Del Beccaro M A, Champoux A N, Bockers T, Mendelman P M
Emergency Services, Children's Hospital and Medical Center, Seattle, WA 98105.
Ann Emerg Med. 1992 Dec;21(12):1418-22. doi: 10.1016/s0196-0644(05)80052-6.
To determine the diagnostic value of screening laboratory and initial body temperature data in differentiating septic arthritis of the hip from transient synovitis of the hip in children who present to the emergency department with a complaint of hip pain.
Retrospective review of cases of septic arthritis of the hip and transient synovitis of the hip in a 1:2.5 ratio.
An urban regional children's hospital with 20,000 annual ED visits.
Ninety-four children with transient synovitis of the hip and 38 children with septic arthritis of the hip were identified. The children with septic arthritis of the hip had a significantly higher initial temperature (38.1 C versus 37.2 C, P = .000014), mean erythrocyte sedimentation rate (44 mm/hr versus 19 mm/hr, P = .000001), and mean WBC count (13,200/mm3 versus 11,200/mm3, P = .02). However, the degree of overlap in these variables was large. The combination of an erythrocyte sedimentation rate of more than 20 mm/hr and/or a temperature of more than 37.5 C identified 97% of all cases of septic arthritis of the hip.
There is clinically significant overlap in the erythrocyte sedimentation rate, temperature, and WBC count in children with septic arthritis of the hip versus transient synovitis of the hip. All children with an irritable hip without a clearly identified source who have an erythrocyte sedimentation rate of more than 20 mm/hr or a temperature of more than 37.5 C should be considered for diagnostic hip aspiration.
确定在因髋关节疼痛到急诊科就诊的儿童中，筛查实验室检查和初始体温数据在鉴别髋关节化脓性关节炎与髋关节一过性滑膜炎方面的诊断价值。
以1:2.5的比例对髋关节化脓性关节炎和髋关节一过性滑膜炎病例进行回顾性研究。
一家年急诊量达20000例的城市地区儿童医院。
共识别出94例髋关节一过性滑膜炎患儿和38例髋关节化脓性关节炎患儿。髋关节化脓性关节炎患儿的初始体温显著更高（38.1℃对37.2℃，P = 0.000014），平均红细胞沉降率更高（44mm/小时对19mm/小时，P = 0.000001），平均白细胞计数更高（13200/mm³对11200/mm³，P = 0.02）。然而，这些变量的重叠程度很大。红细胞沉降率超过20mm/小时和/或体温超过37.5℃这一组合可识别出97%的所有髋关节化脓性关节炎病例。
髋关节化脓性关节炎患儿与髋关节一过性滑膜炎患儿在红细胞沉降率、体温和白细胞计数方面存在临床上显著的重叠。所有髋关节疼痛但病因不明且红细胞沉降率超过20mm/小时或体温超过37.5℃的患儿均应考虑进行诊断性髋关节穿刺。
