Role of ultrasonography in diagnosis of septic arthritis of hip in infants.

Authors:Basawaraj N G , Keshavamurthy M , Giridhar AG , Srinath M G
Int J Biol Med Res. 2012; 3(3): 1889 - 1891.  |  PDF File

Abstract

The Septic arthritis of the hip requires urgent attention and it is not only Medical emergency, it is also surgical emergency. Even minimal delay in diagnosis and treatment causes permanent disability, Crippling and lifelong hip deformity. The Ultrasonography of the hip is one of the basic and initial imaging modality with very good sensitivity to diagnose joint effusion and ultrasonography referred as the orthopedic stethoscope. This study is to evaluate the role of ultrasonography in the diagnosis and clinical management of suspected cases of septic arthritis of hip in neonates and infants. This study was prospective collection of data and analysis involving 60 infants admitted to hospital with suspected septic arthritis of hip. There were 36 Male and 24 Female infants. The Age group ranged from 2 days to 6 months old infants the mean age being 45 days. All the infants were undergone laboratory investigations and hip ultrasonography. Clinically patients had Fever and Excessive cry on effected limb movement. Laboratory investigation yielded Elevated C - Reactive Protein, Elevated WBC counts and Elevated ESR. The ultrasound of hip showed joint effusion with quantity of effusion from 0.5 cc – 3.5 cc, the fluid was echogenic in 41 patients and in 8 patients there were dependent debris. The joint capsule was elevated and in 6 patients there was synovial thickening. Among 54 hip joints in 46 patients diagnosed as septic arthritis by ultrasonography, 5 hip joints did not show septic arthritis by surgery. The specificity 80 %, sensitivity of 96.3%, positive predictive value 94.6% and negative predictive value 85.7 %. One patients among the surgically treated septic arthritis developed septic dislocation of the hip. To conclude Ultrasonography is an effective primary imaging modality in early detection of septic arthritis of hip in infants. Line of clinical management can be confidently decided on sonographic diagnosis.