Pediatric Urologic Emergencies

In this blog, we’re going to dive into the topic of  pediatric urologic emergencies. We’re going to focus on some of the more uncommon emergencies such as:  phimosis, paraphimosis, priapism, entrapment injuries, testicular torsion, epididymitis, varicocele, and hydrocele. It’s important to note that UTI’s and Kidney stones are also common in peds, and often require additional work-up as often indicate abnormal anatomy or disease processes.

The Limping Child

Background

Most children begin walking between 12 and 18 months. Their initial gait starts broad-based, often with short asymmetric steps. At faster speeds, they often develop foot slapping and asymmetric arm swinging. By ages 3-5 years-old, children start to walk with more fluidity and symmetric strides. By ages 5-7 years-old, their gait begins to resemble the same pattern as an adult.

Kocher Criteria…In a Rush

This week’s 5-minute Journal Article discussion covered

“Validation of a Clinical Prediction Rule for the Differentiation Between Septic Arthritis and Transient Synovitis of the Hip in Children” by Kocher et al.

 

Why is it important to differentiate between septic arthritis and transient synovitis in pediatric patients? Because both diseases can present similarly with acute onset of pain, fever, limp or inability to bear weight and patients holding their hip in the flexed, abducted, externally rotated (FABER) position. The difference is transient synovitis is exactly that, transient, while septic arthritis can lead to permanent joint damage and disability if not treated aggressively with surgical intervention and IV antibiotics.