Role of ultrasound and inflammatory factors in the management of pediatric hip joint effusion
Authors' conclusion
Since septic arthritis was not observed in any of the patients with effusion volume < 0.5 cc and normal inflammatory factors (ESR or CRP), conservative management and close follow-up can be recommended in these patients instead of joint fluid aspiration.
Study context
- Population
- Children aged < 14 years referred to Akbar pediatric hospital in 2020–2022 with hip pain or limping and hip joint effusion on US46 girls
- Participants
- 115 children
- Exposure
- Septic arthritis vs reactive arthritis
- Septic arthritisn = 23
- Reactive arthritisn = 92reference
- Outcome
- Septic arthritis vs reactive arthritis: inflammatory markers, US findings and low-risk rule (effusion volume in anterior recess <0.5 cc with low ESR or CRP)
Methodological detailslongitudinal, single-centre
- Longitudinal
- Single-centre
Main finding
As reported in the abstract
- C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), unlike aspirate volume, effusion volume measured on US, capsule thickness, total thickness and capsule-to-effusion ratio, significantly higher in septic arthritis
- P < 0.001
- Significant agreement between volume of measured fluid in anterior recess and volume of aspirated fluid
- 2.5 times, P < 0.001
Observational data: associations, not effects.
Further findings
Agreement between US-measured anterior-recess fluid volume and aspirated fluid volume
- Significant agreement (2.5 times, P < 0.001)
Original publication
Role of ultrasound and inflammatory factors in the management of pediatric hip joint effusion. Pediatr Rheumatol Online J. Published 19 December 2023. doi:10.
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