TEALE FENNING Medical Education    FAQ   Search   Memberlist   Usergroups   Register   Profile   Log in to check your private messages   Log in  mrcog courses for doctors congenital dislocation of hip          TEALE FENNING Forum Index -> MRCOG Part 2: MCQ & Past Paper questions View previous topic :: View next topic   Author Message farha Century Club Joined: 18 May 2007 Posts: 156 Posted: Fri May 02, 2008 7:32 am    Post subject: congenital dislocation of hip CONGENITAL DISLOCATION OF HIP 1)Hips are dislocated at birth 2)has heriditary association 3)occur in boys 4)90%occur in third born child 5)face presentation is common 6)osteoarthritis is the long term complication if untreated 7)risk of recurrence is negligible 8)xrays in the neonatal period is diagnostic Back to top cpeedahsa Century Club Joined: 21 Apr 2007 Posts: 921 Posted: Fri May 02, 2008 1:12 pm    Post subject: Re: congenital dislocation of hip farha wrote: CONGENITAL DISLOCATION OF HIP 3)occur in boys True It can occur in boys too. (80-90% of CDH occurs in girls) Back to top cpeedahsa Century Club Joined: 21 Apr 2007 Posts: 921 Posted: Fri May 02, 2008 1:14 pm    Post subject: Re: congenital dislocation of hip farha wrote: CONGENITAL DISLOCATION OF HIP Currently preferred term is Developmental dysplasia of the hip Back to top cpeedahsa Century Club Joined: 21 Apr 2007 Posts: 921 Posted: Fri May 02, 2008 1:19 pm    Post subject: Re: congenital dislocation of hip farha wrote: CONGENITAL DISLOCATION OF HIP 1)Hips are dislocated at birth Maybe, this question should have been worded Quote: Hips are always dislocated at birth It is then more clear and specific to answer it as False. On the other hand if the question is worded Quote: Hips maybe dislocated at birth -Answer is True DDH is a developmental (ongoing) process, variable in manifestation and not always detectable at birth DDH dysplasia/ abnormal formation of the hip joint occurring between fetal life and maturity as a result of instability The hips are not dislocated at birth, but if a dislocation occurs, then the complications of the dislocation - malformation of the hip socket, twisting of the thigh bone (femoral anteversion), and hip muscle shortening (contractures) will develop. Hips that are found to be normal at birth (and even in the first few months of life) can subsequently be found to be abnormal later. Last edited by cpeedahsa on Fri May 02, 2008 6:56 pm; edited 3 times in total Back to top cpeedahsa Century Club Joined: 21 Apr 2007 Posts: 921 Posted: Fri May 02, 2008 1:23 pm    Post subject: Re: congenital dislocation of hip farha wrote: CONGENITAL DISLOCATION OF HIP 2)has heriditary association True etiology of congenital dislocation of the hip is a developmental fault of the hip system produced by extrinsic factors—growth circumstances—with a combination of hereditary and environmental faults which alter the normal growth potential or the intrinsic mosaic pattern Back to top cpeedahsa Century Club Joined: 21 Apr 2007 Posts: 921 Posted: Fri May 02, 2008 1:24 pm    Post subject: Re: congenital dislocation of hip farha wrote: CONGENITAL DISLOCATION OF HIP 5)face presentation is common False Breech more common Breech presentation increases the risk of DDH. The extended breech position in which knees are extended is a higher risk than with knees flexed. Elective caesarean section reduces the risk compared with vaginal breech delivery but it remains higher than after a cephalic presentation Last edited by cpeedahsa on Fri May 02, 2008 1:39 pm; edited 1 time in total Back to top cpeedahsa Century Club Joined: 21 Apr 2007 Posts: 921 Posted: Fri May 02, 2008 1:26 pm    Post subject: Re: congenital dislocation of hip farha wrote: CONGENITAL DISLOCATION OF HIP 6)osteoarthritis is the long term complication if untreated True Complications of untreated CDH/DDH osteoarthritis pain abnormal gait unequal leg length decreased agility Back to top cpeedahsa Century Club Joined: 21 Apr 2007 Posts: 921 Posted: Fri May 02, 2008 1:38 pm    Post subject: Re: congenital dislocation of hip farha wrote: CONGENITAL DISLOCATION OF HIP 8)xrays in the neonatal period is diagnostic False X Rays only after 3 months old-- ossification centers By the time an infant reaches 3-5 months age, the femoral nucleus of ossification has appeared, and the bony architecture of the hip is sufficiently well developed that a dislocated hip can be reliably detected on radiographs. The age at which the diagnosis can be made by radiography is, however, near the upper limit of the age for successful treatment of hip dysplasia using the Pavlik harness Back