[Ultrasonographic differentiation of painful hip in developmental age].

INTRODUCTION: The most common diseases in the group of painful hip are transient synovitis, rheumatoid arthritis, infective (septic) arthritis, Perthes disease and slipping of the upper femoral epiphysis.

METHODOLOGY: The algorhythm covers the first and control examinations in certain time intervals (after: 3-7, 7-15, 21-30 days; as well as 2-4 months).

RESULTS AND DISCUSSION: The most frequent feature of painful hip is transient synovitis with 65%, Perthes disease with 13%, septic arthritis with 6%, rheumatoid arthritis and slipping of the upper femoral epiphysis with 2.5%. The ratio boys and girls was 2.3:1. The average age in the group of the painful hip was 6.8 years, in the group of TS 6.5 years. The most frequent clinical signs were limping in 84.2% and hip pain in 79.6%. Through the follow up period the difference of the anterior capsular distance was established for symptomatic hip: the average value on the first exam was 8.1 mm, and on the final exam 4.7 mm 3.6 mm. In transient synovitis, there was no difference in measured values of the anterior and lateral femoral head distance for both hips. The medial duration of synovial effusion, measured ultrasonographically, was 10.6 days, and the duration of the clinical signs was 8.7 days. The prolongated synovitis was recorded in 17.6%, and Perthes disease in 8.4%. The average value of anterior capsular distance in these patients was 5.4 mm. In group of Perthes disease the values of anterior capsular distance during control examinations showed increase that implicated the lateralisation or extrusion of the femoral head. The values of anterior distance of the femoral head were without significant difference.

CONCLUSION: The ultrasonography should be the method of choice in painful hip differentiation regardless of the age. The ultrasonography can replace radiography safely in the primary diagnostic procedure as well as through the control examination.