Transient synovitis, septic hip, and Legg-Calvé-Perthes disease: an approach to the correct diagnosis

Pediatr Clin North Am. 2014 Dec;61(6):1109-18. doi: 10.1016/j.pcl.2014.08.002. Epub 2014 Sep 29.

Abstract

Transient synovitis, septic hip, and Legg-Calvé-Perthes disease are common conditions in children. Distinguishing between these disorders can be a diagnostic challenge. Similar presentations, in an age group difficult to examine, coupled with literature that is confusing creates difficulty. It is important to make the correct diagnosis of septic hip in a timely fashion to avoid serious and potentially crippling consequences. As there is no single test for discriminating between these conditions, knowledge of the nuances of clinical presentation, physical examination, laboratory investigations, and imaging is essential. Judicious use of clinical algorithms can complement clinical acumen.

Keywords: Clinical algorithm; Effusion; Fever; Non–weight bearing; Range of motion.

Publication types

  • Review

MeSH terms

  • Algorithms
  • Arthritis, Infectious / complications
  • Arthritis, Infectious / diagnosis*
  • Child
  • Child, Preschool
  • Diagnosis, Differential
  • Fever / etiology
  • Hip Joint / diagnostic imaging
  • Humans
  • Infant
  • Legg-Calve-Perthes Disease / complications
  • Legg-Calve-Perthes Disease / diagnosis*
  • Pain / etiology
  • Radiography
  • Range of Motion, Articular
  • Synovitis / complications
  • Synovitis / diagnosis*
  • Ultrasonography