BOOK
Textbook of Orthopaedics, Trauma and Rheumatology E-Book
Raashid Luqmani | Benjamin Joseph | James Robb | Daniel Porter
(2012)
Additional Information
Book Details
Abstract
Winner of the prize for New Edited Book at The Royal Society of Medicine & The Society of Authors' Medical Book Awards, this textbook for medical students covers orthopaedics, trauma and rheumatology in one volume. It offers both core information regarding what the student needs to know about these specialties and an extensive series of cases with questions and answers that illustrate the thinking behind common everyday practice. The book offers a standard approach to history taking and physical examination, and relevant anatomy, highlighting the reasons for the different approaches within each specialty as required.
- Provides a comprehensive overview of musculoskeletal medicine and surgery perfectly tailored for the busy medical student
- Illustrated in full colour throughout
- Succinct coverage of essential topics helps aid understanding whilst avoid unnecessary detail thus saving time
- Uniform style of chapters throughout allows readers to easily scan through for the information required
- Useful summary boxes outline the main points of each condition including aetiology, pathology, epidemiology, clinical features, investigations, management and prognosis
- 100 case histories with questions illustrate the range of clinical problems that students will encounter during their clinical placements
- A new chapter on Sports and Exercise Injury
- A new restructured chapter on fractures pulls together the text into a more logical presentation of the subject
- Additional text on sports injuries to children will be included
- A refocused chapter on the multi-professional team approach to the management of musculoskeletal disorders
- An update of the therapeutics in all chapters
- 50 new case studies included.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front cover | cover | ||
| Textbook of Orthopaedics, Trauma and Rheumatology | i | ||
| Copyright page | iv | ||
| Table of Contents | v | ||
| List of contributors | viii | ||
| Acknowledgements | x | ||
| List of abbreviations | xi | ||
| Introduction | xv | ||
| Musculoskeletal disorders | xv | ||
| Impairment, disability and handicap | xvi | ||
| Reference | xvii | ||
| Principles of evidence-based practice | xvii | ||
| 1 Musculoskeletal System | 1 | ||
| 1 Clinical History and Examination | 3 | ||
| lEssential facts | 3 | ||
| General considerations | 3 | ||
| History | 3 | ||
| General physical examination | 3 | ||
| ‘Red flags’ in non-traumatic disorders | 5 | ||
| Malignancy | 6 | ||
| Infection | 6 | ||
| Spinal disorders | 6 | ||
| Giant cell arteritis | 6 | ||
| Slipped upper femoral epiphysis | 6 | ||
| Summary | 7 | ||
| Examination of limbs | 7 | ||
| look | 7 | ||
| feel | 7 | ||
| move | 8 | ||
| special tests | 8 | ||
| Shoulder | 8 | ||
| Overview of anatomy and examination | 8 | ||
| Elbow | 15 | ||
| 2 Management of Musculoskeletal Problems | 79 | ||
| 5 Medical management of arthritis | 81 | ||
| lEssential facts | 81 | ||
| Analgesics | 81 | ||
| Need for analgesia | 81 | ||
| Practical use of analgesics | 81 | ||
| Paracetamol | 82 | ||
| Codeine and dihydrocodeine | 82 | ||
| Tramadol | 82 | ||
| Stronger opiates | 82 | ||
| Compound analgesics | 82 | ||
| Other drugs | 83 | ||
| Non-steroidal anti-inflammatory drugs | 83 | ||
| Classification | 83 | ||
| Indications | 83 | ||
| Mechanism of action and COX1/COX2 effects | 83 | ||
| Conventional nsaids | 83 | ||
| COX2 drugs (COXIBS) | 84 | ||
| Adverse reactions to NSAIDs | 84 | ||
| Topical NSAIDs | 85 | ||
| Disease-modifying anti-rheumatic drugs | 85 | ||
