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Flashcards in Pediatric hip Deck (24):
1

The ______ is the common physis around which the acetabulum grows

triradiate cartilage- confluence of ilium, ischium, pubis

2

Describe femoral head blood supply in children

- first few months of life: metaphyseal vessels of femoral neck
- by about 8 months, ossification begins and blood supply is from femoral artery via medial and lateral femoral circumlfex, penetrate directly into femoral head

3

Hip infections in infants can occur via:

direct hematogenous seeding of femoral head via metaphyseal vessels

4

Describe presentation of septic arthritis of the hip in young children

fussy, fever, limited range of motion due to pressure and pain

5

What is transient synovitis?

occurs exclusively in pre-pubetal children, viral etiology possible- occurs after respiratory tract infections
resolves without complications

6

Definitive diagnosis of septic arthritis vs transient synovitis is made via:

- ultrasound showing effusion
- guided aspiration and analysis of joint fluid

7

What factors may be predictors of the likelihood of septic arthritis in a child?

WBCs > 12k
ESR> 40
fever
not weightbearing

8

Describe the spectrum of developmental dysplasia of the hip

dislocated, dislocatable, subluxed, subluxable, radiographic abnormalities

9

In developmental dysplasia of the hip, the femoral head fails to remain stably located within the ___________

acetabular cartilage

10

What factors may predispose children to developmental dysplasia of the hip?

female
first born
breech
family history

post-natal: papoosing

11

What factors may predispose children to developmental dysplasia of the hip?

female
first born
breech
family history

post-natal: papoosing

12

What exam maneuvers can identify a dislocated hip?

Ortolani
Barlow

13

What babies should be screened for hip dislocation?

breech girls, screen by ultrasound at 3-6 weeks old

14

What is the treatment for DDH?

- bracing if presentation was early enough
- reduction and casting if later presentation
- surgery if persistent

15

Children with DDH are followed through skeletal maturity because any residual dysplasia contributes to the development of hip _________

osteoarthritis

16

What is Legg-Calve-Perthes disease?

idiopathic avascular necrosis in children

17

How does LCP disease present?

necrotic femoral head --> pain in groin, hip, thigh, knee

18

Describe the natural history of LCP disease

development of avascularity
femoral head fragmentation and collapse
revascularization eventually occurs, epiphysis re-ossifies, remodeling can begin

19

What treatments are used for LCP disease?

NSAIDs, rest, bracing/ casting

20

The more _____ the hip is after LCP disease, the greater the risk of later osteoarthritis

dysplastic

21

As children approach puberty, the proximal femur can weaken due to rapidly expanding ______ zone during growth spurts

hypertrophied

22

Some children can develop a stress fracture that results in :

slipped capital femoral epiphysis, SCFE

23

What children are at risk for SCFE?

overweight adolescents, endocrine disorders

24

What is the major complication of SCFE?

progressive displacement of the femoral head/ neck to the point of avascular necrosis
later risk of osteoarthritis