Cold of hip

The acute synovite transient , more commonly called cold of hip , is characterized by a feverish Boiterie often unilateral at the old Enfant from three to ten years.

Physiopathology

It is about a reactional Arthrite generally of viral origin .

Private clinic

The boys are more prone than the girls, the generally touched age bracket ranging between three and five years.

Brutal beginning, the refusal of walk with pain to the irradiant support until the Knee with painful limitation of the internal rotation, Abduction and hyperextension, associated with a fébricule. Concepts of a viral Infection, rhinopharyngée in the recent Anamnèse. Strong similar pain has that of a muscular cramp.

Examinations

Biology

The Syndrome S biological inflammatory generally absent or are marked little.

Imageries

The radiography of the basin of face evokes:

a normal épiphyse proximale of the Femur;
an intra-articular épanchement with:

widening of the articular line space,
repression of the periarticular lubricating lines;

a thickening of the soft parts.

In the event of difficult diagnosis, a echography of the Hip and a articular Ponction show a blade of épanchement without purulent arthritis .
A Scintigraphie with the biphosponates marked with the Technétium 99m can be indicated in the event of absence of improvement after one week of treatment, where it will make it possible to observe a hyperfixation.

Differential diagnoses

Ostéoarthrite of hip
Disease of Legg-Calve-Perthes whose first demonstrations resembles the cold of hip. This similarity insite with recontroler any cold of hip by a new radiology in the six to eight weeks which follow the beginning of the symptoms.
Épiphysiolyse of hip

Treatments and evolution

The rest with the bed during one week is impossible to circumvent with, possibly, a discharge in traction of the Lower extremity. Aspirine can be prescribed. A progressive recovery of walk can be then envisagée.
The possibility of a Ostéochondrite primitive of hip beginner should not be excluded.

The clinical and radiological cure must be controlled in a systematic way in sixth week.

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