Scribd Logo
Upload

Welcome to Scribd!

  • Pediatric Examination and Limping Child

    Uploaded by

    nhfbyqvgwh
    6 views37 pages
    This document discusses the evaluation and diagnosis of a limping child. It outlines a range of potential causes for a limp from benign to serious, including transient synovitis, septic arthritis, and malign neoplasm. Key aspects of evaluation include history, physical examination including inspection of joints and gait, and diagnostic tests such as laboratory tests, imaging like x-rays, and joint aspiration if septic arthritis is suspected. Specific conditions that can cause limping like septic arthritis, transient synovitis, trauma, osteomyelitis, and hip disorders are described in terms of symptoms, diagnostic findings, and treatment considerations.

    Original Description:

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    This document discusses the evaluation and diagnosis of a limping child. It outlines a range of potential causes for a limp from benign to serious, including transient synovitis, septic arthritis, and malign neoplasm. Key aspects of evaluation include history, physical examination including inspection of joints and gait, and diagnostic tests such as laboratory tests, imaging like x-rays, and joint aspiration if septic arthritis is suspected. Specific conditions that can cause limping like septic arthritis, transient synovitis, trauma, osteomyelitis, and hip disorders are described in terms of symptoms, diagnostic findings, and treatment considerations.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    6 views37 pages

    Pediatric Examination and Limping Child

    Uploaded by

    nhfbyqvgwh
    This document discusses the evaluation and diagnosis of a limping child. It outlines a range of potential causes for a limp from benign to serious, including transient synovitis, septic arthritis, and malign neoplasm. Key aspects of evaluation include history, physical examination including inspection of joints and gait, and diagnostic tests such as laboratory tests, imaging like x-rays, and joint aspiration if septic arthritis is suspected. Specific conditions that can cause limping like septic arthritis, transient synovitis, trauma, osteomyelitis, and hip disorders are described in terms of symptoms, diagnostic findings, and treatment considerations.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 37

    Limping Child

    Prof.Dr.Hasan Hilmi Muratlı


    Spectrum
    Benign to serious
    Transient synovitis------------------------------------------Septic arthritis
    Malign neoplasm
    Evaluation
    • History
    • Physical examination
    Inspection
    • Swelling, effusion, erythema,warmth (Joints-Extremity)
    • Muscle atrophy
    • Active and passive ROM
    • Gait (Characteristic limp)
    Gait types
    • Antalgic Gait
    Short stepping
    To avoid the pain the child will take quick, soft steps on the affected
    leg
    So reduces the amount of time the extremity is in the stance phase
    • Trendelenburg gait
    • Spastic gait (crouch gait, stiff knee gait, seissoring gait)
    • Gowers’ sign
    Diagnostic tests
    • Based on history and physical examination

    Laboratory tests (Sedim,CRP,Hemogram)


    X-rays
    Ultrasonography
    Bone scintigraphy
    CT
    MRI
    Special consideration of different age group
    • Toddlers (1-3 years)
    • Children (4-10 years)
    • Adolescents (11-15 years)
    Septic arthritis
    • Acut onset of joint pain
    • Progress to a febrile systemic illness
    • Fever, chills and malaise
    • Pain during the ROM
    • Swelling, warmth, tenderness on palpation
    • WBC count, Sedim, CRP ----elevated
    • %50 blood cultures are positive
    • Radiography-------soft tissue and capsule swelling
    • Joint aspiration is important
    Joint aspiration
    • WBC is generally higher than 50.000 cells/ml
    • Polymorphonuclear leukocytes are greater than %75
    • Gram stain
    • Synovial fluid culture is positive
    (Staph. Aereus, Group B Streptococcus, H.İnfluenza etc. )
    Treatment
    • Drainage
    • Antibioterapy
    Complications
    • Hip disclocation
    • Avascular necrosis
    • Osteoarthritis
    • Osteomyelitis
    • Sepsis
    Transient synovitis
    • Most common cause of lower extremity pain in childhood
    • Rapid onset of hip pain
    • Limited ROM
    • History of an antecedent viral illness
    • Mimic of septic arthritis
    • Rarerly have indications of systemic illness
    • WBC, Sedim, CRP are usually normal
    • In ultrasound, joint effusion
    Joint aspiration
    • WBC is around 5000-15.000 cells/mlt.
    Treatment
    • Bed rest
    • Non weight bearing
    • NSAIDs
    Travma
    Acute onset
    History?
    Physical Examination
    Toddler fracture
    Osteomiyelitis
    • Lab
    • History
    • Fracture
    • Antibotics
    • Surgery(-ies?)
    Hip- DDH
    • Exam
    • History
    • Treatment
    Hip- SCFE
    • Acute-chronic
    • Internal rotation
    Hip-LCP
    • Legg Calve Perthes
    • Xray-MRI
    • Exam
    • Internal rotation
    • Follow-up
    • Surgery
    Knee
    • Blount Dissease
    Knee
    • Discoid lateral meniscus
    • 2. decade
    • Lateral McMurray +
    • MRI
    • Surgery
    Neurologic problems
    • Exam
    • Birth history
    • Onset-progress
    Tumors
    • Duration
    • Pain charasteristics
    • Lesion charasteristics
    Tumors

    You might also like