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Intracapsular pressure in hip synovitis in children
1Department of Orthopedic Surgery, Nagoya University School of Medicine, Japan.
Acta Orthopaedica Scandinavica
|August 1, 1991
Summary
High hip joint pressure in children can cause pain and ischemia. Aspiration can relieve this pressure, as seen in a septic arthritis case where it reversed epiphyseal ischemia.
Area of Science:
- Pediatric Orthopedics
- Medical Imaging
- Surgical Procedures
Background:
- Painful hip conditions in children can lead to increased intracapsular pressure.
- Elevated pressure may compromise blood flow to the epiphysis, causing ischemia.
- Understanding pressure dynamics is crucial for effective management of pediatric hip pain.
Purpose of the Study:
- To measure intracapsular pressure in painful pediatric hips.
- To correlate pressure with hip position and fluid volume.
- To investigate the effect of pressure and aspiration on epiphyseal blood flow.
Main Methods:
- Scintimetry and direct intracapsular pressure recordings were performed in 10 children with painful hips.
- Pressure measurements were taken at various hip positions (extension, 90° flexion, semiflexion).
- Aspiration of joint fluid was performed, and its volume correlated with pressure.
Main Results:
- Extremely high intracapsular pressures were recorded, particularly in extension with maximum internal rotation.
- In three cases, pressure exceeded estimated systolic blood pressure.
- A strong correlation was found between aspirated fluid volume and intracapsular pressure.
Conclusions:
- Intracapsular pressure in painful pediatric hips can reach critically high levels.
- Aspiration effectively reduces intracapsular pressure.
- In septic arthritis, decompression via aspiration reversed scintigraphically noted epiphyseal ischemia.