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Sonographic measurement of transient synovitis in children: diagnostic value of joint effusion

Koichi Yabunaka1, Mutsumi Ohue, Norio Morimoto

  • 1Department of Radiology, Katsuragi Hospital, 250-1 Makami Cho, Kishiwada, Osaka 596-0842, Japan. yabuchanrt@yahoo.co.jp

Radiological Physics and Technology
|July 13, 2011
PubMed

Insights

Ultrasonography (US) for diagnosing childhood hip synovitis may be improved. Measuring effusion space, not just joint space differences, offers more accurate visualization of synovitis in pediatric hip pain.

Area of Science:

  • Pediatric Orthopedics
  • Diagnostic Imaging
  • Rheumatology

Background:

  • Transient synovitis is a common cause of hip pain in children.
  • Current diagnostic criteria for ultrasonography (US) of transient synovitis rely on ultrasonographic joint space (UJS) thickness differences.
  • The established US criterion for hip effusion is a UJS thickness difference greater than 2.0 mm.

Purpose of the Study:

  • To evaluate the diagnostic criteria for ultrasonography in children with transient synovitis.
  • To compare the accuracy of UJS thickness differences versus effusion space measurements for diagnosing hip synovitis.

Main Methods:

  • A prospective study involving 34 children with painful hips who underwent ultrasonography.
  • Measurement of ultrasonographic joint space (UJS) and effusion space in both symptomatic and asymptomatic hips.
  • Comparison of UJS thickness between symptomatic and asymptomatic hips.

Main Results:

  • Ultrasonography detected joint effusion in 31 of 34 children.
  • A significant proportion (8 of 31) of UJS measurements between symptomatic and asymptomatic hips showed differences less than 2.0 mm, challenging the current criterion.
  • Effusion space measurements provided clearer visualization of synovitis.

Conclusions:

  • The standard ultrasonographic criterion for hip effusion (UJS difference >2.0 mm) may not be sufficiently sensitive for diagnosing transient synovitis in all cases.
  • Measuring the effusion space directly is suggested as a more accurate method for visualizing and diagnosing synovitis in pediatric hip conditions.

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