Ultrasonography of the painful hip in children

ABSTRACT

Fifty patients [aged 20 months to 12 years] presenting to the Orthopedic and Pediatric Clinics with a painful hip were reviewed. All patients were apyrexial with normal ESR, blood count and normal radiographic appearance of the hips. Effusion in 28 hips was diagnosed by ultrasound when a side difference of 2 mm or more in the distance between the femoral neck and the echogenic anterior capsule was measured on the anterior scan. At the time of the first US examination, the average anterior capsule distance [ACD] of the affected and unaffected hips was 8.5 mm and 4.8 mm, respectively. The management protocol was determined according to the US findings upon presentation. All patients were followed up by ultrasound until disappearance of the hip effusion, the latter persisted for an average of 9.3 days. Ultrasound was recommended as the main imaging technique in the diagnosis and follow up of the painful hip in children as it allows for the first time an objective assessment of the condition assisting greatly in its management. Furthermore, it may help select cases requiring hospital treatment leading to obvious financial savings