HIPThe role of ultrasound in differentiating septic arthritis from transient synovitis of the hip in childrenZamzam, Mohamed MedhatAuthor Information King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia Correspondence and requests for reprints to Dr Mohamed Medhat Zamzam, MD, King Khalid University Hospital (KKUH), P.O. Box 7805, Riyadh 11472, Saudi Arabia Tel: +96614679596; fax: +96614679436; e-mail: [email protected] Journal of Pediatric Orthopaedics B: November 2006 - Volume 15 - Issue 6 - p 418-422 doi: 10.1097/01.bpb.0000228388.32184.7f Buy Metrics Abstract A total of 154 children admitted with septic arthritis (n=81) or transient synovitis (n=73) were studied retrospectively. Ultrasound findings for 127 patients were correlated with the final diagnosis. Sensitivity, specificity and positive predictive value of ultrasound for the diagnosis of pediatric septic hip were 86.4, 89.7 and 87.9%, respectively. Unsatisfactory outcome occurred more significantly in children, for whom treatment was initiated more than 4 days after the onset of symptoms and those who had a false-negative ultrasound study. Ultrasound cannot be used safely to distinguish between pediatric septic hip and transient synovitis. It may be a method of value to detect minimal hip effusion. A predictive algorithm using clinical, laboratory and ultrasound findings could be beneficial. © 2006 Lippincott Williams & Wilkins, Inc.