By Molly Lewis
I’m about to start a pediatric orthopedics rotation, so here is a pediatric orthopedic mnemonic.
This mnemonic actually applies as much to pediatricians as to pediatric orthopedic surgeons, since pediatricians are the doctors who do the majority of Developmental Dysplasia of the Hip (DDH) screening!
I’m guessing you’ve heard of the 5 F’s of gallbladder disease (Female, fat, fertile, forty, and fair).
Here are another 5 F’s to keep in mind while screening newborns for DDH:
- (DDH is a congenital dysplasia of the hip joint in which 1 or both of the baby’s hips are dislocated or subluxed (partially dislocated). It is important to diagnose and treat because, left untreated, the patient will develop arthritis and difficulty ambulating).
DDH Risk factors (5 F’s):
- First born
- Female
- Family history of DDH
- Feet (breech position)
- Fluid (oligohydramnios)
Whether on a USMLE test question or on your pediatrics rotation, a baby with these risk factors may have DDH!
- Exam maneuvers to do: Barlow and Ortolani tests
- Next test: order an Ultrasound (US) if the patient is 6 m old or younger (after that, order XR’s).
- Treatment: for most: non-operative: Pavlik harness if < 6 months old, spica cast if > 6 m – 1 ½ yrs old, surgery if these fail or if patient is > 1 ½ yrs old
Bibliography
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Cholelithiasis 5 F’s: http://www.med.umich.edu/lrc/coursepages/m1/anatomy2010/html/clinicalcases/cholelithiasis/cholelithiasis.html
DDH 5 F’s: http://eorif.com/developmental-dysplasia-hip
DDH info: https://online.epocrates.com/noFrame/showPage.do?method=diseases&MonographId=742&ActiveSectionId=42