ABSTRACT
The neonate is unable to relate specific complaints of pain and may not exhibit the usual signs of illness or infection. Septic arthritis of the hip is a surgical emergency in the neonate, and it should be considered in any irritable or ill child who has a high index of suspicion. Prompt diagnosis and immediate treatment are necessary. Nearly all babies undergo routine examination of the hip for dysplasia. It is recognized that limitation of abduction of the hip in the neonate may not represent developmental dysplasia of the hip but may represent other etiologies, such as fracture, infection, congenital anomaly, or tumor. The following case report illustrates the importance of careful clinical evaluation of an apparent asymptomatic neonate.
Subject(s)
Arthritis, Infectious/congenital , Arthritis, Infectious/diagnosis , Hip Joint , Ilium , Osteomyelitis/congenital , Osteomyelitis/diagnosis , Streptococcal Infections/diagnosis , Humans , Infant, Newborn , Male , Streptococcal Infections/congenitalABSTRACT
In this study, botulinum toxin was used to treat paralytic scoliosis. Twelve children with paralytic scoliosis and severe, complicating additional diseases required surgical delay. Although this use of botulinum toxin is experimental, alternative treatments posed greater risks. An institutional review board protocol for nonestablished dosage and indication for treatment was initiated to monitor safety and effect. Treatment was intended to supplement, not replace, other desirable treatment modalities. The effect was to be measured by the return of efficacy of conservative treatment in halting curve progression. Short-term results show that none of the children had worsened scoliosis; all had some reduction in curve measurement (up to >50 degrees).
