pubis to form the acetabulum of the os coxae, in children, the triradiate cartilage closes at an approximate bone age of 12 years for girls and 14 years for boys.[1]
How does the blood supply to the head of a child’s femur as it ossifies?
before the growth plate in the neck of the femur forms blood flows to the whole head via the metaphysical vessels
after ossification of the head of the femur, medial femoral circumflex supplies the head of the femur
What is the differential diagnosis for a child that has painful hip moment as evidenced by limited range of movement and is generally irritable when having to walk?
transient synovitis (inflammation of the synovium that comes and goes)
septic arthritis
inflammatory lyme
What specific symptoms make septic arthritis more likely than transient synovitis?
white blood cell count >12k
sedimenation rate >40
not weight bearing
fever T>100.4
Define developmental dysplasia of the hip.
DDH is a spectrum of malalignment of the hip spanning from normal through subluxed, dislocatable and dislocated
Which infants should be screened for hip dysplasia?
females that are born breech, screening X-ray with ortolans/barlow examination
Which infants should be screened for hip dysplasia?
females that are born breech, screening X-ray with ortolans/barlow examination
How is hip dysplasia treated in young children?
initial treatment may be via a Pavlik Harness (keeps out of the positions where the head dislocates)
for more severe cases surgical reduction and casting (pressure can cause the cartilaginous acetabulum to mold around the head of the femur)
Describe what occurs in Legg-Calve-Perthes Disease.
idiopathic necrosis of the head of the femur, with slow collapse of the shape of the ball
although most patients will continue to able to walk, many will have abnormal wear and tear
earlier onset, patients are often able to recover earlier in development
Who does slipped capital femoral epiphysis effect?
disorganization of the physis causes a stress fracture within the head of the femur causing it to slip
Which infants should be screened for developmental dysplaisa of the hip?
females that are born breech especially those with a family history, screening X-ray with ortolans/barlow examination
Describe a slipped capital femoral epiphysis and its consequences.
disorganization of the physis causes a stress fracture within the head of the femur causing it to slip
usually affects mostly adolescents particularly with those with excess weight
risk of blood flow so most are internally fixed in-situ
