Septic Arthritis |
- Acute onset of severe joint pain, fever, inability to bear weight
- Swelling, redness, warmth over the joint
- Hip is most commonly affected
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- Joint aspiration: purulent fluid, positive culture
- Elevated WBC, CRP, ESR
- Ultrasound: shows joint effusion
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- Urgent IV antibiotics
- Surgical drainage or lavage
- Close monitoring for complications (e.g., osteomyelitis)
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Osteomyelitis |
- Acute onset of pain, fever, swelling
- Refusal to bear weight
- Tenderness over the affected bone
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- X-ray: may be normal early but show bone changes later
- MRI: highly sensitive for detecting early osteomyelitis
- Blood cultures, elevated WBC, CRP, ESR
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- IV antibiotics (targeting suspected organisms)
- Surgical debridement if abscess or severe infection
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Developmental Dysplasia of the Hip (DDH) |
- Often presents in infancy but can present later with limping
- Hip instability, asymmetric leg length
- Restricted hip abduction
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- Ultrasound in infants
- X-ray in older children
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- Pavlik harness in infants
- Surgical reduction in older children
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Transient Synovitis (Irritable Hip) |
- Common in children aged 3-8 years
- Acute onset of hip pain and limp
- Low-grade fever (if any)
- Child usually well-appearing
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- Ultrasound: may show joint effusion
- Exclusion of septic arthritis (e.g., blood work)
- Normal blood tests (CBC, CRP, ESR)
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- Rest and reduced weight-bearing
- NSAIDs for pain relief
- Usually self-limiting, resolves in 1-2 weeks
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Legg-Calvé-Perthes Disease |
- Insidious onset of limping and hip/knee pain
- More common in boys aged 4-10 years
- Limited hip abduction and internal rotation
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- X-ray: shows avascular necrosis of the femoral head
- MRI: early detection of necrosis
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- Activity modification and physiotherapy
- Bracing or casting to reduce stress on the hip
- Surgical intervention in severe cases
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Slipped Capital Femoral Epiphysis (SCFE) |
- Adolescents (usually overweight) aged 10-16 years
- Groin, thigh, or knee pain
- Antalgic gait with limited internal hip rotation
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- X-ray: shows displacement of the femoral epiphysis
- Frog-leg lateral view is most diagnostic
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- Immediate non-weight bearing
- Surgical pinning of the femoral head to prevent further slippage
- Monitor for complications such as avascular necrosis
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Juvenile Idiopathic Arthritis (JIA) |
- Chronic joint pain and swelling, limp that worsens in the morning
- Multiple joints may be affected
- Systemic symptoms (fever, rash) in some cases
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- Elevated inflammatory markers (CRP, ESR)
- Positive ANA or rheumatoid factor (in some cases)
- X-ray: may show joint space narrowing or erosions
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- NSAIDs or corticosteroids for inflammation
- DMARDs (e.g., methotrexate) in more severe cases
- Physical therapy to maintain joint function
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Fracture |
- History of trauma or fall
- Local tenderness, swelling, and inability to bear weight
- Deformity may be present in severe cases
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- X-ray: confirms fracture
- CT or MRI in complex or occult fractures
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- Immobilization (casting or splinting)
- Surgical fixation in severe cases
- Pain management with analgesics
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