| Indications | 85 | ||
| Commonly used DMARDs | 85 | ||
| Methotrexate | 85 | ||
| Leflunomide | 86 | ||
| Sulfasalazine | 86 | ||
| Other DMARDs | 86 | ||
| Combining DMARDs | 87 | ||
| Current best practice with dmards | 87 | ||
| early treatment | 87 | ||
| treating to target | 87 | ||
| withdrawing dmards | 87 | ||
| pregnancy | 87 | ||
| immunization | 87 | ||
| Best approach | 87 | ||
| Biologics | 88 | ||
| Indications for biologics | 88 | ||
| Clinical effects | 88 | ||
| Adverse effects | 89 | ||
| Immune responses to biologics | 89 | ||
| Biologics during surgery and major medical illness | 89 | ||
| Vaccination | 89 | ||
| New biologics | 89 | ||
| BEYOND BIOLOGICS-SMALL MOLECULES | 90 | ||
| Steroids | 90 | ||
| Background | 90 | ||
| Systemic steroids | 90 | ||
| Side-effects | 90 | ||
| Intra-articular and soft-tissue steroid injections | 90 | ||
| Drugs for gout | 91 | ||
| Allopurinol | 91 | ||
| Febuxostat | 91 | ||
| Colchicine | 92 | ||
| Drugs for metabolic bone disease | 92 | ||
| Further reading | 92 | ||
| 6 Musculoskeletal infection | 93 | ||
| lEssential facts | 93 | ||
| Introduction | 93 | ||
| Pathology of musculoskeletal infection | 93 | ||
| Clinical presentation of musculoskeletal infection | 94 | ||
| Principles of management of musculoskeletal infection | 94 | ||
| Specific infections | 95 | ||
| Cellulitis | 95 | ||
| Acute myositis/pyomyositis | 95 | ||
| Acute septic arthritis | 95 | ||
| Acute osteomyelitis | 96 | ||
| Chronic osteomyelitis | 96 | ||
| Special situations | 98 | ||
| Necrotizing fasciitis | 98 | ||
| Gangrene | 98 | ||
| Tuberculosis of bones and joints | 98 | ||
| Sickle cell disease | 99 | ||
| Implant-related infection | 99 | ||
| Immunocompromised patients | 100 | ||
| Poliomyelitis | 100 | ||
| leprosy | 100 | ||
| Further reading | 100 | ||
| 7 Role of the allied health professional | 101 | ||
| lEssential facts | 101 | ||
| Role of the nurse specialist | 101 | ||
| Nurse-led clinics | 101 | ||
| education | 102 | ||
| dmards and blood monitoring | 102 | ||
| rheumatology helpline | 103 | ||
| specialist clinics | 103 | ||
| non-medical prescribing | 103 | ||
| Summary | 103 | ||
| Role of the physiotherapist | 103 | ||
| Physiotherapy assessment | 103 | ||
| Therapy | 104 | ||
| Walking aids | 104 | ||
| Postoperative rehabilitation | 104 | ||
| Role of the occupational therapist | 104 | ||
| Preoperative assessment | 104 | ||
| Energy conservation advice | 105 | ||
| Joint protection | 105 | ||
| Cognitive behavioural approaches | 105 | ||
| Role of the podiatrist | 105 | ||
| Podiatry examination of the lower limb | 105 | ||
| Treatment | 106 | ||
| Role of the orthotist and orthoses | 106 | ||
| Orthotic terminology | 106 | ||
| Orthotic function | 106 | ||
| Biomechanical principles of orthotic function | 106 | ||
| Summary | 108 | ||
| Further reading | 108 | ||
| 8 Surgical management of joint disorders | 109 | ||
| lEssential facts | 109 | ||
| Introduction | 109 | ||
| Arthroscopy | 109 | ||
| Repair or excision of intra-articular soft-tissue structures | 109 | ||
| Joint stabilization | 110 | ||
| Loose bodies | 110 | ||
| Ligament reconstruction | 110 | ||
| Synovectomy | 110 | ||
| Osteotomy | 110 | ||
| Arthroplasty | 111 | ||
| Total joint replacement | 111 | ||
| Hemi-arthroplasty | 112 | ||
| Excision arthroplasty | 112 | ||
| Arthrodesis | 112 | ||
| Further reading | 113 | ||
| 3 Trauma | 115 | ||
| 9 Fracture management | 117 | ||
| Essential facts | 117 | ||
| Definition of fracture | 118 | ||
| Principles of treatment | 118 | ||
| Non-operative treatment | 118 | ||
| Relative indications for non-operative treatment | 118 | ||
| Types of non-operative treatment | 119 | ||
