Seyahi Aksel, Uludag Serkan, Altıntaş Burak, Demirhan Mehmet
American Hospital, Department of Orthopaedics and Traumatology, Istanbul, Turkey.
J Med Case Rep. 2011 Jul 13;5:305. doi: 10.1186/1752-1947-5-305.
The high incidence of transient synovitis in early childhood makes it the first suspected pathology in a limping child. Trauma, which has long been regarded as a causative factor for transient synovitis, may be underestimated in a non-cooperative toddler.After excluding most serious conditions, such as septic arthritis, a speculative diagnosis of transient synovitis can be made, and this can easily mask a subtle musculoskeletal injury.
We report the cases of three Caucasian patients (two boys, aged 20-months- and three-years-old, and one girl, aged two-years-old), with tibial torus and toddler's fractures which were late-diagnosed due to an initial misdiagnosis of transient synovitis of the hip.
In a non-cooperative child musculoskeletal trauma can be mistaken as a simple causative factor for transient synovitis of the hip and this can easily prevent further investigation for a possible subtle musculoskeletal injury of the lower extremities.Our experience with the presented cases suggests the need to be more vigilant in the differential diagnosis of transient synovitis in young children.
幼儿期短暂性滑膜炎的高发病率使其成为跛行儿童首先怀疑的病理情况。长期以来被视为短暂性滑膜炎病因的创伤,在不配合的幼儿中可能被低估。在排除诸如化脓性关节炎等最严重的情况后,可做出短暂性滑膜炎的推测性诊断,而这很容易掩盖细微的肌肉骨骼损伤。
我们报告了3例白种人患者的病例(2名男孩,年龄分别为20个月和3岁,1名女孩,年龄为2岁),他们因最初被误诊为髋关节短暂性滑膜炎而导致胫骨结节骨软骨炎和幼儿骨折的诊断延迟。
在不配合的儿童中,肌肉骨骼创伤可能被误诊为髋关节短暂性滑膜炎的简单病因,这很容易阻碍对下肢可能存在的细微肌肉骨骼损伤的进一步检查。我们对所报告病例的经验表明,在幼儿短暂性滑膜炎的鉴别诊断中需要更加警惕。