Emergency department diagnosis of pediatric hip effusion and guided arthrocentesis using point-of-care ultrasound.
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.
Tsung
James W
JW
Department of Emergency Medicine, Bellevue Hospital Center/NYU School of Medicine, New York, New York 10016, USA.
Blaivas
Michael
M
D001170:Arthritis, Infectious; D002648:Child; D002675:Child, Preschool; D004636:Emergency Service, Hospital; D005260:Female; D006621:Hip Joint / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D007592:Joint Diseases / Q000000981:diagnostic imaging* / Q000473:pathology / Q000628:therapy; D008297:Male; D019095:Point-of-Care Systems; D025242:Spondylarthropathies / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D013585:Synovitis / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D014463:Ultrasonography