Developmental Dysplasia of the Hip (DDH) is one of the most common orthopedic hip diseases of the pediatric population. There is a predominance in females and patients with known risk factors. Objective: To evaluate the characteristics of DDH in a reference center and compare them with the literature. Methods: This is a cross-sectional observational study based on the review of medical records and radiographs from which epidemiological data such as laterality, age at diagnosis, acetabular index, radiographic classification and others were collected. Results: A total of 297 medical records were found between May 1974 and June 2009. Of those, 147 patients (216 affected hips) were eligible for the survey. Most of the patients came from the state of São Paulo (91.1%), were born in autumn/winter (66.7%), reported as Caucasians (76.9%), with bilateral involvement (46.9%) and mean age at diagnosis of 22.8 months. Conclusion: The most frequent type of DDH was high dislocation (28.7%), and the acetabular index progressively increased with the age. The International Hip Dysplasia Institute classification was found to be more reproducible than Tönnis classification. Delayed diagnosis was associated with the absence of risk factors and with bilaterality. Level of Evidence III, Retrospective comparative study.

RESUMOA claudicação na criança é uma queixa frequente nos consultó-rios dos pediatras, dos ortopedistas pediátricos e nos pronto-socorros. Diversas são as causas para essa condição e identificá-las torna-se um desafio. Quanto maior a idade do paciente, melhor é a coleta da anamnese e mais completo se torna o exame físico, facilitando o raciocínio médico na busca da origem do distúrbio. Para facilitar a abordagem, três grupos etários podem e devem ser considerados. No grupo etário infantil, de um aos três anos de idade, os diagnósticos mais prováveis incluem: sinovite transitória, artrite séptica, desordens neurológicas (paralisia cerebral (PC) branda e distrofia muscular), displasia do desenvolvimento do quadril (DDQ), coxa vara, artrite reumatoide juvenil (ARJ) e neoplasias (osteoma osteoide, leucemia); no grupo etário escolar, dos quatro aos 10 anos de idade, além dos diagnósticos acima, doença de Legg-Calvé-Perthes, menisco discoide, discrepâncias de comprimento dos membros inferiores e "dor do crescimento"; nos adolescentes, dos 11 aos 15 anos de idade: epifisiólise, DDQ, condrólise, síndromes de overuse, osteocondrite dissecante e coalizão tarsal. A proposta deste trabalho é atualizar o leitor em relação à abordagem do paciente pediátrico que apresenta claudicação e discutir as suas prováveis causas. Descritores

Limping in children is a common complaint at pediatric, pediatric orthopaedic offices and in emergency rooms. There are several causes for this condition, and identifying them is a challenge. The older the patient, the better the anamnesis and more detailed the physical examination will be, enabling an easier medical assessment for searching the source of the disorder. In order to make the approach easier, three age groups can and should be considered. Among infants (1 to 3 years old), diagnosis will most likely be: transitory synovitis, septic arthritis, neurological disorders (mild brain palsy (BP) and muscular dystrophy), congenital hip dislocation (CHD), varus thigh, juvenile rheumatoid arthritis (JRA) and neoplasias (osteoid osteoma, leukemia); in the scholar age group, between 4 and 10 years old, in addition to the diagnoses above, Legg-Calvé-Perthes disease, discoid meniscus, inferior limbs discrepancy and unspecific muscular pain; in adolescents (11 to 15 years old): slipped capital femoral epiphysis, congenital hip dislocation, chondrolysis, overuse syndromes, dissecans osteochondritis, and tarsal coalition. The purpose of this study is to provide an update on how to approach pediatric patients presenting with limping, and to discuss its potential causes.

Objective To analyze the characteristics of patients diagnosed with pediatric osteoarticular infections treated in a level III trauma center in São Paulo, Brazil.Methods We retrospectively analyzed patients admitted between September 2012 and August 2014. The outcomes analyzed were: age, sex, diagnosis, etiologic agent, anatomic location, time to diagnosis, history of previous trauma and infection, laboratory tests, treatment, and complications.Results Twenty patients were included, 50% with septic arthritis, 35% with osteomyelitis, and 15% with both. Boys were predominant (80%), and the mean age was 6.6 years. The most common etiologic agent was Staphylococcus aureus. C-reactive protein value and erythrocyte sedimentation rate were elevated. The infections were treated with antibiotic therapy (intravenous and oral) and oxacillin was most frequently used. Most patients underwent at least one surgical procedure, and 35% of patients had complications.Conclusion This epidemiological mapping identified clinical and demographic characteristics which are useful for improving preparation for care. Future prospective studies with longer patient follow-up and the development of treatment protocols are needed to improve therapeutic decision-making and the prognosis of children with suspected osteoarticular infections. Evidence Level II; Prognostic studies - Investigation of the effect of patient characteristics on the outcome of the disease.

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