Pediatric Hip Tenosynovitis

4 yo child seen @ HJD, w/ hip pain for 8 hours. No URI Sx.

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This u/s demonstrates a nice hip joint effusion. The hypoechoic, homogenous collection argues against (but can’t r/o) a septic hip. Seeing a joint effusion also decreases the chance of osteomyelitis, which is usually not associated with an effusion.

Hip effusions should be measured form the anterior femoral neck cortex to the OUTSIDE of the joint capsule. More than 5mm in a child is abnormal

The child had a low Kocher score and improved over 2 days without treatment.

Below is the normal contralateral hip

http://www.youtube.com/watch?v=BvzyAoBDE0Q.