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Should we Continue to Screen for Developmental Dysplasia of the Hip in Clubfoot? Our Experience and Review of the Literature

Volume 7 | Issue 2 | May-August 2021 | Page: 07-11 | Teixeira R, Ovídio J, Arcangelo J, Campagnolo J, Tavares D Authors: Teixeira R [1], Ovídio J [2], Arcangelo J [2], Campagnolo J [2], Tavares D [2] [1] Hospital São Francisco Xavier, Lisbon, Portugal. [2] Hospital Dona Estefânia, Lisbon, Portugal Address of Correspondence Dr. Raquel Teixeira, […]

Iliopsoas Abscess in Children – A Forgotten Diagnosis

Volume 7 | Issue 2 | May-August 2021 | Page: 17-19 | Vinod Raj, Abhishek Chinya, Sanjay Sardessai, Jeevan Vernekar Authors: Vinod Raj [1], Abhishek Chinya [1], Sanjay Sardessai [2], Jeevan Vernekar [2] [1] Department of Paediatric Surgery, Goa Medical College and Hospital, Goa, India. [2] Department of Radiology, Goa Medical College and Hospital, Goa, India Address […]

Should we Continue to Screen for Developmental Dysplasia of the Hip in Clubfoot? Our Experience and Review of the Literature

Iliopsoas Abscess in Children – A Forgotten Diagnosis

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Should we Continue to Screen for Developmental Dysplasia of the Hip in Clubfoot? Our Experience and Review of the Literature

Volume 7 | Issue 2 | May-August 2021 | Page: 07-11 | Teixeira R, Ovídio J, Arcangelo J, Campagnolo J, Tavares D

Authors: Teixeira R [1], Ovídio J [2], Arcangelo J [2], Campagnolo J [2], Tavares D [2]

[1] Hospital São Francisco Xavier, Lisbon, Portugal.
[2] Hospital Dona Estefânia, Lisbon, Portugal

Address of Correspondence
Dr. Raquel Teixeira,
Rua dos Quartéis 80, r/c direito, 1300-483 Ajuda, Lisbon, Portugal.
E-mail: rt.corda@gmail.com

Abstract

Objective: The association between clubfoot and developmental dysplasia of the hip (DDH) remains uncertain, with only a few studies linking both. However, clubfoot is considered as a risk factor for DDH. The aim of this study was to determine the incidence of DDH and evaluate the need for routine hip imaging in our population of children with clubfoot.
Methods: Retrospective analysis of all patients treated for clubfoot in our center between 2010 and 2019. We included patients with hip imaging for DDH in the first 12 months of life.
Results: There were 108 children with clubfoot who underwent DDH screening. 92 had idiopathic clubfoot and 16 had syndromic clubfoot. Of the patients with idiopathic clubfoot, 2 (2.2%) had DDH; one had a clinically unstable hip and the other patient underwent hip screening on account of the clubfoot alone. Among patients with syndromic clubfoot, 3 (18.8%) had developmental dysplasia of the hip. Two of them had an abnormal hip examination while the other had normal hip clinical examination but other established risk factors for DDH.
Conclusion: A targeted ultrasound or radiological screening programme for DDH in idiopathic clubfoot diagnosed hip dysplasia in only 1 child that would have otherwise been missed by clinical examination alone. We conclude that hip imaging is not warranted in children with idiopathic clubfoot and regular clinical screening may suffice. In syndromic clubfoot, due to the higher incidence of DDH, we recommend specific ultrasound screening even in the presence of a normal hip examination.
Keywords: Clubfoot, Screening, Developmental dysplasia of the hip.

References

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8. Sadler B, Gurnett CA, Dobbs MB. The genetics of isolated and syndromic clubfoot. J Child Orthop. 2019;13(3):238-244.
9. Werler MM, Yazdy MM, Mitchell AA, et al. Descriptive epidemiology of idiopathic clubfoot. Am J Med Genet Part A. 2013;161(7):1569-1578.
10. Mahan, Susan; Yazdy, Mahsa; Kasser, James; Werler M. Is it worthwhile to routinely ultrasound screen children with idiopathic clubfoot for hip dysplasia? J Pediatr Orthop. 2013;33(8).
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19. Wynne-Davies R, Littlejohn A, Gormley J. Aetiology and interrelationship of some common skeletal deformities. (Talipes equinovarus and calcaneovalgus, metatarsus varus, congenital dislocation of the hip, and infantile idiopathic scoliosis). J Med Genet. 1982;19(5):321-328.
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How to Cite this Article: Teixeira R, Ovídio J, Arcangelo J, Campagnolo J, Tavares D | Should We Continue to Screen for Developmental Dysplasia of the Hip in Clubfoot? Our Experience and Review of the Literature | International Journal of Paediatric Orthopaedics | May-August 2021; 7(2): 07-11.

