Orthopaedics

Paediatric Orthopaedics

Service

The Edinburgh Children’s Orthopaedics (ECO) Team looks after children and young people with MSK conditions both locally in Lothian and as a tertiary referral centre from the rest of Scotland. We are a team of orthopaedic surgeons, specialty doctors, specialist physiotherapists and orthopaedic practitioners. We are primarily based at RHCYP and have clinics at St Johns Hospital, Fife and The Astley Ainsley Hospital.

We accept referrals for patients aged 0-15 (up until their 16^th birthday) but for certain conditions, we may continue to see young people after their 16^th birthday, and we are able to see patients up until their 18^th birthday, at the patient’s request.

Emergency

We offer a 24 hour a day emergency service for

fractures and acute MSK injury, including suspected non-accidental injury
suspected bone and joint infection

Please send the patient direct to RHCYP ED. Prior contact with the orthopaedic registrar is not required. ED will initially manage the acutely limping child.

Urgent

Please refer the following patients for urgent review in clinic

Suspected bone or soft tissue cancer
Fracture diagnosed or managed outwith NHS Lothian
Complications of recent orthopaedic surgery
Suspected developmental dysplasia of the hip (DDH)
Newly diagnosed clubfoot (congenital talipes equinovarus)

The following conditions are potentially urgent, but can be diagnosed/ excluded radiologically

Perthes
- X-ray: frog leg lateral both hips
Slipped capital femoral epiphysis (SCFE)
- X-ray: frog leg lateral both hips
DDH
- Under 9 months old request USS both hips or refer urgently and we will arrange imaging
- Over 9 months old request X-ray: AP pelvis both hips
Soft tissue swelling
- USS

Normal imaging can often avoid the need for orthopaedic clinic referral. Direct access to Radiology for requesting imaging at RHCYP can be found on SCI Gateway (RHCYP > Clinical Radiology > Radiology). Radiology requests can be discussed with the Duty Radiologist: 0131 536 0805.

If in doubt about the urgency of a referral, please contact the orthopaedic registrar via RHCYP switchboard: 0131 536 1000

Routine

Chronic MSK conditions which do not require to be seen within 4 weeks can be referred routinely by letter / SCI Gateway to orthopaedics. Please refer Edinburgh and West Lothian patients, and we will determine if they are to be seen at RHCYP or SJH. We will frequently triage patients to be seen by physiotherapists, and patients can also be referred directly to physiotherapy. We may offer advice rather than an appointment, and please state if you would prefer this on the referral.

Several conditions / normal variants do not need to be seen by orthopaedics, and more information can be found in Primary Care Management