Rare Diseases Symptoms Automatic Extraction
Home
A random Abstract
Our Project
Our Team
Epidemiology, diagnosis, and treatment of pericapsular pyomyositis of the hip in children.
[pyomyositis]
The
yield
of
synovial
fluid
cultures
in
patients
meeting
clinical
criteria
for
septic
hip
arthritis
remains
low
.
In
the
presence
of
positive
blood
cultures
,
these
patients
are
diagnosed
and
treated
as
"
presumed
septic
arthritis
.
"
We
hypothesized
that
some
of
these
patients
may
instead
have
an
extra
-articular
infection
,
such
as
pericapsular
pyomyositis
.
An
IRB-approved
prospective
study
of
children
with
suspected
septic
hip
arthritis
at
a
tertiary
care
children
's
hospital
over
a
2
-
year
time
period
was
conducted
.
Children
were
evaluated
with
a
previously
published
clinical
algorithm
with
the
addition
of
magnetic
resonance
imaging
(
MRI
)
.
Of
the
53
patients
presenting
with
an
acutely
irritable
hip
,
32
%
were
found
to
have
pericapsular
pyomyositis
,
whereas
15
%
were
diagnosed
with
septic
arthritis
.
Although
C-
reactive
protein
(
CRP
,
≥
33
.
1
mg
/
L
)
performed
well
at
predicting
infection
,
there
were
no
significant
differences
in
CRP
,
erythrocyte
sedimentation
rate
,
white
blood
cell
count
,
temperature
,
or
weight-bearing
status
in
children
with
septic
arthritis
compared
with
pericapsular
pyomyositis
.
In
addition
to
MRI
,
there
was
a
difference
in
the
size
of
hip
effusion
on
ultrasound
,
which
was
significantly
smaller
in
cases
of
pericapsular
pyomyositis
.
CRP
(
≥
74
.
3
mg
/
L
)
was
found
to
be
predictive
of
need
for
surgical
intervention
in
children
with
pericapsular
pyomyositis
.
Correct
anatomic
diagnosis
of
the
site
of
infection
is
essential
for
the
efficient
care
of
the
child
.
Herein
,
we
found
that
pericapsular
pyomyositis
is
twice
as
common
as
septic
arthritis
in
children
presenting
with
an
acutely
irritable
hip
.
Clinical
algorithms
are
incapable
of
differentiating
these
pathologies
suggesting
that
both
be
considered
under
the
current
diagnosis
previously
referred
to
as
"
presumed
septic
arthritis
.
"
Incorrect
diagnosis
of
a
septic
arthritis
in
the
presence
of
a
pericapsular
pyomyositis
could
potentially
lead
to
unnecessary
debridement
of
the
joint
in
the
presence
of
extra
-articular
infection
,
thus
contaminating
the
joint
.
Conversely
,
debriding
the
joint
instead
of
the
epicenter
of
the
infection
can
prolong
the
infectious
process
.
For
these
reasons
,
we
conclude
that
MRI
has
the
potential
to
improve
the
clinical
care
of
children
by
providing
a
more
precise
diagnosis
.
Level
II
-
"
Diagnostic
"
[
Development
of
diagnostic
criteria
on
the
basis
of
consecutive
patients
(
with
universally
applied
reference
"
gold
"
standard
)
]
.
Diseases
Validation
Diseases presenting
"septic arthritis"
symptom
acute rheumatic fever
familial hypocalciuric hypercalcemia
pyomyositis
This symptom has already been validated
