Module 1, General Medical Level

The mother of a 3 year old female with Down's Syndrome noticed clicking in the left hip which has been present since age 2. Except for recurrent bouts of otitis media she is otherwise healthy and started walking at 24 months of age.

Question 1A

Because of general ligamentous laxity clicking in the hips of children with Down's syndrome is common and of little concern.

Question 1B

Developmental dislocation of the hip(DDH) is one of the primary concerns, therefore an ultrasound should be ordered to rule out DDH.

Question 1C

Because of recurrent otitis media this child may have seeded the hip joint and have septic hip.

Question 1D

This child may develop a dislocated hip with very minor trauma.

Question 1E

Children with Downs are at risk for rheumatoid arthritis which may start with a mild limp.

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