Point-of-Care Ultrasound-Guided Aspiration of the Hip Joint by an Emergency Medicine Physician

Abstract

Objectives: Early administration of antibiotics is crucial to treating septic hip. This study aimed to describe the clinical course and outcomes of children with septic hip diagnosed using point-of-care ultrasound (POCUS)guided hip aspirations performed by an emergency medicine physician.Methods: A retrospective case series analysis.

Point-of-Care Ultrasound-Guided Arthrocentesis of a Pediatric Septic Ankle

“…Finally, a study by Thom et al 13 showed that POCUS of the hip joint performed by emergency physicians led to expedited diagnosis (68 vs 208 minutes) and arthrocentesis (211 vs 602 minutes) in septic arthritis cases compared with radiology-performed studies. Previous work has described successful POCUS-guided diagnosis and arthrocentesis of shoulder, knee, and hip effusions in pediatric patients by emergency physicians, but to our knowledge, POCUS use for drainage of a pediatric ankle effusion by emergency physicians has not been described 10,12,13 …”

“…9 Several case series have illustrated that emergency physicians can use POCUS to both diagnose joint effusions and to perform joint aspiration. 1,2,7,[10][11][12][13] A retrospective review of 101 POCUS examinations by Acuna et al 7 showed that POCUS use for arthrocentesis was successful in 92.1% of cases when performed by emergency medicine residents. Gibbons et al 14 showed that ultrasound-guided aspiration of medium joints (elbow, wrist, ankle) in 44 adult ED patients had a 94% success rate compared with 60% success in landmark-guided aspiration.…”

“…Previous work has described successful POCUS-guided diagnosis and arthrocentesis of shoulder, knee, and hip effusions in pediatric patients by emergency physicians, but to our knowledge, POCUS use for drainage of a pediatric ankle effusion by emergency physicians has not been described. 10,12,13 CONCLUSIONS Septic arthritis is a pediatric orthopedic emergency that warrants timely diagnosis and treatment to avoid long-term sequelae and disability. Aspiration of the pediatric hip and knee by emergency medicine physicians using POCUS has been described, but dynamic ultrasound-guidance arthrocentesis of the pediatric ankle by emergency physicians has not been well documented in the literature.…”

“…Point-of-care ultrasound aids in joint fluid aspiration as it locates the area of maximal fluid and avoids vascular structures and tendons 9 . Several case series have illustrated that emergency physicians can use POCUS to both diagnose joint effusions and to perform joint aspiration 1,2,7,10–13 . A retrospective review of 101 POCUS examinations by Acuna et al 7 showed that POCUS use for arthrocentesis was successful in 92.1% of cases when performed by emergency medicine residents.…”