You are here

Article Text

Article menu
Download PDFPDF
Archimedes
QUESTION 2
  1. H C Taekema,
  2. PR Landham,
  3. I Maconochie
  1. Department of Paediatrics, Royal United Hospital, Bath, UK; hestertaekema@doctors.org.uk
  2. Department of Orthopaedic Surgery, Musgrove Park Hospital, Taunton, UK
  3. Paediatric Emergency Department, St Mary’s Hospital, London, UK

    https://doi.org/10.1136/adc.2008.152264

    Statistics from Altmetric.com

      Request Permissions

      If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

      DISTINGUISHING BETWEEN TRANSIENT SYNOVITIS AND SEPTIC ARTHRITIS IN THE LIMPING CHILD: HOW USEFUL ARE CLINICAL PREDICTION TOOLS?

      A 3-year-old boy presents to the emergency department with a limp. He has been reluctant to weight bear on his right leg during the day and has a temperature of 37.9°C. Hip examination is painful. What clinical or laboratory tests could help discriminate between septic arthritis and transient synovitis?

      Structured clinical question

      In children [patient] presenting with acute hip pain, is there a single clinical or laboratory test [intervention] that will distinguish between septic arthritis and transient synovitis [outcome]?

      Clinical bottom line

      • There is no one investigation or blood test that can distinguish between septic arthritis and transient synovitis. (Grade B)

      • There is no clinical prediction rule that has been validated by multi-centre prospective studies involving large patient numbers. (Grade B)

      • The combined presence of fever, non-weight bearing, C-reactive protein >20 or erythrocyte sedimentation rate >40, and a white cell count >12 is suspicious of septic arthritis. (Grade B)

      Search strategy and outcome

      Medline 1991–2007, using the PubMed interface. Search: “septic arthritis AND hip” resulted in …

      View Full Text

      Footnotes

      • Competing interests: None.