1
PAEDIATRICS MEDICINE SCIENCE PEDS:
ORTHOPEDICS STUDY GUIDE REVIEW EXAM
A 6-year-old who comes Avascular necrosis of the proximal fever
to the clinic with limp and
left knee pain. He is
notably short for his age.
The pain is worse after
soccer practice and
exacerbated by internal
rotation of his hip. At times
the pain is severe enough
that he refuses to walk.
His temperature is 37.1°C
(98.8°F), pulse is 102/min,
respirations are 24/min,
and blood pressure is
102/74 mm Hg. A hip
radiograph is obtained
and shows the left
proximal femoral epiphysis
to be misshapen and
more horizontal
compared to the
unaffected right hip, the
femoral head appears
collapsed.
Insidious onset of a dull ache or throbbing
localized to the groin, lateral hip, or buttocks
Sx of Avascular Necrosis associated with weight-bearing activities that
,2
progresses to pain at rest and night pain
Usually one hip is affected
Think trauma, steroid use, or AVN
sickle cell
AVN is AKA as... Legg-Calve' Perthes disease
MRI
Dx of AVN
Bone Scintogrophy
, 3
May be conservative or may eventually need a joint
replacement
Tx of AVN
Bisphosphonates, Core decompression
A 4-month-old female Congenital Hip Dysplasia
with asymmetric thigh
creases during a routine
checkup. Physical exam
reveals that the left lower
limb is shorter than the
right and lies externally
rotated. Hip abduction is
limited to 30 degrees.
Ortolani’s test is positive,
producing a soft “clunk”
with anterior relation of
the femoral head into
the acetabulum.
Radiographs reveal a
superiorly displaced left
proximal femoral
metaphysis and a
shallow, hypoplastic left
acetabulum. The infant is
treated in a Pavlik
abduction harness for
congenital hip
dislocation.
What is congenital hip problem where the socket or acetabulum - and the
dysplasia? femoral head are misaligned, resulting in an
unstable hip joint
PAEDIATRICS MEDICINE SCIENCE PEDS:
ORTHOPEDICS STUDY GUIDE REVIEW EXAM
A 6-year-old who comes Avascular necrosis of the proximal fever
to the clinic with limp and
left knee pain. He is
notably short for his age.
The pain is worse after
soccer practice and
exacerbated by internal
rotation of his hip. At times
the pain is severe enough
that he refuses to walk.
His temperature is 37.1°C
(98.8°F), pulse is 102/min,
respirations are 24/min,
and blood pressure is
102/74 mm Hg. A hip
radiograph is obtained
and shows the left
proximal femoral epiphysis
to be misshapen and
more horizontal
compared to the
unaffected right hip, the
femoral head appears
collapsed.
Insidious onset of a dull ache or throbbing
localized to the groin, lateral hip, or buttocks
Sx of Avascular Necrosis associated with weight-bearing activities that
,2
progresses to pain at rest and night pain
Usually one hip is affected
Think trauma, steroid use, or AVN
sickle cell
AVN is AKA as... Legg-Calve' Perthes disease
MRI
Dx of AVN
Bone Scintogrophy
, 3
May be conservative or may eventually need a joint
replacement
Tx of AVN
Bisphosphonates, Core decompression
A 4-month-old female Congenital Hip Dysplasia
with asymmetric thigh
creases during a routine
checkup. Physical exam
reveals that the left lower
limb is shorter than the
right and lies externally
rotated. Hip abduction is
limited to 30 degrees.
Ortolani’s test is positive,
producing a soft “clunk”
with anterior relation of
the femoral head into
the acetabulum.
Radiographs reveal a
superiorly displaced left
proximal femoral
metaphysis and a
shallow, hypoplastic left
acetabulum. The infant is
treated in a Pavlik
abduction harness for
congenital hip
dislocation.
What is congenital hip problem where the socket or acetabulum - and the
dysplasia? femoral head are misaligned, resulting in an
unstable hip joint
