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The value of hip aspiration in pediatric transient synovitis.
MedLine Citation:
PMID:  23389564     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
INTRODUCTION: : Hip transient synovitis (TS) is a common pediatric orthopaedic problem. Although a self-limiting illness, it often makes the patient temporarily disabled and poses a diagnostic difficulty because of its similarity to septic arthritis in clinical manifestations. The aim of this study was to evaluate the use of a single ultrasound-guided hip aspiration as a treatment modality for TS.
METHODS: : Between the years 1984 and 1989, 112 children with TS were treated through bed rest and using nonsteroidal anti-inflammatory drugs (group 1). Between the years 1990 and 1999, 119 children diagnosed with TS were treated using hip aspiration, bed rest, and nonsteroidal anti-inflammatory drugs (group 2). Recovery parameters were compared between these patient groups.
RESULTS: : Twenty-four hours after admission, limping was noted in 92% and 10% of the patients in groups 1 and 2, respectively, (P<0.001). Refusal to bear weight was observed in 14% and 1% in groups 1 and 2, respectively, (P<0.001), and hip joint pain was reported in 81% and 6% in groups 1 and 2, respectively, (P<0.001). Larger joint effusions were found to be the reason behind the inability to bear weight.
CONCLUSIONS: : Pain due to TS may be because of capsule stretching owing to the accumulation of joint effusion. Ultrasound-guided hip aspiration relieves pain and limitation in movement and provides rapid differential diagnosis from septic arthritis of the hip joint.
Authors:
Boaz Liberman; Amir Herman; Amos Schindler; Nir Sherr-Lurie; Abraham Ganel; Uri Givon
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of pediatric orthopedics     Volume:  33     ISSN:  1539-2570     ISO Abbreviation:  J Pediatr Orthop     Publication Date:  2013 Mar 
Date Detail:
Created Date:  2013-02-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8109053     Medline TA:  J Pediatr Orthop     Country:  United States    
Other Details:
Languages:  eng     Pagination:  124-7     Citation Subset:  IM    
Affiliation:
*Orthopaedic Oncology Unit ‡Department of Orthopedic Surgery §Talpiot Medical Leadership Program ∥Pediatric Orthopaedic Unit, Edmond and Lilly Safra Hospital for Children, Sheba Medical Center, Tel-Hashomer, Israel †Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
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