| Operative treatment methods | 119 | ||
| External fixation | 119 | ||
| indications for external fixation | 119 | ||
| Internal fixation | 119 | ||
| indications for internal fixation | 120 | ||
| Dislocations | 120 | ||
| Arthroplasty | 121 | ||
| Early local complications of fractures | 121 | ||
| Compartment syndrome | 121 | ||
| Nerve injury | 122 | ||
| Vascular injury | 122 | ||
| plan of management for fracture with vascular injury | 122 | ||
| Infection | 122 | ||
| Late local complications | 123 | ||
| Non-union | 123 | ||
| patient risk factors for delayed or non-union | 123 | ||
| fracture risk factors for delayed or non-union | 123 | ||
| Mal-union | 124 | ||
| Post-traumatic osteoarthritis | 124 | ||
| Avascular necrosis | 124 | ||
| Complex regional pain syndrome | 124 | ||
| General complications of fractures | 125 | ||
| Fat embolism | 125 | ||
| risk factors for development of FES | 125 | ||
| Deep venous thrombosis and pulmonary embolism | 125 | ||
| Complications of immobility | 126 | ||
| Further reading | 126 | ||
| 10 Management of multiple trauma | 127 | ||
| lEssential facts | 127 | ||
| History | 127 | ||
| Initial assessment | 128 | ||
| Primary survey | 128 | ||
| Shock | 128 | ||
| Thoracic trauma | 129 | ||
| Abdominal trauma | 129 | ||
| Head injury | 129 | ||
| Musculoskeletal injuries in multiple trauma | 129 | ||
| Further reading | 131 | ||
| 11 Children’s fractures | 132 | ||
| lEssential facts | 132 | ||
| Structure of a child’s bone | 132 | ||
| Types of fracture | 132 | ||
| Physeal (growth plate) injuries | 134 | ||
| Periosteum | 135 | ||
| Fracture healing | 135 | ||
| Remodelling | 135 | ||
| Summary | 136 | ||
| Non-accidental injury | 137 | ||
| Assessment | 138 | ||
| Differential diagnosis | 138 | ||
| Investigations | 139 | ||
| Inter-agency working | 139 | ||
| Further reading | 139 | ||
| 12 Regional injuries | 140 | ||
| lEssential facts | 140 | ||
| Upper limb injuries | 140 | ||
| Fractures of the clavicle and shoulder girdle | 140 | ||
| clavicular fractures | 140 | ||
| scapular fractures | 141 | ||
| shoulder injuries | 141 | ||
| acromio-clavicular dislocations | 141 | ||
| gleno-humeral dislocation | 141 | ||
| proximal humeral fractures | 142 | ||
| Humeral shaft fractures | 143 | ||
| Fractures around the elbow | 143 | ||
| distal humeral fractures | 143 | ||
| olecranon fractures | 145 | ||
| radial head and neck injuries | 145 | ||
| elbow dislocations and fracture dislocations | 146 | ||
| Fractures of the forearm | 147 | ||
| Fractures at the wrist | 149 | ||
| fractures of the carpus | 150 | ||
| scaphoid fractures | 150 | ||
| other carpal bones | 150 | ||
| fractures of the metacarpals and phalanges | 151 | ||
| history and clinical assessment | 151 | ||
| management of metacarpal and phalangeal shaft fractures | 152 | ||
| unstable and intra-articular fractures | 152 | ||
| Tendon and nerve injuries in the hand | 152 | ||
| tendon injuries | 152 | ||
| extensor tendon injuries | 152 | ||
| flexor tendon injuries | 153 | ||
| nerve injuries | 153 | ||
| Lower limb injuries | 154 | ||
| Pelvic and acetabular fractures | 154 | ||
| pelvic fractures | 154 | ||
| management | 154 | ||
| acetabular fractures | 155 | ||
| radiology | 155 | ||
| management | 155 | ||
| Hip fractures | 155 | ||
| anatomy, classification and epidemiology | 156 | ||
| clinical findings | 156 | ||
| management | 156 | ||
| intra-capsular fractures | 157 | ||
| extra-capsular fractures | 157 | ||
| outcome after hip fracture | 157 | ||
| Femoral shaft fractures | 157 | ||
| clinical and radiographic assessment | 157 | ||
| treatment | 158 | ||
| Distal femoral fractures | 159 | ||
| Soft-tissue knee injuries | 160 | ||
| ligament injury | 160 | ||
