The epidemiology of transient synovitis in Liverpool, UK

Harrison, W. D.; Vooght, A. K.; Singhal, Ritu; Bruce, Colin; Perry, Daniel C.

doi:10.1007/s11832-014-0556-5

Cited by 18 publications

(21 citation statements)

References 26 publications

(49 reference statements)

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“…Knee pain, the most common complaint at PPCC (17 %) [4], represented the fourth complaint in the ED, whereas other less common complaints, such as elbow or hip pain, were more frequent in younger children as previously reported [13,14,18,19].…”

Section: Discussionsupporting

confidence: 54%

Epidemiology of musculoskeletal pain in a pediatric emergency department

et al. 2015

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The objectives of this study were (1) to determine the percentage of emergency department (ED) visits due to musculoskeletal pain (MSP) by children 3-14 years of age during a period of 1 year; (2) to determine the most frequent presenting complaints; and (3) to characterize their etiology. A cross-sectional study was performed on children aged 3-14(11/12) years attended at the ED of a tertiary hospital due to MSP. The demographic and clinical characteristics of the patients were reviewed 5 days each month for 12 consecutive months. Study days were selected by computer-generated simple random sampling. Out of 4,531 visits to the ED, 826 were due to MSP (18.2 %; 95 % CI 17.1-19.4 %). When compared with children with no skeletal complaints, children with MSP had a similar sex distribution but were older (mean ± SD 7 ± 3.5 years vs 9.9 ± 3.1 years; p < 0.0001). The most common complaints were pain at the wrist (19 %), ankle (19 %) and finger (15 %). The most common etiology was trauma (88.4 %), including contusions (38 %), fractures (21 %) and sprains (18 %). Children with hip (6.7 ± 3 years; p < 0.0001) and elbow (7.8 ± 3.5 years; p < 0.0001) complaints were younger than children with pain in other locations, whereas children with wrist pain (10.5 ± 2.6 years; p < 0.002) and joint sprains (10.7 ± 2.7 years; p < 0.0001) were older. Fractures were more frequent in boys (64 vs 36 %, p = 0.008; OR 1.6; CI 1.1-2.2). Visits to the ED due to MSP increased with age. Pain at three locations represented 50 % of the presenting complaints. Trauma was the principal etiology, but fractures only represented one-fifth of the total.

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Section: Discussionsupporting

confidence: 54%

Epidemiology of musculoskeletal pain in a pediatric emergency department

et al. 2015

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“…The demographics of our sample are in keeping with those reported elsewhere [ 1 , 3 ]. Most of the children in our sample were between 3 and 7 years, and males were more than twice as likely as females to present with TSH.…”

Section: Discussionmentioning

confidence: 88%

“…Epidemiological data on the incidence of TSH are generally lacking. One study from the Netherlands revealed an incidence of 76.2 cases per 100,000 person-years [ 1 ], while a recent English study found an annual incidence of 25.1 cases per 100,000 children aged 14 years or less [ 3 ]. The peak age of incidence appears to be between 4 and 10 years, with boys being more than twice as likely to develop TSH as girls [ 1 – 3 ].…”

Section: Introductionmentioning

confidence: 99%

Peripheral eosinophilia in children with transient synovitis of the hip: 7-year experience from a single centre in New Zealand

Alamri

Cockfield

2016

Journal of Children's Orthopaedics

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PurposeHip pain with limping is a common presentation in childhood. The most common diagnosis in young children is transient synovitis of the hip (TSH), a benign and self-limiting condition. In our clinical practice, we observed eosinophilia in children presenting with irritable hip more commonly than would otherwise be expected. The aims of this study were to assess the prevalence of eosinophilia in children with TSH, and to evaluate the clinical outcomes of this sub-group of patients.MethodsThis study retrospectively examined the data of all paediatric patients admitted to Christchurch Public Hospital, Christchurch, New Zealand. TSH cases were compared with age- and sex-matched controls.ResultsA total of 103 patients were included. Compared with controls, TSH patients had significantly higher eosinophil counts (303 ± 236 vs. 380 ± 337 cells/μL, respectively, p = 0.049). Fourteen patients (15.6 %) had eosinophilia, with a mean eosinophil count of 986 (±321) cells/µL. Children who had eosinophilia did not differ from the rest of the sample in their age (mean 4.6 vs. 4.4 years, p = 0.74) or ethnicity (85.7 vs. 85.5 % European, p = 0.99). Eosinophilic children were not more likely to be atopic (i.e. have history of allergic rhinitis, asthma and/or eczema) than non-eosinophilic children (21.4 vs. 10.5 %, p = 0.37). There was a shorter hospital stay in eosinophilic children (mean 16.3 ± 6 h) than in non-eosinophilic children (mean 21.5 ± 18.8 h), although this was not statistically significant (p = 0.058).ConclusionsTo the authors’ knowledge, this is the first study to explore the relationship between TSH and eosinophilia. We found a sizeable minority (15.6 %) of children with TSH to have eosinophilia. While the difference in hospital stay was not statistically significant, a correlation between peripheral eosinophilia and length of hospital stay of TSH patients is possible. Whether this correlation is clinically meaningful remains to be answered.Level of evidence Retrospective prognostic study; level II.

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“…Skeletal immaturity or ‘skeletal standstill’ is well described in Perthes’ disease and this may be related to societal exposures, such as worsening socio-economic deprivation. 46 An at risk skeletally immature hip may then suffer a relatively benign injury to the cartilage, and through a process such as transient synovitis, 47 these events may be enough to precipitate the onset of LCP through vascular occlusion.…”

Section: Discussionmentioning

confidence: 99%

New insights into the biomechanics of Legg-Calvé-Perthes’ disease

Pinheiro

Dobson

Perry

et al. 2018

Bone & Joint Research

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ObjectivesLegg–Calvé–Perthes’ disease (LCP) is an idiopathic osteonecrosis of the femoral head that is most common in children between four and eight years old. The factors that lead to the onset of LCP are still unclear; however, it is believed that interruption of the blood supply to the developing epiphysis is an important factor in the development of the condition.MethodsFinite element analysis modelling of the blood supply to the juvenile epiphysis was investigated to understand under which circumstances the blood vessels supplying the femoral epiphysis could become obstructed. The identification of these conditions is likely to be important in understanding the biomechanics of LCP.ResultsThe results support the hypothesis that vascular obstruction to the epiphysis may arise when there is delayed ossification and when articular cartilage has reduced stiffness under compression.ConclusionThe findings support the theory of vascular occlusion as being important in the pathophysiology of Perthes disease.Cite this article: M. Pinheiro, C. A. Dobson, D. Perry, M. J. Fagan. New insights into the biomechanics of Legg-Calvé-Perthes’ disease: The Role of Epiphyseal Skeletal Immaturity in Vascular Obstruction. Bone Joint Res 2018;7:148–156. DOI: 10.1302/2046-3758.72.BJR-2017-0191.R1.

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The epidemiology of transient synovitis in Liverpool, UK

Cited by 18 publications

References 26 publications

Epidemiology of musculoskeletal pain in a pediatric emergency department

Epidemiology of musculoskeletal pain in a pediatric emergency department

Peripheral eosinophilia in children with transient synovitis of the hip: 7-year experience from a single centre in New Zealand

New insights into the biomechanics of Legg-Calvé-Perthes’ disease

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