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MSK AM > The limping child > Flashcards

The limping child Flashcards

1
Q

What are the common causes of limping children?

A 
Septic arthritis
Osteomyelitis
Perthes
SUFE
Toddler's fracture
Soft tissue injury
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2
Q

What are the less common causes of a limping child?

A

Non accidental injury
Tumour
Endocrinopathies

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3
Q

What does SUFE stand for?

A

Slipped upper femoral epiphysis

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4
Q

What is SUFE?

A

Posteriomedial displacement of proximal femoral epiphysis in relation to the neck

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5
Q

Who is SUFE seen in?

A

9-16 year olds, typically over 11s

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6
Q

What is SUFE associated with?

A

Growth spurt

Obesity

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7
Q

What causes SUFE?

A

Increased load

Weak physis

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8
Q

What are the signs and symptoms of SUFE?

A 
Pain- groin, knee, thigh
Limited range of movement
Limp
History of trauma
External rotation, esp on flexion
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9
Q

What is the investigation for SUFE?

A

Frog lateral xrays

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10
Q

What is the treatment of SUFE?

A

Operative- pin in situ

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11
Q

What causes septic arthritis?

A

Typically staph aureus

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12
Q

What is the presentation of septic arthritis?

A 
Limping with no weight bearing
Pseudoparalysis
Swollen, red joint
Pain
Feverish
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13
Q

What are the common route of infection in septic arthritis?

A

Haematenogous spread
Dissemination from osteomyelitis
Spread from adjacent soft tissue infection

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14
Q

What investigations are done for septic arthritis?

A

Observation
Temperature
Bloods- WCC, CRP, ESR, Creatinine kinase, cultures
Ultrasound

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15
Q

What is the treatment of septic arthritis?

A

IV antibiotics, then switch to oral

Surgical- wash out joint

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16
Q

What is the most common causative organism of osteomyelitis?

A

Staph aureus

17
Q

What is the presentation of osteomyelitis?

A 
Pain
Localised signs and symptoms
Fever in 60%
Have better weight bearing and ROM
Less unwell than septic arthritis, but "not right"
18
Q

What investigations are done for osteomyelitis?

A

Observation
Temperature
Bloods- WCC, CRP, ESR, creatinine kinase, cultures
US

19
Q

What is the treatment of osteomyelitis?

A

Antibiotics

Surgical

20
Q

What are the indications for surgery in osteomyelitis?

A

Collection in periosteum
Infection spreads to joint
Atypical bacteria
Debridement of dead tissue

21
Q

What is transient synovitis?

A

Inflammation of joint secondary to virus

22
Q

What is the presentation of transient synovitis?

A

Limp- hobbling, will weight bear
No temperature
Recent viral infection
Normally fairly well

23
Q

What investigations are done for transient synovitis?

A

Observation
Temperature
Occasionally US

MSK AM (37 decks)

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