| meniscal tears | 160 | ||
| patellar dislocation | 161 | ||
| Tibial plateau fractures | 161 | ||
| imaging | 161 | ||
| management | 161 | ||
| Tibial shaft fractures | 162 | ||
| epidemiology | 162 | ||
| clinical and radiographic assessment | 162 | ||
| management | 162 | ||
| Distal tibial fractures | 164 | ||
| Ankle fractures | 165 | ||
| epidemiology | 165 | ||
| clinical and radiographic assessment | 165 | ||
| management | 165 | ||
| outcome | 166 | ||
| Hindfoot and forefoot injuries | 166 | ||
| talus fractures | 166 | ||
| Calcaneus fractures | 166 | ||
| Mid-foot injuries | 167 | ||
| Metatarsal and phalangeal injuries | 167 | ||
| Further reading | 168 | ||
| 13 Sport and exercise associated problems in adults | 169 | ||
| lEssential facts | 169 | ||
| Introduction | 169 | ||
| Bone stress | 169 | ||
| The female athlete triad | 170 | ||
| Tendinopathy | 171 | ||
| Jumper’s knee (patellar tendinopathy) | 171 | ||
| Recurrent exertional compartment syndrome (recs, chronic compartment syndrome) | 172 | ||
| Patello-femoral pain syndrome (anterior knee pain, chondromalacia patellae) | 172 | ||
| Ilio-tibial band friction syndrome (runner’s knee, ilio-tibial band syndrome) | 172 | ||
| Lower leg pain | 172 | ||
| Groin pain | 172 | ||
| Buttock pain | 174 | ||
| Further reading | 174 | ||
| 4 Rheumatology | 175 | ||
| 14 Generalized musculoskeletal problems | 177 | ||
| lEssential facts | 177 | ||
| Chronic pain | 177 | ||
| Importance of a positive diagnosis | 178 | ||
| Fibromyalgia | 178 | ||
| Complex regional pain syndrome | 178 | ||
| Chronic fatigue syndrome (cfs) | 179 | ||
| Hypermobility syndrome | 179 | ||
| Rheumatic manifestations of metabolic and endocrine diseases | 180 | ||
| diabetes mellitus | 180 | ||
| limited joint mobility (diabetic cheiro-arthropathy, diabetic hand syndrome) | 181 | ||
| dupuytren’s contracture | 181 | ||
| palmar flexor tenosynovitis | 181 | ||
| adhesive capsulitis (frozen shoulder) | 181 | ||
| osteopenia | 182 | ||
| carpal tunnel syndrome | 182 | ||
| diffuse idiopathic skeletal hyperostosis (forestier disease) | 182 | ||
| diabetic amyotrophy | 183 | ||
| scleroedema | 183 | ||
| neuropathic arthropathy (charcot’s joint) | 183 | ||
| bone and joint infection | 183 | ||
| diabetic muscle infarction | 184 | ||
| osteoarthritis | 184 | ||
| thyroid disease | 184 | ||
| osteoporosis | 184 | ||
| thyroid acropachy | 184 | ||
| effects of treating thyroid disease on the musculoskeletal problems | 184 | ||
| hyperparathyroidism | 185 | ||
| hyperadrenocortisolism | 185 | ||
| acromegaly | 185 | ||
| alkaptonuria (ochronosis) | 186 | ||
| osteoarticular disorders of renal origin | 186 | ||
| β2-microglobin amyloidosis | 187 | ||
| crystal arthropathies | 187 | ||
| bone and joint infections | 187 | ||
| primary hyperlipidaemia | 187 | ||
| lysosomal storage disorders | 187 | ||
| glycogen storage disease | 188 | ||
| haemochromatosis | 188 | ||
| pathogenesis | 188 | ||
| clinical features | 188 | ||
| investigations | 188 | ||
| differential diagnosis | 188 | ||
| treatment | 188 | ||
| Further reading | 189 | ||
| 15 Osteoarthritis and crystal arthropathies | 190 | ||
| lEssential facts | 190 | ||
| Osteoarthritis | 191 | ||
| Epidemiology | 191 | ||
| Pathology and pathogenesis | 192 | ||
| Clinical features | 193 | ||
| Common clinical presentations | 194 | ||
| Atypical and ‘secondary’ osteoarthritis | 195 | ||
| Investigations | 196 | ||
| Management | 196 | ||
| non-pharmacological modalities of therapy | 196 | ||
| pharmacological modalities of therapy | 197 | ||
| surgery | 197 | ||
| Natural history and prognosis | 199 | ||
| Crystal arthritis and deposition-associated disease | 199 | ||
