🦆 - Paediatrics

Question 1

Case

6-year-old boy w/hip pain. Gradual worsening over weeks, No trauma, Antalgic gait, Limitation of active and passive movement. Mild CRP rise (10), Normal WCC. Dx?

Answer 1

Perthes disease

(Legg-Calvé-Perthes disease)
A rare/idiopathic childhood condition where temporary loss of blood supply causes the hip’s femoral head to soften, collapse, and potentially reshape over 2–5 years. Affecting children aged 3–12 (most commonly 4–9).
Presents with a persistent limp and hip, groin, or knee pain that worsens with activity,.

Question 2

Kid w/Acute onset of Severe hip pain, refusal to weight bear + Systemically unwell. Labs show: High CRP, Raised WCC. Dx?

Answer 2

Septic arthritis

Question 3

Early plain x-ray changes in Perthes Disease:

Answer 3

Widening of the joint space.
Sub chondral linear lucency.

Question 4

What is the pathology in Perthes disease?

Answer 4

Idiopathic avascular necrosis of the femoral head.

Question 5

How does septic arthritis of the hip typically present in children?

Answer 5

Acute pain, refusal to weight bear, high ESR (No CRP!), high WCC, systemic illness.

Question 6

What are key differentiating features between transient synovitis and Perthes disease?

Answer 6

Both cause child hip pain/limp.

• Transient synovitis = Often triggered by viruses, sudden, acute, self-limited, resolves in days–weeks.
• Perthes = Idiopathic, progressive stiffness, weeks–months

Question 7

What is the typical age range for SUFE?

Answer 7

10–16 years (adolescents), often overweight.