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

The painful hip: evaluation of criteria for clinical decision-making

“…Leukocytosis was not signi®cant. These results are in agreement with earlier studies [5,16,23]. We found that two or all criteria were met in all patients with septic arthritis (sensitivity 100%), but in only seven patients with transient synovitis (speci®city 89%) when hip ultrasound showed eusion.…”

“…Investigation schemes based on clinical examination and laboratory tests (ESR and complete blood count) identi®ed patients with a septic condition in the area of the hip with a sensitivity of up to 97% but had a relatively low speci®city which resulted in a large number of hospital admissions [5,16,23]. Other schemes based on medical imaging required hip joint aspiration in a large proportion of patients and often hospital admission.…”

“…for an irritable hip, especially in the 3-to 8-year range [23,24]. However, transient synovitis may be diagnosed only by exclusion of other disorders, particularly septic arthritis and osteomyelitis.…”

The limping child: an algorithm to outrule musculoskeletal sepsis

“…It is by far the most prevalent cause of an acute, atraumatic limp in a child, particularly in the 3-to 8-year-old age group [16][17][18].…”

Review Article: Paediatric Bone and Joint Infection

“…Four clinical features and lab investigations have been shown to discriminate well between a septic hip and an irritable (or non-infected) hip. 65 These are severe spasms, localised tenderness, pyrexia greater than 38° and ESR greater than 20. A combination of any two of these produces a specificity of 91% and a sensitivity of 95% for sepsis.…”