A 7-year-old boy with abrupt onset of pain in hip with hip held in abduction. Hemogram is normal. ESR is raised. What is the next line of management?
Urgent USG guided aspiration of hip is needed to examine the fluid and rule out septic ahritis . However lack of systamic symptoms like fever and and normal hemogram indicate towards Transient synovitis of hip. TRANSIENT (TOXIC) SYNOVITIS OF HIP It is self-limiting, inflammatory condition of synovium. It is common cause of hip pain and limping in children from 6 to 12 years of age. Absence of fever and systemic illness USG reveals mild effusion and widening of joint space. Joint aspiration usually reveal a WBC count between 5,000 and 15,000 cells/mL, with more than 25% polymorphonuclear leukocytes. Aspiration should be done to rule out other causes of synovitis. The primary aim of treatment is to expedite spontaneous resolution with brief period of bed rest and non-weight bearing, light traction and use of oral NSAIDs.
Hospitalize and observe
Ambulatory observation
Intravenous antibiotics
USG guided aspiration of hip
Joint and Soft tissue infections