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level: Lecture 17: Joint and Bone Conditions in Kids

Questions and Answers List

level questions: Lecture 17: Joint and Bone Conditions in Kids

QuestionAnswer
The childhood condition "Transient Synovitis" has another name. What is it?Toxic Synovitis
What is Transient Synovitis?A childhood condition, characterized by sudden onset of pain, limp, and mild restriction of hip motion, especially abduction and internal rotation. Oversimplified: a childhood condition, inflammation of the hip joint.
While the exact cause of Transient Synovitis is unknown, what is one of the 3 possible causes discussed in the lecture?1. Active or recent viral infection (esp respiratory). 70% of the time true. 2. Hypersensitivity, post-vaccination 3. Relationship with Legg-Calve-Perthes: some children with TS may develop LCP.
What is the main and most obvious symptom of transient synovitis?A limp (caused by hip pain).
What's the best treatment for transient synovitis?Bed rest and limiting activities
What is Legg-Calvé-Perthes Disease (LCPD)?It is an idiopathic necrosis where the capital femoral epiphysis (femoral head) has an interruption of blood supply, causing a collapse/flattening of the femoral head.
What is the cause of Legg-Calvé-Perthes Disease (LCPD)?It is idiopathic (unknown).
Are the after effects of Legg-Calvé-Perthes Disease (LCPD) permanent?Yes and no. No - Revascularization and new bone formation = healed. Other times: Yes - Deformities in the femoral head and epiphyseal plate. Yes - Bone infarction and necrosis which may invade cartilage, subchondral bone and growth plate Yes - The child has disproportionate growth with mild short stature.
Both Legg-Calvé-Perthes Disease and Transient Synovitis have the classic symptom of a limp, and pain during abduction and internal rotation of the hip... but what's the main difference between the two?Legg-Calvé-Perthes Disease effects the bone and Transient Synovitis affects the joint.
What disease MIGHT the lasting effects of Legg-Calvé-Perthes Disease cause in the patient's future?Osteoartheritis (Degenerative Joint Disease)
One is what basic treatment goal you should have when treating a patient with Legg-Calvé-Perthes Disease, that an osteopath can help with? Restoration and maintenance of a good range of motion.  Prevention of CFE collapse, excursion and subluxation (strengthening via gentile techniques, w/o weight bearing). (Gentile traction techniques can help)
What heals Legg-Calvé-Perthes Disease (What causes the restricted blood supply to end, typically)?Trick question. It heals on its own.