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The irritable hip. Scintigraphy in 192 children
1Royal Manchester Childrens' Hospital, Pendlebury, Salford, Great Britain.
Acta Orthopaedica Scandinavica
|February 1, 1992
Summary
Transient synovitis may present with varying patterns, some indicating early stages of Legg-Calvé-Perthes disease. Radionuclide scintigraphy helps identify these subtle cases, suggesting a spectrum of femoral head ischemia.
Area of Science:
- Pediatric Orthopedics
- Radiology
- Nuclear Medicine
Background:
- Transient synovitis is a common cause of hip pain in children.
- Its exact etiology is debated, with potential links to other hip conditions.
- Distinguishing transient synovitis from early Legg-Calvé-Perthes disease is clinically important.
Purpose of the Study:
- To investigate the different patterns of transient synovitis using radionuclide scintigraphy.
- To determine the relationship between transient synovitis and Legg-Calvé-Perthes disease.
- To identify potential subclinical forms of Legg-Calvé-Perthes disease.
Main Methods:
- Retrospective analysis of 192 pediatric patients with transient synovitis.
- Radionuclide scintigraphy performed shortly after presentation.
- Correlation of scintigraphic findings with radiographic outcomes over 4 years.
Main Results:
- Three distinct scintigraphic patterns were observed in transient synovitis.
- Fifteen patients (7.8%) showed evidence of femoral head ischemia.
- Of these, 4 developed classic Legg-Calvé-Perthes disease, while 11 showed a radiographically silent form.
Conclusions:
- Transient synovitis may represent a spectrum of conditions, including a silent form of Legg-Calvé-Perthes disease.
- Radionuclide scintigraphy can detect early femoral head ischemia not apparent on initial radiographs.
- These findings suggest a potential link between transient synovitis and Legg-Calvé-Perthes disease etiology.