Date post: | 01-Jun-2015 |
Category: |
Health & Medicine |
Upload: | rem-kulung |
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Perthe’s disease
Case discussion
case
• Sandhya Gaire• 6 yr 7 mths old girl• Grade I student• Informant uncle• c/o- pain rt groin X 6-7 mths• occasional limp
• Pain dull aching in nature• Aggravated by exertion and sitting down in
squatting position• No radiation• NO h/o trauma, fever, rashes
Examination
• Gait- antalgic on exertion• Cannot sit cross legged• Can squat• Trendelenberg test negative• Tenderness +ve on anterior hip jt line
Range of motion
• Flexion 140-140• Extension 10-15• Adduction 40-40• Abduction 30-60• Ext rot in ext – 30-30• Ext rot in flex – 50-50• Int rot in ext – 10-20• Int rot in flex – 0-20
• Wasting of thigh 2cm• Wasting of calf 0.5 cm• No LLD• Telescoping test –ve• Sectoral sign +ve
3 months follow up
• Intensity of pain increased• Limp increased• Parents are worried
Changes in findings
• Int rot in ext – 20-20• Int rot in flex -10-20• Abduction – 45-60
To the floor
What next?