Thursday, May 19, 2011

Congenital hip dysplasia - Signs and symptoms

Clinical presentations depend on the age of the child. Infants presenting with unstable balance, children and abduction limited to examining older children shows a limp, joint pain and osteoarthritis.Early clinical manifestations are identified during examination of the newborn and make ortolan maneuver when it detects a palpable click when the balance is reduced in and out of the acetabulum and over neolimbus. Click ortolan described it as deriving from subluxation or reduction thigh. Ortolan sign refers to as a click felt when the balance is reduced in the acetabulum with hip abduction. To do this correctly handling the patient should be relaxed. It examines only one hip at a time.Cylindrical examination for child 3-6 months is different. At this point, if the balance is displaced in position. Galeazzi sign is a classic for unilateral hip dislocation. It is done when the patient is supinatie knees and hips flexed. Consideration must demonstrate shortening of a single member.
Unilateral dislocations cause significant inequality of the legs, the imbalance of the weight and pain of the thigh and knee.Developing false acetabulum is associated with adverse prognosis in 75% of patients. Other physical signs include asymmetry late dislocations buttock or lateral skin folds, decreased abduction on the affected side, walk or bipedal position with external rotation and inequality between the legs.
Bilateral dislocations of the hip, especially in old age is difficult to diagnose. The condition manifests as hiperlordoza many unilateral dysplasia of the signs are present, as Galeazzi sign, or asymmetric copasa folds of skin.The patient should be examined to exclude other neuromuscular disorders. Proximal femoral focal deficiency may manifest as hip dysplasia. Since the femoral head does not ossify radiography is differential. Other neuromuscular illnesses include Charcot-Marie-Tooth disease.
Spectrum of congenital dysplasia of the hip:Dysplastic balance: the balance shows the inadequate training of the acetabulum. The condition may not be clinically apparent but make many radiographic abnormalities.Subluxated balance: the femoral head can be partially displaced out of the acetabulum.Disrupt the balance: the femoral head is completely outside the acetabulum. Dizlocatiile are divided into two types:-Teratology-occurring early in utero and is associated with other problems, such as Larsen syndrome, or spina bifida artrogripoza.These dislocations are extremely rare and requires surgical intervention-Classical-dislocations usually occur in healthy children and can develop prenatal and postnatal.
Disease progression:Although for most patients the problem resolves spontaneously within the first months of life, persitienta dysplasia can cause chronic pain, disorders of growth and weight and degenerative arthritis. In its severe hip dysplasia is one of the most common birth defects conhenitale and a leading cause of disability in childhood.Failure to diagnose and treat hip dysplasia in the immediate neonatal period may cause significant morbidity: the need to open and develop osteoarthritis therapies. The possible complications of treatment include recurrent dysplasia, recurrent dislocations and femoral head avascular necrosis.

1 comment:

  1. Osteoarthritis is the form of arthritis generally associated with growing older. This condition results from the natural aging process in which the cartilage, a rubbery substance that protects the joints, begins to wear down.

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