to top cpeedahsa Century Club Joined: 21 Apr 2007 Posts: 921 Posted: Fri May 02, 2008 1:39 pm    Post subject: Re: congenital dislocation of hip farha wrote: CONGENITAL DISLOCATION OF HIP 7)risk of recurrence is negligible false Positive family history of the condition increases the risk in a manner suggestive of multifactorial inheritance Back to top farha Century Club Joined: 18 May 2007 Posts: 156 Posted: Fri May 02, 2008 2:00 pm    Post subject: congenital dislocation of hip excellent ahsa , answers are perfect with explanations . I made these MCQS because this is one of the favourite topics of RCOG and problem is that u hardly find this in obs and gyn boooks Back to top salihabduallah Century Club Joined: 04 Sep 2007 Posts: 120 Posted: Fri May 02, 2008 5:44 pm    Post subject: Re: congenital dislocation of hip [quote="cpeedahsa The hips are not dislocated at birth, .[/quote] not quite sure of that, most probably they are dislocated at birth. Back to top salihabduallah Century Club Joined: 04 Sep 2007 Posts: 120 Posted: Fri May 02, 2008 5:48 pm    Post subject: Re: congenital dislocation of hip Quote: [quote="cpeedahsa] Breech presentation increases the risk of DDH. The extended breech position in which knees are extended is a higher risk than with knees flexed. Elective caesarean section reduces the risk compared with vaginal breech delivery but it remains higher than after a cephalic presentation [/quote] again not sure of that . could you quote ur references please. Back to top farha Century Club Joined: 18 May 2007 Posts: 156 Posted: Fri May 02, 2008 5:51 pm    Post subject: congenital dislocation of hip that is a dodging mcq and it is a developmental disorder and actu ally now it is called congenital dysplasia as AHSA already mentioned that and it is true as i went through google search and confirmed that Back to top rpwalavalkar Teale Fenning Administrator Joined: 20 Jul 2006 Posts: 966 Posted: Fri May 02, 2008 6:14 pm    Post subject: hi farah, good question. i have shifted this from open forum to mcqs. r p.s-- can everyone make sure that posts are written under the correct heading please. _________________ Dr Miss. Raj Walavalkar MBBS MRCOG TealeFenning Administrator SR O&G Wessex Region Back to top cpeedahsa Century Club Joined: 21 Apr 2007 Posts: 921 Posted: Fri May 02, 2008 6:42 pm    Post subject: Re: congenital dislocation of hip salihabduallah wrote: Quote: ="cpeedahsa The hips are not dislocated at birth, . not quite sure of that, most probably they are dislocated at birth. Reference: Current Diagnosis & Treatment in Orthopedics - 4th Ed. (2006) Developmental dysplasia of the hip (DDH) refers to a range of problems of the newborn hip joint that may be shallow, unstable or displaced. The term DDH has replaced ‘congenital dislocation of the hip’ because hip examination may be normal at birth but found subsequently to be unstable or even dislocated. Developmental dysplasia of the hip Neonatal hip relatively unstable joint (muscle is undeveloped, the soft cartilaginous surfaces easily deformed, ligaments are lax) Exaggerated positioning in acute flexion and adduction in utero may occur, especially in breech presentation. excess stretching of the posterior hip capsule joint unstable after delivery. Laxity may reflect family history or the presence of maternal relaxin hormone in the fetal circulatory system. Relative instability asymptomatic subluxation (partial displacement) or dislocation (complete displacement) of the hip joint. Back to top cpeedahsa Century Club Joined: 21 Apr 2007 Posts: 921 Posted: Fri May 02, 2008 6:50 pm    Post subject: Re: congenital dislocation of hip salihabduallah wrote: cpeedahsa wrote: Breech presentation increases the risk of DDH. The extended breech position in which knees are extended is a higher risk than with knees flexed. Elective caesarean section reduces the risk compared with vaginal breech delivery but it remains higher than after a cephalic presentation again not sure of that .could you quote ur references please. Ref: Current Diagnosis & Treatment in Orthopedics - 4th Ed. (2006) Developmental dysplasia of the hip (DDH) occurs in approximately 1 in 1000 live births in whites, is less common in blacks, and may be more common in certain ethnic groups such as North American Indians. In all groups, this disorder is more likely if certain risk factors are present, such as positive family history, ligamentous laxity, breech presentation (and, by association, cesarean delivery), female gender, large fetal size, and first-born status. 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