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Iliopsoas Abscess in Children – A Forgotten Diagnosis

Volume 7 | Issue 2 | May-August 2021 | Page: 17-19 | Vinod Raj, Abhishek Chinya, Sanjay Sardessai, Jeevan Vernekar

Authors: Vinod Raj [1], Abhishek Chinya [1], Sanjay Sardessai [2], Jeevan Vernekar [2]

[1] Department of Paediatric Surgery, Goa Medical College and Hospital, Goa, India.
[2] Department of Radiology, Goa Medical College and Hospital, Goa, India

Address of Correspondence
Dr. Vinod Raj
Department of Paediatric Surgery, Goa Medical College and Hospital, NH 17, Bambolim, Tiswadi, North Goa,
Goa, India. 403202
E-mail: doc.vraj89@gmail.com

Abstract

Iliopsoas abscess is a rare diagnosis in children. We recently encountered two cases which were managed at our institution. A 11-year female presented with thigh and inguinal swelling while 3-year male child presented with limp and fixed flexion deformity of right leg. Due to the differing presentation, imaging studies are often important before management is planned. Ultrasound scan is the most common investigation followed by computerized tomography (CT) scan in a selected few. The girl underwent a CT scan followed by incision and drainage (I&D) of the iliopsoas abscess while the boy underwent ultrasound-guided pigtail catheter insertion. Both cases were successfully treated. Atypical presentation of iliopsoas abscess makes the diagnosis difficult and requires a high degree of clinical suspicion for making correct diagnosis. Imaging studies help with diagnosis in such cases. Less invasive techniques like image-guided aspiration and catheter drainage can be helpful in carefully selected cases.
Keywords: Iliopsoas abscess, Atypical presentation, Percutaneous drainage, Pediatric.

References

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Wong-Chung J, Bagali M, Kaneker S. Physical signs in pyomyositis presenting as a painful hip in children: A case report and review of the literature. Vol. 13, Journal of Pediatric Orthopaedics Part B. 2004. p. 211–3.
Wang E, Ma L, Edmonds EW, Zhao Q, Zhang L, Ji S. Psoas abscess with associated septic arthritis of the hip in infants. J Pediatr Surg. 2010 Dec;45(12):2440–3.
Elliott C. Paediatric Iliopsoas abscess: A case report. Australas J Ultrasound Med. 2013 Nov;16(4):198–201.
Dietrich A, Vaccarezza H, Vaccaro CA. Iliopsoas abscess: Presentation, management, and outcomes. Surg Laparosc Endosc Percutaneous Tech. 2013 Feb;23(1):45–8.
López VN, Ramos JM, Meseguer V, Pérez Arellano JL, Serrano R, Ordonez MAG, et al. Microbiology and outcome of iliopsoas abscess in 124 patients. Medicine (Baltimore). 2009 Mar;88(2):120–30.
Zhou Y, Li G. Diagnosis and management of complicated intra-abdominal infection in adults and children: Guidelines by the Surgical Infection Society and the Infectious Diseases Society of America. Chinese J Infect Chemother. 2010 Jul 20;10(4):241–7.

How to Cite this Article: Raj V, Chinya A, Sardessai S, Vernekar J | Iliopsoas Abscess in Children – A Forgotten Diagnosis | International Journal of Paediatric Orthopaedics | May-August 2021; 7(2): 17-19.

Half Sized Blog Element (Single Author Style)

Half Sized Blog Element (Multi Author Style)

Should we Continue to Screen for Developmental Dysplasia of the Hip in Clubfoot? Our Experience and Review of the Literature

Iliopsoas Abscess in Children – A Forgotten Diagnosis

Should we Continue to Screen for Developmental Dysplasia of the Hip in Clubfoot? Our Experience and Review of the Literature

Iliopsoas Abscess in Children – A Forgotten Diagnosis

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Should we Continue to Screen for Developmental Dysplasia of the Hip in Clubfoot? Our Experience and Review of the Literature

Authors: Teixeira R [1], Ovídio J [2], Arcangelo J [2], Campagnolo J [2], Tavares D [2]

Abstract

(Article Text HTML) (Download PDF)

Iliopsoas Abscess in Children – A Forgotten Diagnosis

Authors: Vinod Raj [1], Abhishek Chinya [1], Sanjay Sardessai [2], Jeevan Vernekar [2]

Abstract

(Article Text HTML) (Download PDF)

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