| Crystal formation and pathogenesis (Fig. 15.6) | 199 | ||
| Calcium pyrophosphate dihydrate crystal deposition | 201 | ||
| epidemiology | 201 | ||
| causes and associations | 201 | ||
| clinical presentation | 202 | ||
| investigations | 202 | ||
| treatment | 202 | ||
| Basic calcium phosphate crystal deposition | 203 | ||
| Gout | 204 | ||
| aetiology | 205 | ||
| clinical features | 207 | ||
| chronic tophaceous gout | 208 | ||
| investigations | 208 | ||
| treatment | 209 | ||
| acute gout | 209 | ||
| recurrent, intercritical and chronic gout | 210 | ||
| asymptomatic hyperuricaemia | 211 | ||
| Further reading | 211 | ||
| 16 Inflammatory arthritis | 213 | ||
| lEssential facts | 213 | ||
| Rheumatoid arthritis | 213 | ||
| Definition | 213 | ||
| Aetiology and pathogenesis | 214 | ||
| Clinical features | 215 | ||
| history | 215 | ||
| examination | 215 | ||
| Early rheumatoid arthritis | 216 | ||
| Investigation | 217 | ||
| Treatment | 217 | ||
| non-pharmacological therapy | 219 | ||
| monitoring response to treatment | 219 | ||
| Prognosis | 220 | ||
| Spondyloarthritis | 220 | ||
| Ankylosing spondylitis | 220 | ||
| definition | 220 | ||
| aetiology/pathogenesis | 220 | ||
| clinical features | 220 | ||
| history | 220 | ||
| examination | 221 | ||
| tests | 221 | ||
| treatment | 221 | ||
| prognosis | 222 | ||
| Psoriatic arthritis | 222 | ||
| definition | 222 | ||
| aetiology/pathogenesis | 222 | ||
| clinical features | 222 | ||
| tests | 223 | ||
| treatment | 223 | ||
| prognosis | 223 | ||
| Reactive arthritis | 223 | ||
| definition | 223 | ||
| aetiology and pathogenesis | 223 | ||
| clinical features | 224 | ||
| tests | 224 | ||
| treatment | 224 | ||
| Arthritis associated with inflammatory bowel disease | 225 | ||
| 5 Orthopaedics | 267 | ||
| 20 Tumours of the musculoskeletal system and pathological fractures | 269 | ||
| lEssential facts | 269 | ||
| Tumours | 269 | ||
| Neoplastic (benign) | 269 | ||
| Neoplastic (malignant) | 271 | ||
| osteosarcoma | 272 | ||
| ewing’s sarcoma | 272 | ||
| chondrosarcoma | 272 | ||
| other malignant tumours | 272 | ||
| adamantinoma | 272 | ||
| multiple myeloma | 272 | ||
| Familial neoplastic traits and musculoskeletal neoplasia | 273 | ||
| Secondary tumours of bone | 274 | ||
| Inflammatory nodules | 274 | ||
| Miscellaneous nodules | 275 | ||
| Pathological fractures | 276 | ||
| Further reading | 277 | ||
| 21 Upper limb | 278 | ||
| lEssential facts | 278 | ||
| Shoulder | 278 | ||
| Osteoarthritis | 278 | ||
| Biceps tendon rupture | 279 | ||
| Impingement syndrome and rotator cuff disease | 279 | ||
| Frozen shoulder | 280 | ||
| Mononeuritis | 280 | ||
| Elbow | 280 | ||
| Osteoarthritis | 280 | ||
| Epicondylitis | 280 | ||
| Nerve entrapment | 280 | ||
| Hand problems | 281 | ||
| Dupuytren’s disease | 281 | ||
| Trigger finger | 281 | ||
| De quervain’s disease | 281 | ||
| Osteoarthritis | 281 | ||
| Rheumatoid arthritis | 281 | ||
| Carpal tunnel syndrome | 282 | ||
| Further reading | 282 | ||
| 22 Cervical and lumbar spine | 283 | ||
| lEssential facts | 283 | ||
| Spinal anatomy | 283 | ||
| Degenerative conditions of the cervical spine | 284 | ||
| Cervical myelopathy | 284 | ||
| Rheumatoid arthritis of the cervical spine | 285 | ||
| ‘Whiplash’ injuries | 287 | ||
| Mechanical back pain | 287 | ||
| Lumbar disc disease | 288 | ||
| Management of lumbar disc herniation | 290 | ||
| Investigations | 290 | ||
| Operative treatment | 290 | ||
| Cauda equina syndrome | 290 | ||
| Spinal stenosis | 290 | ||
| Spondylolysis | 291 | ||
| Spondylolisthesis | 291 | ||
| Thoracic spinal pathology | 291 | ||
| Spinal injury | 292 | ||
| Initial assessment and treatment of spinal cord injury | 292 | ||
