Oblicuidad pélvica o contractura congénita en abducción de la cadera: una entidad poco conocida / Congenital pelvic obliquity or congenital hip’s abduction contracture: a little known entity

La oblicuidad pélvica congénita es una patología frecuente en el lactante y poco conocida por los pediatras. Se presentan cuatro casos de oblicuidad pélvica simple en lactantes mujeres. Se describen los hallazgos clínicos y radiológicos en el momento del diagnóstico, la actitud terapéutica y la evolución de cada uno de ellos. Los pediatras de Atención Primaria debemos estar atentos a los antecedentes, signos acompañantes y al diagnóstico de esta entidad, así como tener formación en la exploración de la cadera para detectar clínicamente una inestabilidad, preferentemente en la cadera aducta (opuesta a la contracturada). Es importante la interrelación entre Pediatría, Radiología Infantil, Traumatología Infantil y Rehabilitación (AU)

Congenital pelvic obliquity is frequent, although pediatricians are not used to diagnose it. We report four female infants with simple pelvic obliquity. We describe clinical and radiologic findings, their treatment and outcome. Primary care pediatricians must be alert looking for pelvic obliquity in infants. We need to improve our abilities in hip exploration, to detect instability in the adduct hip (in the opposite of the contractured hip). Is very important to work together: pediatricians, radiologist, orthopedist and rehabilitation physician (AU)

Klinefelter syndrome and short stature: an unusual combination.

Klinefelter syndrome is not easy to diagnose in childhood because of the absence of significant manifestations before puberty. Three main clinical signs should suggest the diagnosis in a child: small testes, tall stature, and mental retardation or learning problems. We present a patient with Klinefelter syndrome and short stature due to growth hormone deficiency. His height was below the third percentile for age and his bone age delayed. Maximal serum GH levels after insulin-induced hypoglycemia and clonidine were low, demonstrating GH deficiency. He received growth hormone treatment with good response. The diagnosis of Klinefelter syndrome was made at puberty, because the patient did not present a normal progression of testicular development and puberty. At that moment, a karyotype was made confirming the suspected diagnosis. We wish to emphasize the rare association between Klinefelter syndrome and growth hormone deficiency.