Wang Huaikeng,Huang Shaomin,Wu Haiyi,et al.Risk factors for recurrence of transient synovitis of the hip in children[J].Journal of Clinical Pediatric Surgery,,22():861-865.[doi:10.3760/cma.j.cn101785-202112006-012]
Risk factors for recurrence of transient synovitis of the hip in children
- Keywords:
- Hip Joint; Synovitis; Root Cause Analysis; Surgical Procedures; Operative; Child
- Abstract:
- Objective To explore the risk factors for recurrence of transient synovitis (TS) of the hip in children.Methods From January 2017 to January 2020,clinical data were retrospectively reviewed for 158 hospitalized children with transient synovitis of the hip.They were assigned into two groups of recurrent and non-recurrent according to whether TS recurred or not.The inter-group differences in age,gender,inilateral/bilateral,onset time,thickness of anterior cervical space,effusion,oral ibuprofen or not,abnormal rate of inflammatory parameters (white blood cell,C-reactive protein & erythrocyte sedimentation rate) were compared.Multivariate Logistic regression analysis was utilized for determining the risk factors of TS recurrence.Results The rate of bilateral simultaneous onset was much higher in recurrent group than that in non-recurrent group[(9/16,56.25%) vs.(36/142,25.35%)].And the difference was statistically significant (P=0.021).No significant inter-group differences existed in age (5.63±2.12 vs.5.50±2.33 years),gender (male/female,11/5 vs.101/41),onset time (3.32±2.41 vs.4.62±5.03 day),thickness of anterior cervical space (1.00±0.12 vs.0.99±0.26 cm),effusion (0.48±0.11 vs.0.46±0.18 cm),oral ibuprofen or not (6/16,37.50% vs.55/142,38.73%),abnormal rate of inflammatory parameters (leukocytosis 2/16,12.50% vs.20/142,14.08%,elevated C-reactive protein 1/16,6.25% vs.11/142,7.75%,elevated sedimentation rate (6/16,37.50% vs.43/142,30.28%)(P>0.05).Logistic regression analysis revealed that bilateral simultaneous onset (OR=3.72,P=0.017) was an independent risk factor of TS recurrence.Age,gender,onset time,thickness of anterior cervical space,effusion and erythrocyte sedimentation rate were not correlated with recurrence of TS (P>0.05).Conclusion Children with a simultaneous onset of TS are more likely to relapse.
References:
[1] Landin LA,Danielsson LG,Wattsg?rd C.Transient synovitis of the hip.Its incidence,epidemiology and relation to Perthes’ disease[J].J Bone Joint Surg Br,1987,69(2):238-242.DOI:10.1302/0301-620X.69B2.3818754.
[2] Ryan DD.Differentiating transient synovitis of the hip from more urgent conditions[J].Pediatr Ann,2016,45(6):e209-e213.DOI:10.3928/00904481-20160427-01.
[3] Cook PC.Transient synovitis,septic hip,and Legg-Calvé-Perthes disease:an approach to the correct diagnosis[J].Pediatr Clin North Am,2014,61(6):1109-1118.DOI:10.1016/j.pcl.2014.08.002.
[4] Uziel Y,Butbul-Aviel Y,Barash J,et al.Recurrent transient synovitis of the hip in childhood.Longterm outcome among 39 patients[J].J Rheumatol,2006,33(4):810-811.
[5] Schmidt WA,Schmidt H,Schicke B,et al.Standard reference values for musculoskeletal ultrasonography[J].Ann Rheum Dis,2003,63(8):988-994.DOI:10.1136/ard.2003.015081.
[6] Tien YC,Yang CY,Chih HW.The normal width of anterior hip synovial recess in children[J].J Pediatr Orthop,2000,20(2):264-266.DOI:10.1097/01241398-200003000-00026.
[7] Harrison WD,Vooght AK,Singhal R,et al.The epidemiology of transient synovitis in Liverpool,UK[J].J Child Orthop,2014,8(1):23-28.DOI:10.1007/s11832-014-0556-5.
[8] Dubois-Ferrière V,Belaieff W,Lascombes P,et al.Transient synovitis of the hip:which investigations are truly useful?[J].Swiss Med Wkly,2015,145:w14176.DOI:10.4414/smw.2015.14176.
[9] Kastrissianakis K,Beattie TF.Transient synovitis of the hip:more evidence for a viral aetiology[J].Eur J Emerg Med,2010,17(5):270-273.DOI:10.1097/MEJ.0b013e32832b1664.
[10] 郭氧,林山,李楠竹.关节镜在儿童髋关节一过性滑膜炎治疗中的应用[J].中国骨科临床与基础研究杂志,2012,4(6):423-426.DOI:10.3969/j.issn.1674-666X.2012.06.004. Guo Y,Lin S,Li NZ.Application of arthroscopy for hip transient synovitis in children[J].ChinJ Clin Basic Orthop Res,2012,4(6):423-426.DOI:10.3969/j.issn.1674-666X.2012.06.004.
[11] Whitelaw CC,Varacallo M.Transient synovitis[M/OL]//Anon.StatPearls[Internet].Treasure Island:StatPearls Publishing,2023:NBK459181.https://pubmed.ncbi.nlm.nih.gov/29083677/.
[12] Oliver E,Sinha P,Khwaja M,et al.How not to miss infective causes of hip pain in children[J].Br J Hosp Med (Lond),2021,82(5):1-8.DOI:10.12968/hmed.2020.0206.
[13] Do TT.Transient synovitis as a cause of painful limps in children[J].Curr Opin Pediatr,2000,12(1):48-51.DOI:10.1097/00008480-200002000-00010.
[14] Liberman B,Herman A,Schindler A,et al.The value of hip aspiration in pediatric transient synovitis[J].J Pediatr Orthop,2013,33(2):124-127.DOI:10.1097/BPO.0b013e31827268b8.
[15] Skinner J,Glancy S,Beattie TF,et al.Transient synovitis:is there a need to aspirate hip joint effusions?[J].Eur J Emerg Med,2002,9(1):15-18.DOI:10.1097/00063110-200203000-00005.
[16] Givon U,Liberman B,Schindler A,et al.Treatment of septic arthritis of the hip joint by repeated ultrasound-guided aspirations[J].J Pediatr Orthop,2004,24(3):266-270.DOI:10.1097/00004694-200405000-00006.
Memo
收稿日期:2021-12-6。
基金项目:厦门市医疗卫生指导性项目(35022202142D1246);厦门市儿童医院青年科研项目(CHP-2019-YRF-0024)
通讯作者:裴新红,Email:peizane163@.com