Clinical and Radiological Differentiation of Septic Arthritis and Transient Synovitis of the Hip

Chin, Twy; Tse, KS

doi:10.12809/hkjr1716813

Cited by 7 publications

(8 citation statements)

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“…The clinical outcome was reported unsatisfactory for four out of eight patients who had false-negative ultrasound results (24). Chin et al (2017). assessed the capsule thickness relative to the effusion thickness at the femoral recess;…”

Section: Discussionmentioning

confidence: 99%

“…ROC curves for joint effusion thickness demonstrated a respective sensitivity and speci city of 71% and 56% at a cut-off point of 7.5 mm, therefore suggesting it is a satisfactory diagnostic factor for septic arthritis. They ultimately concluded that ultrasound can aid in predicting septic arthritis when predominant capsule thickening relative to joint effusion and increased thickness of the anterior femoral recess and joint effusion thickness > 7.5 mm should warn the physician of a possibility of septic arthritis (9). In our study, although the synovial thickness in reactive arthritis was higher than in septic arthritis (1.83 ± 0.7mm vs. 2.55 ± 0.9mm), but we didn't nd a signi cant difference between them (p = 0.262).…”

Section: Discussionmentioning

confidence: 99%

“…Few ultrasound features of the hip joint have been identi ed as distinguishing factors between septic arthritis and transient synovitis. For instance, increased synovial thickness relative to effusion thickness at the ultrasonographic view of the anterior femoral recess has been found to be indicative of septic arthritis (9). However, no study has evaluated the predictive value of ultrasonographic estimations of hip articular uid volume in differentiating septic arthritis.…”

Section: Page 3/13mentioning

confidence: 99%

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Role of ultrasound and inflammatory factors in the management of pediatric hip joint effusion

alamdaran,

nejad,

Nouri

et al. 2023

Preprint

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Background: Septic arthritis is an important differential diagnosis of hip joint pain. Joint aspiration analysis is a necessary diagnostic measure for septic arthritis. In order to reduce the need for joint aspiration, we compared the combination of ultrasound findings and laboratory findings to separate septic arthritis from reactive arthritis. Methods: Children aged <14 years who were referred to Akbar pediatric hospital in 2020-2022 with hip pain or limping were included in this longitudinal study. Participants underwent ultrasound examinations of the hip and blood samples were obtained from them. After confirming an effusion, dependent on patient status and clinical diagnosis, one of the following approaches was recommended; the close follow-up, or the ultrasound-guided aspiration of the hip joint effusion, and or arthrotomy. The various ultrasound and laboratory were documented. Data were analyzed and P<0.001 being considered statistically significant. Results: Overall, 115 patients with a mean age of 3.43 ± 5.76 years, 46 of whom were girls, were studied. The final diagnosis in 23 cases (20.0%) was septic arthritis and 92 (80.0%) had reactive arthritis. Serum CRP and ESR unlike aspirate volume, effusion volume measured on ultrasound, capsule thickness, total thickness, and recorded capsule-to-effusion ratio were significantly higher in patients with septic arthritis (P<0.001). There was a significant agreement between the volume of measured fluid in the anterior recess and the volume of aspirated fluid (2.5 times, P<0.001). Septic arthritis was not observed in any of the patients with effusion volume in anterior recess less than 0.5cc and ESR less than 40 or CRP less than 15. Conclusion: Since septic arthritis was not observed in any of the patients with effusion volume <0.5cc and normal inflammatory factors (ESR or CRP), conservative management and close follow-up can be recommended in these patients instead of joint fluid aspiration.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Page 3/13mentioning

confidence: 99%

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Role of ultrasound and inflammatory factors in the management of pediatric hip joint effusion

alamdaran,

nejad,

Nouri

et al. 2023

Preprint

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“…US is also helpful in the differential diagnosis of JIA, which is based on clinical examination and the exclusion of other chronic arthropathies [ 12 ]. Nevertheless, apart from characteristic US findings, e.g., in subperiosteal abscess [ 15 ], the clinical scenario and laboratory data are crucial in differential diagnosis, which reflects the high sensitivity but low specificity of US [ 12 , 16 , 17 , 18 , 19 ].…”

Section: Update In Ultrasoundmentioning

confidence: 99%

Advances in Musculoskeletal Imaging in Juvenile Idiopathic Arthritis

et al. 2022

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Over the past decade, imaging of inflammatory arthritis in juvenile arthropathies has significantly advanced due to technological improvements in the imaging modalities and elaboration of imaging recommendations and protocols through systematic international collaboration. This review presents the latest developments in ultrasound (US) and magnetic resonance imaging (MRI) of the peripheral and axial joints in juvenile idiopathic arthritis. In the field of US, the ultra-wideband and ultra-high-frequency transducers provide outstanding spatial resolution. The more sensitive Doppler options further improve the assessment and quantification of the vascularization of inflamed tissues, and shear wave elastography enables the diagnosis of tissue stiffness. Concerning MRI, substantial progress has been achieved due to technological improvements in combination with the development of semiquantitative scoring systems for the assessment of inflammation and the introduction of new definitions addressing the pediatric population. New solutions, such as superb microflow imaging, shear wave elastography, volume-interpolated breath-hold examination, and MRI-based synthetic computed tomography open new diagnostic possibilities and, at the same time, pose new challenges in terms of clinical applications and the interpretation of findings.

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“…US is useful for the early diagnosis of pediatric septic arthritis (SA), particularly in the hip joint. US shows high sensitivity and low specificity 261 262 263 264 . US features, such as predominant synovial (capsular) thickening associated with increasing joint effusion, high fever, and high serum CRP level are predictive of hip SA 265 .…”

Section: Pediatric Applicationsmentioning

confidence: 99%

The EFSUMB Guidelines and Recommendations for Musculoskeletal Ultrasound – Part II: Joint Pathologies, Pediatric Applications, and Guided Procedures

et al. 2021

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The second part of the Guidelines and Recommendations for Musculoskeletal Ultrasound (MSUS), produced under the auspices of EFSUMB, following the same methodology as for Part 1, provides information and recommendations on the use of this imaging modality for joint pathology, pediatric applications, and musculoskeletal ultrasound-guided procedures. Clinical application, practical points, limitations, and artifacts are described and discussed for every joint or procedure. The document is intended to guide clinical users in their daily practice.

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Clinical and Radiological Differentiation of Septic Arthritis and Transient Synovitis of the Hip

Cited by 7 publications

References 0 publications

Role of ultrasound and inflammatory factors in the management of pediatric hip joint effusion

Role of ultrasound and inflammatory factors in the management of pediatric hip joint effusion

Advances in Musculoskeletal Imaging in Juvenile Idiopathic Arthritis

The EFSUMB Guidelines and Recommendations for Musculoskeletal Ultrasound – Part II: Joint Pathologies, Pediatric Applications, and Guided Procedures

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