Neocleous Charalambos, Diakolios Konstandinos, Adramerina Alkistis, Varveris Evangelos, Tsioni Vasiliki, Machairidou Konstandina
Department of Medical Pediatrics, General Hospital of Rhodes, Rhodes, Greece.
Acta Med Acad. 2015;44(2):191-7. doi: 10.5644/ama2006-124.146.
The aim of this report is to highlight the importance of close observation and follow-up in children who present with an acutely irritable hip. This is because hip pain is a symptom of not only benign but also severe conditions. Thus, at the time of the initial presentation, hip pain can be misdiagnosed. This report serves as an example for a wide range of doctors such as orthopaedic surgeons, paediatricians, emergency room physicians or primary care physicians, because these are the first-line doctors who treat patients with a painful hip.
We herein present a three-year-old child who was admitted to our hospital with pain in the right leg and initially diagnosed with transient synovitis of the hip. An additional examination two days later, after severe deterioration of the clinical picture, revealed that our patient was actually suffering from Guillain-Barré syndrome. Failure to diagnose Guillain-Barré syndrome and initiating prompt treatment is potentially life-threatening.
Clinicians should be aware that hip pain could be the presenting complaint of Guillain-Barré syndrome, a syndrome that has many clinical features. Even when all the clinical and laboratory findings indicate a benign condition, Guillain- Barré syndrome should still be considered. Therefore, close observation and follow-up in children who present with an acutely irritable hip is highly recommended. In this way, the potentially catastrophic consequences of more severe conditions can be avoided.
本报告旨在强调对急性髋关节疼痛患儿进行密切观察和随访的重要性。这是因为髋关节疼痛不仅是良性疾病的症状,也是严重疾病的症状。因此,在初次就诊时,髋关节疼痛可能会被误诊。本报告为骨科医生、儿科医生、急诊室医生或初级保健医生等众多医生提供了一个范例,因为这些是治疗髋关节疼痛患者的一线医生。
我们在此介绍一名三岁儿童,该患儿因右腿疼痛入院,最初被诊断为髋关节一过性滑膜炎。两天后,在临床症状严重恶化后进行的进一步检查显示,我们的患者实际上患有吉兰 - 巴雷综合征。未能诊断出吉兰 - 巴雷综合征并及时开始治疗可能会危及生命。
临床医生应意识到髋关节疼痛可能是吉兰 - 巴雷综合征的首发症状,该综合征具有许多临床特征。即使所有临床和实验室检查结果均表明病情为良性,仍应考虑吉兰 - 巴雷综合征。因此,强烈建议对急性髋关节疼痛患儿进行密切观察和随访。通过这种方式,可以避免更严重疾病可能带来的灾难性后果。