Pediatric Lyme Arthritis of the Hip: The Great Imitator?
Background: Lyme arthritis (LA) of the hip can present similarly to septic arthritis (SA) and transient synovitis (TS). The primary purpose of this study was to determine clinical and laboratory parameters differentiating LA of the hip from SA or TS among children who had undergone hip aspiration during the evaluation of hip pain. Methods: This was a retrospective review of all patients who underwent hip aspiration for the evaluation of hip pain at a tertiary care children’s hospital in a Lyme endemic area. Clinical and laboratory data were reviewed and comparative analyses were performed between those diagnosed with LA, SA, and TS. Independent samples t test, ANOVA, and χ2 test were used to compare clinical and laboratory variables as appropriate. Multivariable logistic regression was used to elucidate independent predictors of LA. Statistical significance was set at P
Condition: Back Pain Interventions: Other: Global Postural Reeducation Program; Other: Hamstring Stretch Program Sponsor: Riphah International University Completed
Condition: Postoperative Pain Interventions: Procedure: lower abdominal surgery; Other: Erector spinae plane block; Other: Transversus abdominis plane block Sponsor: National Cancer Institute, Egypt Recruiting
Conditions: Pain Syndrome; Propofol Infusion Syndrome; Injection Site Irritation Interventions: Device: Warming patch; Device: Cotton patch Sponsor: First People's Hospital of Chenzhou Completed
Condition: Pain Measurement in Geriatric Patients Intervention: Other: No intervention Sponsor: Prince of Songkla University Not yet recruiting
Conditions: Rheumatoid Arthritis; Quality of Life Interventions: Other: COVID-19 survey; Other: RAPID-3; Other: WHOQOL-BREF; Other: DASS-21 instrument (depression and anxiety); Other: IER-R (posttraumatic stress) Sponsor: National Institute of Medical Sciences and Nutrition, Salvador Zubiran Recruiting
Condition: Neck Pain Interventions: Device: Graston technique; Other: post isometric relaxation; Other: exercises Sponsor: Riphah International University Recruiting
Conditions: Major Depressive Disorder; Chronic Pain Interventions: Device: Active rTMS/Active iTBS DFPLC/Sham Pain M1; Device: Sham rTMS/ Active iTBS Pain; Device: Active rTMS/Active iTBS Sponsor: University of California, Los Angeles Not yet recruiting
Conditions: Pain, Postoperative; Pain; Anxiety Interventions: Other: VR - Distraction; Other: VR - Biofeedback Sponsor: Children's Hospital Medical Center, Cincinnati Enrolling by invitation
Purpose of review To review the clinical diagnosis, management and natural history of septic arthritis of the hip (SAH) in the pediatric patient, and to highlight new information that may improve the management of these patients. Recent findings The basics of management of possible pediatric SAH have remained largely unchanged for generations. New questions have been raised regarding the role and timing of advanced imaging (MRI) in the evaluation of patients with possible SAH. Published criteria have been derived to guide the need for MRI studies in these patients. Validation of these guidelines continues. Recent revi...
Conclusions: Although septic arthritis of the knee and Lyme monoarthritis share common features that can make them difficult to distinguish clinically, the presence of pain with short arc motion, C-reactive protein of>4.0 mg/L, patient-reported history of fever, and age younger than 2 years were independent predictive factors of septic arthritis in pediatric patients. The more factors that are present, the higher the risk of having septic arthritis. Level of Evidence: Diagnostic Level III. See Instructions for Authors for a complete description of levels of evidence.