Abstract
Background
Acute or recurrent hip pain in adults can be a challenging presentation in the emergency
department. While ultrasound is routinely used in the evaluation of pediatric patients
with hip pain and a new limp, it is not commonly used for this purpose in adult emergency
medicine. This case series demonstrates the clinical utility of point-of-care ultrasound
(POCUS) in adult patients with acute or recurrent hip pain because performance of
POCUS was the critical action that led to the identification of pathologic hip effusions
in this series of adults.
Case Series
This case series includes 5 patients in whom clinical suspicion existed for the presence
of a hip effusion and possible septic arthritis, despite nondiagnostic radiographic
findings. Ultrasound was used to detect the effusion and guide subsequent arthrocentesis,
imaging, or surgical intervention. In all patients, computed tomography scans or magnetic
resonance imaging scans were later used to confirm the presence of effusion. In all
5 patients (2 women and 3 men, with a mean age of 47.4 years), POCUS accurately detected
the presence of hip effusion. Two of 5 synovial collections were caused by septic
arthritis as confirmed by synovial fluid microbiologic examination.
Why Should an Emergency Physician Be Aware of This?
This case series emphasizes the clinical utility of POCUS in adult patients with acute
and recurrent hip pain to detect a hip effusion, particularly in patients with significant
risk factors for septic arthritis. POCUS can also be used to guide further imaging,
arthrocentesis, surgical consultation, and intervention.
Keywords
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Article info
Publication history
Published online: January 22, 2020
Accepted:
November 23,
2019
Received in revised form:
October 11,
2019
Received:
April 16,
2019
Footnotes
Reprints are not available from the authors.
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
