TY - JOUR
T1 - The value of Hip aspiration in pediatric transient synovitis
AU - Liberman, Boaz
AU - Herman, Amir
AU - Schindler, Amos
AU - Sherr-Lurie, Nir
AU - Ganel, Abraham
AU - Givon, Uri
PY - 2013/3
Y1 - 2013/3
N2 - INTRODUCTION:: Hip transient synovitis (TS) is a common pediatric orthopaedic problem. Although a self-limiting illness, it often makes the patient temporarily disabled and poses a diagnostic difficulty because of its similarity to septic arthritis in clinical manifestations. The aim of this study was to evaluate the use of a single ultrasound-guided hip aspiration as a treatment modality for TS. METHODS:: Between the years 1984 and 1989, 112 children with TS were treated through bed rest and using nonsteroidal anti-inflammatory drugs (group 1). Between the years 1990 and 1999, 119 children diagnosed with TS were treated using hip aspiration, bed rest, and nonsteroidal anti-inflammatory drugs (group 2). Recovery parameters were compared between these patient groups. RESULTS:: Twenty-four hours after admission, limping was noted in 92% and 10% of the patients in groups 1 and 2, respectively, (P<0.001). Refusal to bear weight was observed in 14% and 1% in groups 1 and 2, respectively, (P<0.001), and hip joint pain was reported in 81% and 6% in groups 1 and 2, respectively, (P<0.001). Larger joint effusions were found to be the reason behind the inability to bear weight. CONCLUSIONS:: Pain due to TS may be because of capsule stretching owing to the accumulation of joint effusion. Ultrasound-guided hip aspiration relieves pain and limitation in movement and provides rapid differential diagnosis from septic arthritis of the hip joint.
AB - INTRODUCTION:: Hip transient synovitis (TS) is a common pediatric orthopaedic problem. Although a self-limiting illness, it often makes the patient temporarily disabled and poses a diagnostic difficulty because of its similarity to septic arthritis in clinical manifestations. The aim of this study was to evaluate the use of a single ultrasound-guided hip aspiration as a treatment modality for TS. METHODS:: Between the years 1984 and 1989, 112 children with TS were treated through bed rest and using nonsteroidal anti-inflammatory drugs (group 1). Between the years 1990 and 1999, 119 children diagnosed with TS were treated using hip aspiration, bed rest, and nonsteroidal anti-inflammatory drugs (group 2). Recovery parameters were compared between these patient groups. RESULTS:: Twenty-four hours after admission, limping was noted in 92% and 10% of the patients in groups 1 and 2, respectively, (P<0.001). Refusal to bear weight was observed in 14% and 1% in groups 1 and 2, respectively, (P<0.001), and hip joint pain was reported in 81% and 6% in groups 1 and 2, respectively, (P<0.001). Larger joint effusions were found to be the reason behind the inability to bear weight. CONCLUSIONS:: Pain due to TS may be because of capsule stretching owing to the accumulation of joint effusion. Ultrasound-guided hip aspiration relieves pain and limitation in movement and provides rapid differential diagnosis from septic arthritis of the hip joint.
KW - Hip pain
KW - Transient synovitis
KW - hip aspiration
UR - http://www.scopus.com/inward/record.url?scp=84873894010&partnerID=8YFLogxK
U2 - 10.1097/BPO.0b013e31827268b8
DO - 10.1097/BPO.0b013e31827268b8
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AN - SCOPUS:84873894010
SN - 0271-6798
VL - 33
SP - 124
EP - 127
JO - Journal of Pediatric Orthopaedics
JF - Journal of Pediatric Orthopaedics
IS - 2
ER -