Value of arthrosonography in diagnosis of juvenile irritable hip.

ABSTRACT

This study was designed to evaluate the role of US in the early diagnosis and management of irritable hip in pediatric patients. Full history taking, general examination and thorough local examination of all body joints, especially the hip joints, were performed. Laboratory investigations including hemogram, ESR, CRP, ASO, ANA, RF, tuberculin test, complete urinalysis and stool analysis were done. Radiological examination, especially plain X-ray, AP and frog lateral position was also done. Bilateral hip US, guided US aspiration and analysis of the joint effusion, if needed, were carried out. The results showed that arthrosonography is superior, accurate and early diagnostic tool compared with plain X-ray for the detection of joint effusion as well as it can be used also for guided aspiration for diagnostic, therapeutic and follow up of articular fluid collections. Arthrosonography can detect 1 mm of hip effusion, which is lacking in plain X-ray. Although US can detect gross bony abnormalities in anterior aspect of femoral head and neck, bone disease is better detected by plain X-ray. Therefore, both US and X-ray are complementary in the evaluation of hip diseases in pediatrics