| Further management of spinal column and/or cord injury | 292 | ||
| Further reading | 292 | ||
| 23 Lower limb | 293 | ||
| lEssential facts | 293 | ||
| Hip | 293 | ||
| Hip osteoarthritis | 293 | ||
| Trochanteric bursitis | 293 | ||
| Rectus femoris sprain/avulsion | 293 | ||
| Psoas bursa | 294 | ||
| Meralgia paraesthetica | 294 | ||
| Acetabular labral injury | 294 | ||
| Avascular necrosis | 294 | ||
| Referred pain | 294 | ||
| Non-musculoskeletal pathology | 294 | ||
| Knee | 294 | ||
| Septic arthritis | 294 | ||
| Cysts and bursae | 294 | ||
| Menisci | 295 | ||
| Osteoarthritis | 296 | ||
| Foot and ankle | 296 | ||
| General examination | 296 | ||
| Ankle and hindfoot osteoarthritis | 296 | ||
| Rheumatoid arthritis | 296 | ||
| Flat feet | 296 | ||
| Toes | 296 | ||
| Toe-nails | 297 | ||
| Further reading | 297 | ||
| 6 Paediatrics | 299 | ||
| 24 Normal variants in children | 301 | ||
| lEssential facts | 301 | ||
| Gait variants | 301 | ||
| Bow legs and knock-knees | 302 | ||
| Growing pains | 302 | ||
| Anterior knee pain | 303 | ||
| Calcaneo-valgus | 303 | ||
| Flat feet | 303 | ||
| Sever’s disease | 304 | ||
| Toe deformities | 304 | ||
| Further reading | 305 | ||
| 25 Upper and lower limb disorders in children | 306 | ||
| lEssential facts | 306 | ||
| Sprengel’s shoulder | 306 | ||
| Syndactyly | 306 | ||
| Polydactyly | 307 | ||
| Trigger thumb | 307 | ||
| Obstetric brachial plexus palsy | 307 | ||
| Paediatric foot and ankle | 308 | ||
| Definitions of position and deformity | 308 | ||
| Presentation of foot deformities at different ages | 308 | ||
| birth | 308 | ||
| metatarsus adductus | 308 | ||
| congenital talipes equinovarus (clubfoot or congenitally inverted foot) | 308 | ||
| childhood | 309 | ||
| osteochondritic conditions | 309 | ||
| pes cavus | 309 | ||
| tiptoe walking | 310 | ||
| early adolescence | 310 | ||
| flat foot, pes cavus and toe deformities | 310 | ||
| Symptomatic accessory navicular | 310 | ||
| Tarsal coalition | 310 | ||
| Hallux valgus | 310 | ||
| miscellaneous abnormalities | 311 | ||
| The knee in childhood | 311 | ||
| Presentation at different ages | 311 | ||
| birth | 311 | ||
| early childhood | 311 | ||
| referred pain | 311 | ||
| patello-femoral dysfunction | 311 | ||
| mid-childhood | 312 | ||
| later childhood | 312 | ||
| meniscal tears | 312 | ||
| adolescence | 312 | ||
| ligament tears | 312 | ||
| osteochondritis dissecans | 313 | ||
| tibial tubercle pain | 314 | ||
| joint laxity and patellar instability | 314 | ||
| haematological and other conditions | 314 | ||
| Paediatric hip joint conditions | 314 | ||
| Presentations at different ages | 314 | ||
| birth | 314 | ||
| developmental dysplasia of the hip | 314 | ||
| septic arthritis | 315 | ||
| mid-childhood | 316 | ||
| irritable hip | 316 | ||
| perthes’ disease (legg–calve–perthes’ disease) | 316 | ||
| other causes of limp | 316 | ||
| Dysplasia | 316 | ||
| Infection | 317 | ||
| Chronic arthritis | 317 | ||
| later childhood | 317 | ||
| limp | 317 | ||
| miscellaneous | 317 | ||
| adolescence | 318 | ||
| slipped upper femoral epiphysis | 318 | ||
| reactive synovitis | 318 | ||
| tumour | 318 | ||
| avascular necrosis | 318 | ||
| Further reading | 319 | ||
| 26 The paediatric spine and neuromuscular conditions | 320 | ||
| lEssential facts | 320 | ||
| Paediatric spine | 320 | ||
| Scoliosis | 320 | ||
| idiopathic scoliosis | 320 | ||
| classification | 321 | ||
| aetiology | 321 | ||
| clinical presentation and prognosis | 321 | ||
| Infantile idiopathic scoliosis | 321 | ||
| Adolescent idiopathic scoliosis | 322 | ||
| clinical approach | 322 | ||
| examination | 322 | ||
| radiographic evaluation | 322 | ||
