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Flashcards in Childhood limp Deck (11):
1

What questions should be asked in a paediatric limp history?

Acute vs chronic
Injury or illness association
Impact on child - staying still, unhappy
Systemic features

2

What are the red flags for hip pain in a child?

Nocturnal pain, night sweats, weight loss - ALL
High fever, holding leg abducted - septic arthritis
High fever, not weight-bearing - osteomyelitis
Changeable, unusual history - NAI

3

What are the features of Perthes disease?

4-8 year old boys
Gradual painless limp
Results in deformity and early onset arthritis

4

What are the features of slipped upper femoral epiphysis?

10 years and older boys
Risk: BMI, hypothyroidism
Sudden onset pain not weight bearing or gradual vague pain

5

What are the features of developmental dysplasia of the hip?

Babies
Asymmetrical skin folds, leg length discrepancy, buttock flattening
Older children may present with painless limp

6

What are the features of juvenile idiopathic arthritis?

Any age, multiple joints
7 types

7

What are the seven types of JIA?

Oligoarthritis
Polyarthritis
Enthesitis related
Psoriatic arthritis
Systemic onset
Undifferentiated

8

What are the features of hip pain due to abdominal pathology?

Abdominal pain
Not weight bearing
Nausea
Reduced appetitie

Appendicitis, torsion, inguinal hernia

9

What are the features of transient synovitis?

4-8 year old boys
Acute onset limp
Often preceded by viral illness
Reduced hip movements
Child is systemically well

10

How is transient synovitis treated?

Ibuprofen and paracetamol

11

What safe-netting should be done for transient synovitis?

Attend A&E if child is febrile with limp or non weight bearing limb