Emergency department diagnosis of pediatric hip effusion and guided arthrocentesis using point-of-care ultrasound

J Emerg Med. 2008 Nov;35(4):393-9. doi: 10.1016/j.jemermed.2007.10.054. Epub 2008 Apr 10.

Abstract

Children with complaints of hip pain, a painful limp, or refusal to weight bear commonly present to the Emergency Department (ED). The ability to use point-of-care ultrasound in the ED to diagnose a hip joint effusion and to guide arthrocentesis can be helpful to facilitate diagnosis and management of these children. The capsular-synovial thickness of the hip is measured from the anterior bony cortical surface to the posterior surface of the iliopsoas muscle at the concavity of the femoral neck. A capsular-synovial thickness>5 mm, or >2 mm difference compared to the asymptomatic contralateral hip are the described sonographic criteria for hip joint effusion in children. We report on the use of point-of-care ultrasound to diagnose hip effusion and to guide arthrocentesis in a series of pediatric patients presenting with hip pain to the ED.

MeSH terms

  • Arthritis, Infectious
  • Child
  • Child, Preschool
  • Emergency Service, Hospital
  • Female
  • Hip Joint / diagnostic imaging*
  • Hip Joint / pathology
  • Humans
  • Joint Diseases / diagnostic imaging*
  • Joint Diseases / pathology
  • Joint Diseases / therapy
  • Male
  • Point-of-Care Systems*
  • Spondylarthropathies / diagnostic imaging
  • Spondylarthropathies / pathology
  • Spondylarthropathies / therapy
  • Synovitis / diagnostic imaging
  • Synovitis / pathology
  • Synovitis / therapy
  • Ultrasonography