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University of Debrecen

Department of

Orthopaedic Surgery

Transient synovitis of the hip joint

Perthes’ disease

Slipped capital femoral epiphysis

Coxa vara

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Transient synovitis of the hip joint

• 2-14 years of age

• male : female = 1:1

• sudden

hip/thigh/knee pain

• previous upper

airway infection

• non purulent coxitis

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Transient synovitis of the hip joint

Differential diagnosis from purulent arthritis:

• NO FEVER

• CRP

Treatment:

• Non-steroid anti-inflammatory drug

• Rest

Follow up:

X-ray 3 months later => Perthes’ disease

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Legg-Calve-Perthes’ disease

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Legg-Calve-Perthes’ disease

Boston, USA Berck, France Tübingen, Germany

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Legg-Calve-Perthes’ disease

• 3-13 years of age

• incidence: 0,1-1%

• male : female = 3:1

• 15% bilateral

• duration: 3-5 years

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Legg-Calve-Perthes’ disease

• intermittent pain

• decreased internal rotation

(abduction, extension)

• muscle atrophy

• leg length discrepancy

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Early stage

• no X-ray sign

• wider joint space medially

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Sclerotic stage

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Fragmentation

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End stage

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End stage

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Catterall’s classification

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Herring’s lateral pillar classification

100%

>50%

<50%

A

B

C

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Slipped capital femoral epiphysis

• acute

• chronic

• acute on chronic

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Slipped capital femoral epiphysis

• 10-15 years of age

• male : female = 2:1

• 75% chronic

• knee/thigh/hip pain!

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Slipped capital femoral epiphysis

Drehmann’s sign

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Coxa vara infantum (congenita)

• Decreased collo-diaphyseal angle

• Abbreviation of the leg

• Congenital but recognised only at the age of

3-4 years of age

• Rare

• Progressive

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University of Debrecen

Department of

Orthopaedic Surgery

Osteoarthritis of the hip. Aseptic necrosis of the femoral head.

Replacement of joints.

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ORDER OF VERBAL EXAMS

The students are able to register for the exam on the NEPTUN system. The students pick two titles, from the title list available at the beginning of the Semester. This list can be also found on the web site of the Orthopaedic Department.

Those students who attended at least 70 % of the lectures will pick two titles, but will only be examined on the one of their choice.

In case of a B or C exam the student is not entitled to the above advantage.

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