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[Coxitis fugax--the beginning of Perthes' disease?]

T Mumme1, E Berkemeier, U Maus

  • 1Universitätsklinikum Aachen, Orthopädische Klinik. Torsten.Mumme@GMX.de

Zeitschrift Fur Orthopadie Und Ihre Grenzgebiete
|October 15, 2005
PubMed

Insights

We report a case of hip pain in a child, initially diagnosed as transient hip synovitis. Magnetic resonance imaging (MRI) revealed proximal femur epiphysis necrosis, necessitating prompt surgical decompression for reperfusion.

Area of Science:

  • Pediatric Orthopedics
  • Radiology
  • Surgical Intervention

Background:

  • Transient hip synovitis is a common cause of hip pain in children.
  • Diagnosis typically involves clinical assessment, blood tests, X-rays, and ultrasound.

Observation:

  • A 10-year-old boy presented with acute left hip pain without significant trauma.
  • Initial workup showed an intraarticular effusion but normal blood parameters and X-ray.
  • Magnetic resonance imaging (MRI) revealed complete necrosis of the proximal femur epiphysis.

Findings:

  • The MRI findings indicated avascular necrosis of the femoral epiphysis, a condition distinct from transient synovitis.
  • Surgical intervention with ventral capsular incision and decompression was performed urgently.

Implications:

  • This case highlights the importance of MRI in diagnosing hip pain, especially in older children (>=8 years) presenting with atypical symptoms.
  • Early MRI diagnosis and surgical decompression can facilitate reperfusion and potentially improve outcomes in cases of femoral head avascular necrosis.

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