Septic arthritis is an important differential diagnosis of hip joint pain. Joint aspiration analysis is a necessary diagnostic measure for septic arthritis. In order to reduce the need for joint aspiration, we compared the combination of ultrasound findings and laboratory findings to separate septic arthritis from reactive arthritis. Children aged < 14 years who were referred to Akbar pediatric hospital in 2020–2022 with hip pain or limping were included in this longitudinal study. Participants underwent ultrasound examinations of the hip and blood samples were obtained from them. After confirming an effusion, dependent on patient status and clinical diagnosis, one of the following approaches was recommended; the close follow-up, or the ultrasound-guided aspiration of the hip joint effusion, and or arthrotomy. The various ultrasound and laboratory were documented. Data were analyzed and P < 0.001 being considered statistically significant. Overall, 115 patients with a mean age of 3.43 ± 5.76 years, 46 of whom were girls, were studied. The final diagnosis in 23 cases (20.0%) was septic arthritis and 92 (80.0%) had reactive arthritis. C-reactive protein (CRP) and The erythrocyte sedimentation rate (ESR) unlike aspirate volume, effusion volume measured on ultrasound, capsule thickness, total thickness, and recorded capsule-to-effusion ratio were significantly higher in patients with septic arthritis (P < 0.001). There was a significant agreement between the volume of measured fluid in the anterior recess and the volume of aspirated fluid (2.5 times, P < 0.001). Septic arthritis was not observed in any of the patients with effusion volume in anterior recess less than 0.5 cc and ESR less than 40 mm/hr or CRP less than 15 mg/L. Since septic arthritis was not observed in any of the patients with effusion volume < 0.5 cc and normal inflammatory factors (ESR or CRP), conservative management and close follow-up can be recommended in these patients instead of joint fluid aspiration.

中文翻译：

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超声和炎症因子在小儿髋关节积液治疗中的作用

化脓性关节炎是髋关节疼痛的重要鉴别诊断。关节穿刺分析是化脓性关节炎的必要诊断措施。为了减少关节抽吸的需要，我们结合超声检查结果和实验室检查结果进行比较，以区分化脓性关节炎和反应性关节炎。 <岁儿童这项纵向研究纳入了 2020 年至 2022 年因髋部疼痛或跛行被转诊至 Akbar 儿科医院的 14 名患者。参与者接受了臀部超声检查，并从他们身上获取了血液样本。确认积液后，根据患者状况和临床诊断，建议采用以下方法之一；密切随访，或超声引导下抽吸髋关节积液，和/或关节切开术。记录了各种超声波和实验室检查。分析数据，P ＜0。 0.001 被认为具有统计显着性。总体而言，研究了 115 名平均年龄为 3.43±5.76 岁的患者，其中 46 名是女孩。最终诊断23例（20.0%）为化脓性关节炎，92例（80.0%）为反应性关节炎。化脓性关节炎患者的 C 反应蛋白 (CRP) 和红细胞沉降率 (ESR)（与抽吸体积不同）、超声测量的积液体积、胶囊厚度、总厚度以及记录的胶囊与积液比显着较高（P < ； 0.001)。前隐窝中测量的液体体积与抽吸液体体积之间存在显着的一致性(2.5倍，P＜0.001)。前隐窝积液量小于 0.5 cc、ESR 小于 40 mm/hr 或 CRP 小于 15 mg/L 的患者均未观察到化脓性关节炎。由于在任何积液量＜＜1的患者中均未观察到化脓性关节炎。对于这些患者，建议使用 0.5 cc 和正常炎症因子（ESR 或 CRP）、保守治疗和密切随访，而不是进行关节液抽吸。