Computed tomography and ultrasonography for diagnosis of hip joint effusion in children

Transient synovitis of the hip in the child: Increased levels of proteoglycan fragments in joint fluid

“…Hip joint effusion was diagnosed sonographically ( 5 ) prior to aspiration in all children with synovitis as well as in the five children with manifest LCPD. The mean aspirated volume in the hips with TS was 3.5 (0.5-7.5) ml and in the hips with SAH it was 19.3 (8.0-45) ml; the corresponding value in the LCPD hips was 1.2 (0.2-3.0) ml, and in the CDH hips it was 0.2 ml.…”

“…Synovial fluid was collected following aspiration of 18 hips with the clinical and sonographic diag-nosis of transient synovitis of the hip (TS). Thirteen were boys and 5 were girls; the mean age was 6 (range [3][4][5][6][7][8][9][10][11][12][13][14] years. The mean duration of symptoms at the time of aspiration was 3.4 (range 1-21) days.…”

Management of irritable hip: a review of hospital admission policy.

“…With this in mind, orthopaedic surgeons recommend prompt referral and many orthopaedic units have adopted a policy of admission and investiga-tion of all children with painful hips. Where outpatient 'observation' has been proposed, specialised investigations have been usedfor example, ultrasoundalong with frequent review.17 Although imaging using ultrasound or tomography is useful in showing an effusion, this is not diagnostic as various hip disorders give rise to this, and osteomyelitis may not.17 [18][19][20][21][22] Bone scintigraphy may help in identifying osteomyelitis, but it is not 100% specific and neither is it a practical proposition for the large number of patients referred with mild symptoms. [23][24][25][26] The admission and treatment of irritable hip with traction/bed rest has never been shown to be prognostically beneficial, although until the 1960s such patients were often kept in hospital for many weeks.'…”

Sonography in Total Hip Arthroplasty

“…Since increased intracapsular pressure probably plays a role in implant loosening after THA, the postoperative capsular distension, reflecting intracapsular pressure, has become of interest. Sonography of the hip joint in children is well described and validated [5,6]. To our knowledge, however, there is no data on the reliability of US in THA in adults.…”