Pediatric Hips Flashcards
The acetabulum is composed of what kind of cartilage?
Triradiate cartilage AKA growth plate
When does the femoral head begin to ossify?
3-8 months old from the center outwards
Fluid aspiration if cases of hip effusion can determine between what two abnormalities?
Transient synovitis vs septic arthritis
Symptoms of hip effusion?
Pain
Refuse to weight bear
Irritability
What is a common cause of hip pain between the ages of 3-8 months?
Transient synovitis - mild condition
With transient synovitis, the patient has likely had a history of?
Upper respiratory tract infection
What type of infection is septic arthritis?
Bacterial - medical emergency
In patients with septic arthritis, they will present with elevated levels of what lab values? (3)
- Erythrocyte sedimentation rate
- C-reactive protein
- WBC count
How is septic arthritis treated?
- Antibiotics
- Surgery (if serious)
An abnormal appearance that indicates hip effusion consists of what parameters?
- Capsular thickness >5mm
- 2 mm difference between both hips
What does DDH stand for?
Developmental dysplasia of the hip
What 3 abnormalities does DDH consist of?
- Instability
- Subluxation - partial dislocation but not complete
- Frank Dislocation - not in the socket at all
Causes of DDH?
Mechanical
Physiologic
What maneuver attempts to push the femoral head posteriorly out of the socket?
Barlow - a palpable SENSATION of movement
What maneuver attempts to reduce a recently dislocated hip?
Ortolani - a palpable PHYSICAL movement
What is known as the “ noted relative shortness of the femur with the hips and knees flexed where one knee will appear lower than the other”?
Positive Allis or Galeazzi sign
When is ultrasound of the hip BEST performed?
Up to 6 months
In the coronal scan plane, what angle is usually measured to assess DDH?
Alph angle
What are the 3 “lines” used for obtaining a hip measurement on ultrasound?
Base - straight along ilium though femoral head
Roof - along acetabular roof intersecting baseline
Inclination - Across top of femoral head, through labrum
An alpha angle of what is considered abnormal?
Greater than or equal to 60 degrees
What are we looking for in the TRV scan plane of the hip? (90 degrees of the coronal plane with hips flexed)
- U or V shape that is formed by the ischium and femoral shaft around femoral head
What is the gold standard treatment for DDH?
Pavlik harness
