[Ultrasonography in serous coxitis]

Area of Science:

• Pediatric Orthopedics
• Diagnostic Imaging
• Rheumatology

Background:

• Hip joint effusions, such as those seen in transient synovitis, present diagnostic challenges.
• Accurate and timely diagnosis is crucial for appropriate management and to prevent long-term complications.

Purpose of the Study:

• To establish ultrasonography as the primary imaging modality for acute and subacute hip and thigh pain.
• To define ultrasonographic criteria for intracapsular effusion.
• To evaluate the role of ultrasonography in monitoring transient synovitis and assessing for developmental hip abnormalities.

Main Methods:

• Utilized ultrasonography for imaging patients with acute and subacute hip and thigh pain.
• Established a diagnostic criterion for intracapsular effusion: a side difference ≥ 2.0 mm in anterior joint capsule-femoral neck distance.
• Assessed the utility of ultrasonography in monitoring effusion resorption and evaluating for coxa magna and Legg-Calvé-Perthes disease.

Main Results:

• Ultrasonography is a rapid, reliable, and painless diagnostic technique for hip joint effusion.
• A side difference of ≥ 2.0 mm in the anterior joint capsule-femoral neck distance reliably indicates intracapsular effusion.
• Ultrasonography effectively monitors effusion resorption and aids in the follow-up assessment of developmental hip conditions.

Conclusions:

• Ultrasonography should be the initial imaging method for patients presenting with acute or subacute hip and thigh pain.
• In uncomplicated cases, radiography and scintimetry can be omitted, reserving them for suspected Legg-Calvé-Perthes disease.
• Ultrasonography offers comprehensive assessment from initial diagnosis through long-term follow-up of hip joint effusions and related conditions.