Ultrasonography in the Diagnosis of Transient Synovitis of the Hip and Legg-Calvé-Perthes Disease

Eggl, H.; Drekonja, Thomas; Kaiser, Brigitte; Dorn, U.

doi:10.1097/01202412-199907000-00007

Cited by 28 publications

(11 citation statements)

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“…Additionally, the two hips may not have been evaluated accurately with respect to the bone aspect of the femoral neck as a symmetric line. Additionally, although some investigators recorded maximum anteroposterior dimensions of the UJS [7, 9, 12, 15-17, 20, 22], other reports did not clearly describe the measurement point [8,14,18,19,21]. Our results suggest that the UJS or the effusion space should be measured symmetrically with respect to the femoral neck and measured from the maximum anteroposterior dimension.…”

Section: Measurement Positioncontrasting

confidence: 56%

“…Moreover, US has been shown to be an accurate diagnostic tool for the diagnosis of hip joint effusion in children with transient synovitis or septic arthritis. Many patients with painful hips are considered to have transient synovitis if US depicts a thickening of the ultrasonographic joint space (UJS) of more than 2 mm compared with that in the asymptomatic hip [6][7][8][9][10][11][12][13][14][15]. To our knowledge, however, some reports of UJS measurements have shown a wide range of average thickness values [7-9, 14, 16-21]; so that these criteria might be insufficient for the diagnosis of transient synovitis.…”

Section: Introductionmentioning

confidence: 92%

“…The US diagnostic criteria for hip effusion include a difference [2.0 mm in the UJS thickness between an asymptomatic hip and a symptomatic hip [6][7][8][9][10][11][12][13][14][15]. Eich et al [23] reported that a small effusion can result in a difference of \2 mm, and that symmetric effusions may not be recognized with this criterion.…”

Section: Effusion Spacementioning

confidence: 98%

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Sonographic measurement of transient synovitis in children: diagnostic value of joint effusion

Yabunaka

Ohue

Morimoto

et al. 2011

Radiol Phys Technol

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In an evaluation of the diagnostic criteria for ultrasonography (US) of transient synovitis in children, in a prospective study, 34 consecutive children with a painful hip underwent US. The ultrasonographic joint space (UJS) and the effusion space were measured in both hips, and the width of the UJS thickness in the asymptomatic hips was compared with that in the symptomatic hips. US showed the presence of a joint effusion in 31 of the 34 children and a bilateral effusion in 3. The US diagnostic criterion for hip effusion consists of a UJS thickness difference >2.0 mm between asymptomatic and symptomatic hips. However, we found that 8 of the 31 UJS measurements compared between symptomatic hips and asymptomatic hips exhibited differences of <2 mm. We suggest that effusion space measurements are possible for accurate visualization of synovitis, rather than the recording of differences in UJS measurements between hips.

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Section: Measurement Positioncontrasting

confidence: 56%

Section: Introductionmentioning

confidence: 92%

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Sonographic measurement of transient synovitis in children: diagnostic value of joint effusion

Yabunaka

Ohue

Morimoto

et al. 2011

Radiol Phys Technol

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“… 12 , 14 , 15 The advantages of sonography are its ready availability, low cost and lack of side-effects. 16 …”

Section: Introductionmentioning

confidence: 99%

MRI and sonography in Legg-Calvé-Perthes disease: Clinical relevance of containment and influence on treatment

Jandl

Schmidt

Schulz

et al. 2018

Journal of Children's Orthopaedics

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Abstract:PurposeThe containment orientated treatment of Legg-Calvé-Perthes disease (LCPD) affected hip joints is broadly accepted in the literature. The prerequisite is early recognition of loss of containment. An often-used quantitative MRI containment parameter is the cartilaginous acetabulum-head-index (CAHI). Based on ultrasound (US), we analyzed the newly created ‘femoral head extrusion angle’ (HA) as a containment parameter in comparison with the CAHI in severe LCPD.MethodsIn a prospective study with 40 children (mean age 5.8 years sd 2.3) with unilateral LCPD classified as Catterall group III/IV, we measured the CAHI versus HA to assess the containment of the femoral head. HA in US was determined by the tangent from the bony acetabular rim to the cartilaginous cranio-lateral femoral head.ResultsThe HA was significantly higher in LCPD-affected hip joints (25° sd 7°) than in healthy ones (13° sd 5°; p < 0.001). Correlation analysis of all hip joints revealed a significant correlation between HA and CAHI (r = −0.69; p < 0.001). Hip joints with a low CAHI indicating loss of containment showed a higher HA in sonography.ConclusionThe results of our study suggest that the HA in US is a reliable containment parameter in severe LCPD with a HA > 22° defining a pathologic value. In comparison with the CAHI, HA measurement in ultrasound is easier than the assessment of various parameters to calculate an index. Frequent sonographical follow-up assessment in critical joints is an alternative if MRI is not available, helping to detect an impending loss of containment early enough.Level of EvidenceLevel II

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“…, porém sua contribuição é de aferição incerta, pois depende da história pregressa, somado ao fato de estas crianças serem, na sua maioria, muito ativas e propensas a traumatismos no seu cotidiano. A sinovite transitória também é sugerida como um fator predisponente para a doença, mas há evidências de que apenas um pequeno número de casos de sinovite persiste como DLCP7 . na DLCP[22][23][24] .…”

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Estudo do suprimento arterial da epífise femoral proximal na doença de Legg-Calvé-Perthes pela angioressonância magnética

Grangeiro¹

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Ultrasonography in the Diagnosis of Transient Synovitis of the Hip and Legg-Calvé-Perthes Disease

Cited by 28 publications

References 0 publications

Sonographic measurement of transient synovitis in children: diagnostic value of joint effusion

Sonographic measurement of transient synovitis in children: diagnostic value of joint effusion

MRI and sonography in Legg-Calvé-Perthes disease: Clinical relevance of containment and influence on treatment

Estudo do suprimento arterial da epífise femoral proximal na doença de Legg-Calvé-Perthes pela angioressonância magnética

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