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Related Experiment Videos

Pediatric hip effusions: evaluation with power Doppler sonography

P J Strouse1, M A DiPietro, R S Adler

  • 1Division of Pediatric Radiology, University of Michigan Medical Center, Ann Arbor 48109-0252, USA.

Radiology
|March 12, 1998
PubMed
Summary

Power Doppler sonography cannot reliably differentiate infectious from non-infectious hip effusions in children. Increased blood flow was not consistently detected in septic arthritis cases, meaning joint aspiration remains crucial for diagnosis.

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Area of Science:

  • Pediatric Radiology
  • Musculoskeletal Imaging
  • Diagnostic Ultrasound

Background:

  • Hip effusions in children can be infectious or non-infectious, necessitating accurate diagnosis.
  • Distinguishing between septic arthritis and transient synovitis is critical for timely treatment and preventing joint damage.

Purpose of the Study:

  • To evaluate the efficacy of power Doppler sonography in differentiating infectious (septic arthritis) from non-infectious (transient synovitis) hip effusions.
  • To determine if power Doppler sonography can obviate the need for joint aspiration in pediatric hip effusions.

Main Methods:

  • Prospective evaluation of 29 children (30 hips) with sonographically identified hip effusion.
  • Power Doppler sonography was used to assess blood flow in affected hips compared to contralateral normal hips.

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  • Medical chart review confirmed the final diagnosis for each patient.

    • Main Results:

    • None of 16 patients with transient synovitis showed increased flow on power Doppler sonography.
    • Only one of 11 patients with septic arthritis had asymmetric increased flow; two others had probable increased flow.
    • Three patients with miscellaneous diagnoses exhibited symmetric normal flow.

    Conclusions:

    • Power Doppler sonography did not reliably detect increased blood flow in most cases of pediatric septic arthritis.
    • Normal power Doppler sonography findings do not exclude septic arthritis.
    • Joint aspiration should not be precluded by normal power Doppler sonography findings when clinically indicated.