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