Case Study Pediatric Limp

3205 WordsMay 10, 201313 Pages
Meagan Reeves RN-MSN Student NURS 523 Adv Patho Final Case Study 1. Differential Diagnosis Table Possible Dx | Pertinent S/S for Dx | 1. Toxic Synovitis (Transient Synovitis) | Unilateral hip, thigh, (front and middle of affected hip), and knee pain; decreased ROM on affected side; low grade fever; previous URI | 2. Septic Arthritis | Unilateral hip pain; fever; previous infection; decreased ROM | 3. Pauciarticular Juvenile Rheumatoid Arthritis | Limp in morning; previous infection; decreased ROM | 4. Legg-Calve-Perthes Disease | Limp; short stature, obese; insidious onset | | | 2. Toxic Synovitis i. Toxic Synovitis, or transient synovitis, is a type of childhood arthritis that is thought to be triggered by an acute inflammatory reaction that sometimes follows an upper respiratory infection. It is referred to as “transient”, because pain is said to last only a short time. In this case, the synovial membrane that lines the hip joint is filled with synovial fluid that is secreted by the membrane. Synovitis occurs when the synovium (the lining of the joints) becomes thickened and inflamed. The synovium can become thickened, more cellular, and engorged with fluid in synovitis. It is the most common cause of hip pain in children pre-puberty, which causes arthralgia and arthritis secondary to a transient inflammation of the synovium of the hip. It affects children, ages 3-10, and males at double the rate of females (Whitelaw, 2013). Although transient synovitis is an idiopathic condition, it is most seen after a viral infection. It occasionally develops after getting a vaccine or from taking some medicines. The viral infection, vaccine, or medicine triggers a process that leads to an immune response that affects the joints. This is where the joint becomes inflamed and painful to palpation. It is also unknown why some

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