Sonography for hip joint effusion in adults with hip pain
OBJECTIVE: To study the prevalence of ultrasonic hip joint effusion and its relation with clinical, radiological and laboratory (ESR) findings in adults with hip pain. METHODS: Patients (n = 224) aged 50 years or older with hip pain, referred by the general practitioner for radiological investigation, underwent a standardised examination. The distance between the ventral capsule and the femoral neck, an increase in which represents joint effusion, was measured sonographically. Joint effusion was defined in three different ways: "effusion" according to Koski's definition, "major effusion", and "asymmetrical effusion" based on only individual side differences. RESULTS: "Effusion" was present in 80 (38%), "major effusion" in 20 (9%), and "asymmetrical effusion" in 47 (22%) patients. Pain in the groin or medial thigh, pain aggravated by lying on the side, decreased extension/internal rotation/abduction/flexion, painful external rotation, and pain on palpation in the groin showed a significant relation (adjusted for age and radiological osteoarthritis of the hip) with ultrasonic hip joint effusion. "Major effusion" showed a significant relation with an increased ESR. When patients with bilateral pain and increased ESR were excluded, a side difference in the range of motion of extension of the hip was shown to be a good predictor for "asymmetrical effusion" (positive predictive value: 71%, negative predictive value: 80%). CONCLUSION: This study showed a relatively high prevalence of ultrasonic joint effusion in adults with hip pain in general practice. Furthermore the results indicate a relation between joint effusion and clinical signs.
|Keywords||Aged, Exudates and Transudates/*ultrasonography, Female, Hip Joint/pathology/physiopathology/*ultrasonography, Humans, Joint Diseases/pathology/physiopathology/*ultrasonography, Male, Middle Aged, Osteoarthritis, Hip/ultrasonography, Pain/ultrasonography, Palpation, Range of Motion, Articular|
Bierma-Zeinstra, S.M., Bohnen, A.M., Verhaar, J.A.N., Prins, A., Lameris, J.S., & Ginai, A.Z.. (2000). Sonography for hip joint effusion in adults with hip pain. Annals of the Rheumatic Diseases: an international peer-reviewed journal for health professionals and researchers in the rheumatic diseases. Retrieved from http://hdl.handle.net/1765/9282