If left untreated, DDH results in shortening of the leg with external rotation, painless limp and restricted abduction in flexion. This disorder occurs most commonly in children four to 10 years of age and presents as pain in the hip or knee, limping and fixed flexion deformity. Slipped upper femoral epiphysis also presents as pain and limp and is also more common in males but occurs during adolescence, between the ages of 10 and 15 years. Inflammation of the lacrimal duct produces pain and swelling below the medial canthus of the eye, and local tenderness, excessive lacrimation and fever. The condition occurs when both the proximal and distal ends of the lacrimal duct are partially or completely obstructed because of trauma, infection or concretions of natural secretions.
Sarcoidosis is also a cause of chronic or acute dacryocystitis.
Symptomatic relief should be provided with warm compresses and analgesics. Antibiotic coverage should be selected to treat the most likely pathogens, which include Staphylococcus aureus, Streptococcus species and Haemophilus influenzae. Systemic dicloxacillin or flucloxacillin are frequently used to treat dacryocystitis. Once the acute inflammation is controlled, patients should be taught lacrimal massage. Surgery is indicated only for severe, chronic infections, epiphora or problems in tear drainage.