Flashcards in Childhood hip disorders Deck (29):
What are features of a history which make developmental dysplasia of the hip more likely?
What might you find on examination of a child with developmental dysplasia of the hip?
Asymmetrical groin creases
Positive barlow and ortolani tests
What are the barlow and ortolani instability tests?
Barlow - attempt to dislocate a hip that by flexing and adduction
Ortolani - attempt to relocate a dislocated hip by abduction
What imaging modalities can be used to investigate suspected developmental dysplasia of the hip?
X-ray if epiphysis calcified (>3-6m)
How is developmental dysplasia of the hip treated?
Relocate (closed >3m ; open >9m)
Splint (pavlik harness)
Monitor acetabular development
Surgery if >2y
How is surgery carried out for developmental dysplasia of the hip?
Pre-op gallows traction
Hip spica immobilisation 3 months post-op
Which questions are important to ask in a pre-school child with a limp?
Painful or painless?
History of injury?
Generally well or ill?
What features of a limp would point to infection?
Pain at rest
Pain on movement
Resistance to movement
Systemically unwell (fever)
How is suspected bone infection in a child investigated?
Bloods (FBC, inflammatory markers, culture)
USS for effusion
Tech bone scan
How should bone infection in children be treated?
How does transient synovitis present?
Insidious onset (post viral infection)
Low grade fever/no fever
Usually no reduced movement
What are the results for investigation of transient synovitis?
How is transient synovitis treated?
Conservative - resolves with rest
How does a developmental dysplasia of the hip present late?
Asymmetric hip creases
How should a suspected late presenting developmental dysplasia of the hip be investigated?
What is perthes disease?
Idiopathic avascular necrosis
Which age group gets perthes?
Which gender gets perthes more commonly?
How does perthes present?
How is perthes treated?
Maintenance of hip abduction -
Rest and activity modification
Can perthes be bilateral?
Perthes is associated with a better prognosis if it occurs below age 7. T/F
What can perthes cause?
How does SUFE present?
Adolescent in rapid growth (10-16)
May or may not be bilateral
How is a SUFE investigated and what should be seen?
X-ray (AP & lateral)
In which direction does a SUFE slip?
How is a SUFE classified?
Mild - 3 wks, >60, inability to weight bear
Is an acute unstable hip an emergency?
Yes - risk of avascular necrosis in SUFE