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  #1  
Old 01-22-2013
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Default Musculosk Q

A 7-year-old boy is brought to the pediatrician’s
offi ce by his mother. She fi rst noticed a limp
several days ago. The child is in no discomfort
and has no history of trauma or recent infection.
He is otherwise in good health and has
reached all developmental milestones on time.
Vital signs are within normal limits. Physical
examination reveals limited abduction and internal
rotation of his left leg. The left hip joint
shows no evidence of instability or localized
pain. Deep tendon reflexes are brisk, pulses are
normal, and muscle strength testing shows 5/5
strength bilaterally.What is the most
appropriate treatment for this child’s condition?

(B) Gentle closed reduction
(C) Hospital admission and intravenous antibiotics
(D) Observation and limited weight bearing
(E) Surgical intervention with adjuvant chemotherapy
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  #2  
Old 01-22-2013
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(C) Hospital admission and intravenous antibiotics
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Old 01-22-2013
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Hey Aknz where is choice A
I think the diagnosis is Legg-Calve-Perthes which managed by reduction of the femoral head within acetabulum for proper healing and this accomplish by splint or surgery.
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Old 01-22-2013
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Quote:
Originally Posted by heartbeat View Post
Hey Aknz where is choice A
.
........
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Old 01-23-2013
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diagnosis is Legg-Calve-Perthes

Only option here is D. Legg-Calvé-Perthes disease causes idiopathic avascular necrosis of the femoral head. It most commonly affects boys 4–10 years old and presents as a painless limp when symptomatic. The disease is usually self-limiting with symptoms lasting <18 months. Observation and limited weight bearing are the treatment choices for this condition. Management by an experienced orthopedist is appropriate.

MTB 2 says :

Rest and NSAIDS followed by surgery on both hips.
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Old 01-23-2013
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Quote:
Originally Posted by heartbeat View Post
Hey Aknz where is choice A
I think the diagnosis is Legg-Calve-Perthes which managed by reduction of the femoral head within acetabulum for proper healing and this accomplish by splint or surgery.
Option A was Chemotherapy alone.
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Old 01-23-2013
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Quote:
Originally Posted by aknz View Post
diagnosis is Legg-Calve-Perthes

Only option here is D. Legg-Calvé-Perthes disease causes idiopathic avascular necrosis of the femoral head. It most commonly affects boys 4–10 years old and presents as a painless limp when symptomatic. The disease is usually self-limiting with symptoms lasting <18 months. Observation and limited weight bearing are the treatment choices for this condition. Management by an experienced orthopedist is appropriate.

MTB 2 says :

Rest and NSAIDS followed by surgery on both hips.
You are make me confuse cuz in UW they are mentioned that Legg-Calvé-Perthes disease managed by reduction of the femoral head within acetabulum
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  #8  
Old 01-23-2013
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Quote:
Originally Posted by heartbeat View Post
You are make me confuse cuz in UW they are mentioned that Legg-Calvé-Perthes disease managed by reduction of the femoral head within acetabulum
UW question ID :4533

Manage conservatively with observation and bracing.Surgery is indicated in cases when femoral head do not contain within acetabulum.
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