Department of Trauma and Orthopaedics, Medway Maritime Hospital, Gillingham, Kent, UK.
Department of Trauma and Orthopaedics, Darent Valley Hospital, Dartford, Kent, UK.
Br J Hosp Med (Lond). 2021 May 2;82(5):1-8. doi: 10.12968/hmed.2020.0206. Epub 2021 May 19.
A referral from accident and emergency for a child with hip pain is a scenario commonly faced by orthopaedic juniors on call. The list of differentials is vast and can make assessment and diagnosis challenging, with severe consequences if diagnosis is delayed or missed. Three common causes of paediatric hip pain are septic arthritis, transient synovitis and osteomyelitis. These can all present as a child with atraumatic hip pain, irritability, fever and refusal to weight bear. Differentiating between them can be challenging. A thorough history and examination, combined with appropriate investigations and imaging, is essential. Early diagnosis and prompt treatment are key to reducing irreversible secondary sequelae of joint destruction and long-term functional impairment.
小儿髋关节疼痛的转诊是骨科住院医师在值班时经常面临的情况。鉴别诊断的范围很广，这使得评估和诊断具有挑战性，如果诊断延迟或漏诊，可能会产生严重后果。小儿髋关节疼痛的三个常见病因是化脓性关节炎、一过性滑膜炎和骨髓炎。这些疾病都可能表现为儿童髋关节无创伤性疼痛、烦躁、发热和拒绝负重。鉴别它们具有一定挑战性。详细的病史和体格检查，结合适当的检查和影像学检查至关重要。早期诊断和及时治疗是减少关节破坏和长期功能障碍的不可逆继发性后果的关键。