| treatment | 322 | ||
| congenital scoliosis | 323 | ||
| the spine in spina bifida (myelomeningocele) | 325 | ||
| neuromuscular scoliosis | 326 | ||
| Kyphosis and lordosis | 326 | ||
| Back pain in children | 328 | ||
| clinical approach | 328 | ||
| examination and investigations | 329 | ||
| spondylolysis and spondylolisthesis | 330 | ||
| spinal infection | 330 | ||
| clinical approach | 331 | ||
| investigations | 331 | ||
| treatment | 331 | ||
| other spinal conditions | 332 | ||
| intervertebral disc herniation | 332 | ||
| Clinical presentation | 332 | ||
| Treatment | 332 | ||
| neoplasms | 332 | ||
| Disorders of upper motor neurone, spinal cord, peripheral nerves and muscle in children | 332 | ||
| Spinal muscular atrophy | 333 | ||
| Duchenne muscular dystrophy | 333 | ||
| Becker muscular dystrophy | 334 | ||
| Hereditary motor and sensory neuropathy (charcot–marie–tooth disease) | 335 | ||
| Myotonic dystrophy | 335 | ||
| spina bifida | 335 | ||
| patterns of spina bifida | 335 | ||
| antenatal screening | 335 | ||
| associated anomalies | 335 | ||
| mobility | 336 | ||
| management | 336 | ||
| Cerebral palsy | 336 | ||
| Further reading | 340 | ||
| 27 Arthritis in children | 341 | ||
| lEssential facts | 341 | ||
| Classification | 341 | ||
| Oligoarticular juvenile idiopathic arthritis | 342 | ||
| Eye disease in oligoarticular juvenile idiopathic arthritis | 342 | ||
| Polyarticular juvenile idiopathic arthritis | 342 | ||
| Systemic-onset juvenile idiopathic arthritis | 342 | ||
| Enthesitis-related arthritis | 343 | ||
| Juvenile-onset psoriatic arthritis | 343 | ||
| Differential diagnosis | 343 | ||
| Complications of juvenile arthritis | 344 | ||
| Investigations | 344 | ||
| Management of juvenile idiopathic arthritis | 345 | ||
| Drug therapy | 345 | ||
| Non-drug therapy | 345 | ||
| Further reading | 346 | ||
| 28 Sport and exercise associated problems in children and adolescents | 347 | ||
| lEssential facts | 347 | ||
| Introduction | 347 | ||
| Traction apophysitis (apophysitis) | 347 | ||
| Spondylolysis (pars defect, stress fracture of the spine; see also Chapter 26) | 348 | ||
| Osteochondritis dissecans | 348 | ||
| Snapping hip | 349 | ||
| Patello-femoral pain syndrome (anterior knee pain, chondromalacia patellae) | 349 | ||
| What not to miss | 349 | ||
| Further reading | 349 | ||
| 7 Problem-orientated section | 351 | ||
| Cases | 353 | ||
| Case 1 | 353 | ||
| Case 2 | 353 | ||
| Case 3 | 353 | ||
| Case 4 | 354 | ||
| Case 5 | 354 | ||
| Case 6 | 354 | ||
| Case 7 | 355 | ||
| Case 8 | 355 | ||
| Case 9 | 355 | ||
| Case 10 | 355 | ||
| Case 11 | 356 | ||
| Case 12 | 356 | ||
| Case 13 | 356 | ||
| Case 14 | 357 | ||
| Case 15 | 357 | ||
| Case 16 | 357 | ||
| Case 17 | 357 | ||
| Case 18 | 358 | ||
| Case 19 | 358 | ||
| Case 20 | 358 | ||
| Case 21 | 358 | ||
| Case 22 | 358 | ||
| Case 23 | 359 | ||
| Case 24 | 359 | ||
| Case 25 | 359 | ||
| Case 26 | 360 | ||
| Case 27 | 360 | ||
| Case 28 | 360 | ||
| Case 29 | 361 | ||
| Case 30 | 362 | ||
| Case 31 | 362 | ||
| Case 32 | 362 | ||
| Case 33 | 363 | ||
| Case 34 | 363 | ||
| Case 35 | 363 | ||
| Case 36 | 364 | ||
| Case 37 | 364 | ||
| Case 38 | 365 | ||
| Case 39 | 365 | ||
| Case 40 | 365 | ||
| Case 41 | 366 | ||
| Case 42 | 366 | ||
| Case 43 | 366 | ||
| Case 44 | 367 | ||
| Case 45 | 367 | ||
| Case 46 | 368 | ||
| Case 47 | 368 | ||
| Case 48 | 368 | ||
| Case 49 | 369 | ||
| Case 50 | 369 | ||
| Case 51 | 369 | ||
| Case 52 | 370 | ||
| Case 53 | 370 | ||
| Case 54 | 370 | ||
| Case 55 | 371 | ||
| Case 56 | 371 | ||
| Case 57 | 371 | ||
| Case 58 | 372 | ||
| Case 59 | 372 | ||
| Case 60 | 372 | ||
| Case 61 | 372 | ||
| Case 62 | 373 | ||
