Single best answer (SBA)
Tristan Barrett, Nadeem Shaida, Ashley Shaw, Adrian K. Dixon in Radiology for Undergraduate Finals and Foundation Years, 2018
A 13-year-old boy presents with a limp and associated right hip pain, there is no clear history of trauma. Only an AP film is performed and shows reduced height of the right femoral epiphysis, but normal alignment. The acetabulum is normal and the left hip is unremarkable. What is the most likely diagnosis? Developmental dysplasia of the hip.Perthe’s disease.Non accidental injury.Slipped upper femoral epiphysis.Transient synovitis.
Paediatric orthopaedic disorders
Maneesh Bhatia, Tim Jennings in An Orthopaedics Guide for Today's GP, 2017
Signs of Perthes disease on examination include an antalgic gait, loss of hip abduction and, in particular, reduced rotation in hip flexion. Some patients will present just with knee pain or thigh pain creating more diagnostic difficulty. The disease process differs in each case with some more severely affected than others. In the initial phases, radiographs may be normal to even trained eyes. As the disease progresses, more classical radiological features such as loss of epiphyseal height and head fragmentation are seen (Figure 1.27). This diagnosis should be considered in any persistent limp in an otherwise well child. It differs from transient synovitis in the persistence of symptoms beyond 1 or 2 weeks.
Orthopaedics and musculoskeletal system
Jagdish M. Gupta, John Beveridge in MCQs in Paediatrics, 2020
14.8. Perthes' disease isoften manifest by knee pain.most commonly seen after puberty.a form of avascular necrosis.indistinguishable from transient synovitis at the onset.usually treated by surgery.
Identifying the response process validity of clinical vignette-type multiple choice questions: An eye-tracking study
Published in Medical Teacher, 2023
Francisco Carlos Specian Junior, Thiago Martins Santos, John Sandars, Eliana Martorano Amaral, Dario Cecilio-Fernandes
Boy, three-year-old, was brought to the Emergency Room with pain in the right lower limb and difficulty in walking for one day. Family history: brother with an upper respiratory tract infection for 10 days. Physical examination: T = 36.8 °C; RR = 16 breaths per minute; HR = 90 beats per minute; Limbs: limitation of internal and external rotation of the right hip; does not perform complete extension of the right lower limb. The most likely diagnosis is:Rheumatic fever.Legg-Calve-Perthes disease.Transient synovitis.Juvenile idiopathic arthritis.
Impact of the COVID-19 pandemic on paediatric orthopaedic trauma workload in central London: a multi-centre longitudinal observational study over the “golden weeks”
Published in Acta Orthopaedica, 2020
Kapil Sugand, Chang Park, Catrin Morgan, Rory Dyke, Arash Aframian, Alison Hulme, Stuart Evans, Khaled M Sarraf, Camilla Baker, Katharine Bennett-Brown, Henry Simon, Edward Bray, Lily Li, Noel Lee, Nadia Pakroo, Kashed Rahman, Andrew Harrison
Children represent approximately 2% of all COVID-19 cases but to reduce the risk of increased spread schools and nurseries closed during this period (Docherty et al. 2020). Subsequently, there is an expectation of a reduction in acute referrals for infection-related pathology in the paediatric population. The current literature suggests that children appear to be less susceptible to the effects of COVID-19, often displaying milder symptoms than their adult counterparts (Dong et al. 2020, Henry et al. 2020, Lu and Shi 2020, Ludvigsson 2020). Nevertheless, there have been a number of documented cases of a more serious associated illness similar to that of Kawasaki vasculitis (Harahsheh et al. 2020, Viner and Whittaker. 2020). The concern in the paediatric population is that COVID-19 may cause an increased incidence in the presentation of transient synovitis, or indeed COVID-related septic arthritis and osteomyelitis. In our study there has been an increase in overall referrals for infection, from 2% in 2019 to 6% in 2020. As the pandemic evolves and more information surfaces, further investigation is required to observe the influence of COVID-19 on paediatric musculoskeletal infections. Although we have found an increase in those being referred for infection, this was statistically insignificant. However, a larger and broader population sample may suggest otherwise.
Related Knowledge Centers
- Inflammation
- Joint Capsule
- Sciatica
- Septic Arthritis
- Syndrome
- Synovial Membrane
- Osteomyelitis
- Self-Limiting
- Hip
- Idiopathic Disease