Septic arthritis of the pediatric hip: update on diagnosis and treatment
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 reviews have highlighted the possibility of Lyme disease as a potential cause of monoarticular pediatric hip pain. The role of PCR technology in the diagnosis and management of SAH remains unclear at this time. Summary The child with a limp remains a common and urgent clinical concern. There may be expanded roles for MRI and PCR to better diagnose and treat the involved joint itself, as well as any associated nonarticular area of infection. Lyme disease should remain on the list of possible differential diagnoses in this population, particularly in geographic areas where the disease vector is known to be endemic.
Conclusion Youth that suffer a sport-related knee injury demonstrate on average more negative health-related outcomes consistent with future osteoarthritis compared with uninjured matched controls 3–10 yr after injury. These negative outcomes differ by sex and time since injury.
ConclusionThe yield of routine upper GI series in children with nonspecific symptoms, such as abdominal pain and vomiting, and no surgical history is low. Diagnostic yield was improved in older children and in those complaining of dysphagia and/or foreign body sensation. Routine upper GI series should be avoided in clinically well children with symptoms only of uncomplicated GER and no significant GI history. In children with a history of dysphagia and/or foreign body sensation, an esophagram/barium swallow can suffice.
BLOATED stomach pain is often brought on by consuming foods and drinks which are hard to digest, and one popular beverage which can cause this is coffee. If you enjoy a hot drink but regularly feel bloated, replace coffee with this alternative.
No abstract available
Osteoid osteoma is a relatively common benign bone tumor that mainly occurs in the long bones and is characterized by nocturnal pain that is improved by nonsteroidal anti-inflammatory drugs (NSAIDs). However, intra-articular osteoid osteomas are rare, with an incidence of approximately 13% of osteoid osteomas.2 Intra-articular osteoid osteomas sometimes present with symptoms similar to monoarticular inflammatory arthritis, such as joint tenderness, soft-tissue swelling, synovitis, and joint effusion, which may lead to misdiagnoses or treatment delays.
What is the relationship between gout and chronic kidney disease, and what role could urate-lowering therapy play in the development of CKD in these patients?Arthritis Research &Therapy
CONCLUSIONS The present study demonstrates that cimifugin reduces the migration and chemotaxis of RAW264.7 cells and inhibits the release of inflammatory factors and activation of related signaling pathways induced by LPS. Cimifugin may have potential pharmacological effects against RA. PMID: 30638197 [PubMed - in process]
"The discreet charm" of cardiovascular disease in Rheumatoid Arthritis. Hellenic J Cardiol. 2019 Jan 08;: Authors: Mavrogeni SI PMID: 30639353 [PubMed - as supplied by publisher]
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 wit...
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.