| Case 63 | 373 | ||
| Case 64 | 374 | ||
| Case 65 | 374 | ||
| Case 66 | 374 | ||
| Case 67 | 374 | ||
| Case 68 | 375 | ||
| Case 69 | 375 | ||
| Case 70 | 376 | ||
| Case 71 | 376 | ||
| Case 72 | 376 | ||
| Case 73 | 377 | ||
| Case 74 | 377 | ||
| Case 75 | 378 | ||
| Case 76 | 378 | ||
| Case 77 | 378 | ||
| Case 78 | 378 | ||
| Case 79 | 379 | ||
| Case 80 | 379 | ||
| Case 81 | 380 | ||
| Case 82 | 381 | ||
| Case 83 | 381 | ||
| Case 84 | 381 | ||
| Case 85 | 381 | ||
| Case 86 | 382 | ||
| Case 87 | 382 | ||
| Case 88 | 383 | ||
| Case 89 | 384 | ||
| Case 90 | 384 | ||
| Case 91 | 384 | ||
| Case 92 | 385 | ||
| Case 93 | 385 | ||
| Case 94 | 385 | ||
| Case 95 | 386 | ||
| Case 96 | 386 | ||
| Case 97 | 387 | ||
| Case 98 | 387 | ||
| Case 99 | 387 | ||
| Case 100 | 388 | ||
| Answers | 389 | ||
| Case 1 answers | 389 | ||
| Case 2 answers | 389 | ||
| Case 3 answers | 389 | ||
| Case 4 answers | 389 | ||
| Case 5 answers | 390 | ||
| Case 6 answers | 390 | ||
| Case 7 answers | 391 | ||
| Case 8 answers | 391 | ||
| Case 9 answers | 391 | ||
| Case 10 answers | 391 | ||
| Case 11 answers | 392 | ||
| Case 12 answers | 392 | ||
| Case 13 answers | 393 | ||
| Case 14 answers | 393 | ||
| Case 15 answers | 394 | ||
| Case 16 answers | 394 | ||
| Case 17 answers | 394 | ||
| Case 18 answers | 395 | ||
| Case 19 answers | 395 | ||
| Case 20 answers | 395 | ||
| Case 21 answers | 396 | ||
| Case 22 answers | 396 | ||
| Case 23 answers | 397 | ||
| Case 24 answers | 397 | ||
| Case 25 answers | 398 | ||
| Case 26 answers | 398 | ||
| Case 27 answers | 399 | ||
| Case 28 answers | 399 | ||
| Case 29 answers | 399 | ||
| Case 30 answers | 400 | ||
| Case 31 answers | 400 | ||
| Case 32 answers | 400 | ||
| Case 33 answers | 401 | ||
| Case 34 answers | 401 | ||
| Case 35 answers | 402 | ||
| Case 36 answers | 402 | ||
| Case 37 answers | 403 | ||
| Case 38 answers | 403 | ||
| Case 39 answers | 404 | ||
| Case 40 answers | 404 | ||
| Case 41 answers | 405 | ||
| Case 42 answers | 405 | ||
| Case 43 answers | 406 | ||
| Case 44 answers | 406 | ||
| Case 45 answers | 406 | ||
| Case 46 answers | 407 | ||
| Case 47 answers | 407 | ||
| Case 48 answers | 408 | ||
| Case 49 answers | 408 | ||
| Case 50 answers | 408 | ||
| Case 51 answers | 409 | ||
| Case 52 answers | 409 | ||
| Case 53 answers | 410 | ||
| Case 54 answers | 410 | ||
| Case 55 answers | 411 | ||
| Case 56 answers | 412 | ||
| Case 57 answers | 412 | ||
| Case 58 answers | 413 | ||
| Case 59 answers | 413 | ||
| Case 60 answers | 414 | ||
| Case 61 answers | 414 | ||
| Case 62 answers | 414 | ||
| Case 63 answers | 415 | ||
| Case 64 answers | 415 | ||
| Case 65 answers | 416 | ||
| Case 66 answers | 416 | ||
| Case 67 answers | 417 | ||
| Case 68 answers | 417 | ||
| Case 69 answers | 418 | ||
| Case 70 answers | 418 | ||
| Case 71 answers | 419 | ||
| Case 72 answers | 419 | ||
| Case 73 answers | 420 | ||
| Case 74 answers | 420 | ||
| Case 75 answers | 421 | ||
| Case 76 answers | 421 | ||
| Case 77 answers | 422 | ||
| Case 78 answers | 422 | ||
| Case 79 answers | 423 | ||
| Case 80 answers | 424 | ||
| Case 81 answers | 424 | ||
| Case 82 answers | 425 | ||
| Case 83 answers | 425 | ||
| Case 84 answers | 426 | ||
| Case 85 answers | 426 | ||
| Case 86 answers | 427 | ||
| Case 87 answers | 427 | ||
| Case 88 answers | 428 | ||
| Case 89 answers | 429 | ||
| Case 90 answers | 429 | ||
| Case 91 answers | 430 | ||
| Case 92 answers | 430 | ||
| Case 93 answers | 430 | ||
| Case 94 answers | 431 | ||
| Case 95 answers | 431 | ||
| Case 96 answers | 432 | ||
| Case 97 answers | 432 | ||
| Case 98 answers | 432 | ||
| Case 99 answers | 432 | ||
| Case 100 answers | 433 | ||
| Index | 434 |