Pediatric Imaging
HIP PAIN. 3 yr old boy presents with 1 day of left hip pain and limp; no antecedent trauma. The patient is afebrile. Pediatrician orders left hip series to include AP pelvis. After reviewing the studies what will you tell your ordering physician?
There is slight widening of the left hip joint.
AP and lateral view of the left hip
US Left Hip
Ultrasound demonstrates a hip effusion.
WBC 10.1 x E103/uL range 3.28-9.29 No neturophilia. ESR = 8.
Given that the patient has remained afebrile throughout the time that he has had hip pain, and he has essentially full range of motion in the left hip, (he actively walks and runs with no significant complaint of pain in the left hip), and his white blood cell count and ESR are within normal limits, it is unlikely that this left hip pain is due to a septic arthritis. It is likely that the patient's left hip pain is due to transient synovitis of the left hip. Patient is to be closely monitored and will return to the ER if pain worsens.
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