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J Pediatr Orthop. 2013 Mar;33(2):124-7. doi: 10.1097/BPO.0b013e31827268b8.

The value of hip aspiration in pediatric transient synovitis.

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1
Orthopaedic Oncology Unit, Edmond and Lilly Safra Hospital for Children, Sheba Medical Center, Tel-Hashomer, Israel.

Abstract

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.

PMID:
23389564
DOI:
10.1097/BPO.0b013e31827268b8
[Indexed for MEDLINE]
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