kids ortho

Question 1

A 12-year-old female presents to her GP with bilateral knee pain, swelling and stiffness. On examination, a salmon-pink rash is noted on the legs.

Answer 1

joint pain with a salmon-pink rash is characteristic of juvenile idiopathic arthritis

• arthritis in <16 years old that lasts for more than 6 weeks

Question 2

12 yr old, 3wks of R hip pain, he is able to mobilise and weight-bear with moderate discomfort in an antalgic gait out-toeing. On passively moving the hip, there is a loss of internal rotation of the right leg in flexion

Answer 2

slipped capital femoral epiphysis

loss of internal rotation
- perthes doesnt restrict movement
- JIA is >6wks
–> only one with loss of internal rotation

Question 3

knock knees

Answer 3

usually a self-limited condition, commonly occurring bilaterally, between the ages 3-6, with most cases resolving by the age of 7-8

refer to podiatrist
- if no red flags, symmetrical + no pain/functional impairment

Question 4

Osteochondritis dissecans

Answer 4

worse after run, swelling + locking of knee

-> fragment of bone in knee joint that becomes detached due to lack of blood supply

Question 5

screening for DDH

Answer 5

US ! at 4wks ish

• 1st degree fam hx of hip probs in early life
• breech presentation >=36wks, irrespective of presentation or mode of birth

Question 6

barlows and ortolanis

Answer 6

barlows = attempts to DISLOCATE an articulated femoral head

Ortolani = attemptos to relocate dislocated head

Question 7

imaging for DDH

Answer 7

US
but if >4.5 MONTHs –> xray = 1st line

Question 8

DDH mangement

Answer 8

most spontaneously stabilise by 3-6wks

Pavilk harness in kids younger than 4-5months

older - surgery