The Acute Limping Child Flashcards
What are the common causes for a child to be limping?
Septic arthritis
Osteomyelitis
Perthes
SUFE
Transient synovitis
What would be the features of a history suggestive of an infective cause of the limp?
Malaise
Temperature
Recent URTI/eat infection
Trauma
What investigations would you do in order to confirm or rule out an infective cause of a limp?
Temperature
Blood and synovial fluid culuture
CRP
ESR
WCC
Creatinine:Kinase ratio
Where is septic arthritis most likely to occur?
Knee
Hip
How does septic arthritis present?
Limping
Swollen, red joint
Refusal to move joint
Pain
Temperature
By which routes can infection enter a joint, thereby causing septic arthritis?
Blood
Spread from nearby osteomyelitis
Spread from nearby soft tissue infection
What are the key differences between septic arthritis and transient synovitis?
Septic arthritis:
- Pain more severe
- Raised inflammatory markers & fever
- Systemically unwell
- Refusal to weight bear
Transient synovitis:
- Normal inflammatory markers & no fever
- Systemically well (generally)
- Can slightly weight bear
How is septic arthritis treated?
Aspiration
Arthroscopy
Antibiotics
What are the risk factors for osteomyelitis?
Blunt trauma
Recent infection
What are the presenting symptoms of osteomyelitis?
Pain
Localised signs
Fever
Reduced range of movement
Reduce weight bearing
What is the appearance of x-rays in osteomyelitis?
Bone destruction
Lytic lesions
Periosteal reaction
Apart from x-rays, what other investigations can be performed in a suspected case of osteomyelitis?
MRI
CT scan
USS
What is the most common organism found in osteomyelitis?
Staph aureus
